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Putting Anthropology into Global Health

A Century of Anti–Human African Trypanosomiasis Campaigns in Angola

Jorge Varanda and Josenando Théophile

This analysis of over a century of public health campaigns against human African trypanosomiasis (sleeping sickness) in Angola aims to unravel the role of (utopian) dreams in global health. Attention to the emergence and use of concepts such as neglected tropical diseases (NTDs) and ideas about elimination or eradication highlights how these concepts and utopian dreams are instrumental for the advancement of particular agendas in an ever-shifting field of global health. The article shows how specific representations of the elimination and eradication of diseases, framed over a century ago, continue to push Western views and politics of care onto others. This analysis generates insight into how global health and its politics of power functioned in Angola during colonialism and post-independence.

Open access

Sara Van Belle

In this article, I set out to capture the dynamics of two streams within the field of global health research: realist research and medical anthropology. I critically discuss the development of methodology and practice in realist health research in low- and middle-income countries against the background of anthropological practice in global health to make claims on why realist enquiry has taken a high flight. I argue that in order to provide a contribution to today’s complex global issues, we need to adopt a pragmatic stance and move past disciplinary silos: both methodologies have the potential to be well-suited to an analysis of deep layers of context and of key social mechanisms.

Open access

Diane Duclos, Sylvain L. Faye, Tidiane Ndoye and Loveday Penn-Kekana

The notion of performance has become dominant in health programming, whether being embodied through pay-for-performance schemes or through other incentive-based interventions. In this article, we seek to unpack the idea of performance and performing in a dialogical fashion between field-based evaluation findings and methodological considerations. We draw on episodes where methodological reflections on performing ethnography in the field of global health intersect with findings from the everyday practices of working under performance-based contracts in the Senegalese supply chain for family planning. While process evaluations can be used to understand contextual factors influencing the implementation of an intervention, we as anthropologists in and of contemporary global health have an imperative to explore and challenge categories of knowledge and practice. Making room for new spaces of possibilities to emerge means locating anthropology within qualitative global health research.

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Mohammad Shahbazi

This article presents an account of a Qashqa'i health worker's upbringing, education and training, noting in particular his transition from life in a traditional nomadic family through completion of a formal education. The health worker, Jamal, describes certain problems of modernity and the personal conflict he faces as someone who loves his culture but also wants to see improvements in the health status of his people. Written by a Qashqa'i author, who brings his own sensitivity and cultural knowledge to the text, the article makes some recommendations about the training and integration of rural health workers in Iran.

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Kearsley A. Stewart

Interest in short-term international placements in global health training for U.S.-based medical students is growing; the trend is mirrored for global health undergraduate students. Best practices in field-based global health training can increase success for medical students, but we lack a critical framework for the undergraduate global health field experience. In what ways does an undergraduate field experience in global health resemble a medical student's first international health elective? Is it more similar to a study-abroad programme or a service-learning experience with a focus on personal development, civic responsibility and community engagement? This article suggests that an undergraduate global health field experience contains features of both the international medical elective and a traditional service-learning programme. I analyse a case study of a short-term U.S.-based undergraduate global health project and explore the intersections of research, professional training and service learning.

Open access

Introduction

Anthropological Knowledge and Practice in Global Health

Rodney Reynolds and Isabelle L. Lange

Since the turn of the millennium, conceptual and practice-oriented shifts in global health have increasingly given emphasis to health indicator production over research and interventions that emerge out of local social practices, environments and concerns. In this special issue of Anthropology in Action, we ask whether such globalised contexts allow for, recognise and sufficiently value the research contributions of our discipline. We question how global health research, ostensibly inter- or multi-disciplinary, generates knowledge. We query ‘not-knowing’ practices that inform and shape global health evidence as influenced by funders’ and collaborators’ expectations. The articles published here provide analyses of historical and ethnographic field experiences that show how sidelining anthropological contributions results in poorer research outcomes for the public. Citing experiences in Latin America, Angola, Senegal, Nigeria and the domain of global health evaluation, the authors consider anthropology’s roles in global health.

Open access

‘I’m Not that Kind of Doctor’

On Being In-Between in a Global Health Intervention

Erica Nelson

Within multi-disciplinary global health interventions, anthropologists find themselves navigating complex relationships of power. In this article, I offer a critical reflection on this negotiated terrain, drawing on my experience as an embedded ethnographer in a four-year adolescent sexual and reproductive health research intervention in Latin America. I critique the notion that the transformative potential of ethnographic work in global health remains unfulfilled. I then go on to argue that an anthropological practice grounded in iterative, inter-subjective and self-reflexive work has the potential to create ‘disturbances’ in the status quo of day-to-day global health practice, which can in turn destabilise some of the problematic hubristic assumptions of health reforms.

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Health interregionalism in combating communicable diseases

EU cooperation with ASEAN and the African Union

Vincent Rollet

English abstract: This last decade, regional organizations progressively became unavoidable actors of regional health governance and have been supported by some global health actors to strengthen such a role. Among these actors, the European Union (EU) is the only regional organization that implements health initiatives in cooperation with its regional counterparts. This article focuses on such “health interregionalism” toward Southeast Asia and Africa and in the field of communicable diseases, with the main objective of assessing its nature and identifying its main functions. It concludes that although appreciated and needed, the EU’s health interregionalism should better reflect the EU’s experience in regional health governance in order to represent a unique instrument of development aid and an added value for regional organizations.

Spanish abstract: En el último decenio, las organizaciones regionales se han convertido progresivamente en actores inevitables de la gobernanza regional de la salud, recibiendo el apoyo de actores mundiales para fortalecer esa función. Entre éstos, la Unión Europea (UE) es la única organización regional que implementa iniciativas de salud en cooperación con sus contrapartes regionales. Este artículo se centra en este ““interregionalismo en salud”” hacia el sudeste asiático y África y en el ámbito de las enfermedades transmisibles, con el objetivo de evaluar su naturaleza e identificar sus principales funciones. Concluye que el interregionalismo en salud de la UE debería reflejar mejor su experiencia en materia de gobernanza regional de la salud, al representar un instrumento único de ayuda al desarrollo y un valor añadido para las organizaciones regionales.

French abstract: Au cours de la dernière décennie, les organisations régionales sont progressivement devenues des acteurs incontournables de la gouvernance régionale de la santé et ont été soutenues par certains acteurs mondiaux. Parmi ces acteurs, l’Union européenne (UE) est la seule organisation régionale qui mette en oeuvre des initiatives en matière de santé en coopération avec ses homologues régionaux. L’article se concentre sur cet «interrégionalisme en matière de santé» vers l’Asie du Sud-Est et l’Afrique dans le domaine des maladies transmissibles, afin d’évaluer sa nature et d’identifier ses principales fonctions. Il conclut que, bien qu’apprécié et nécessaire, l’interrégionalisme devrait mieux refléter l’expérience de l’UE en matière de gouvernance de santé régionale afin de représenter un instrument unique d’aide au développement et une valeur ajoutée pour les organisations régionales.

Free access

Ana B. Amaya and Philippe De Lombaerde

English abstract: This introduction to the special section explores the nexus between global health governance and international health diplomacy. In these dynamic governance spaces, particular attention is paid to the multi-level and multi-actor character of global health governance and how health diplomacy functions in such a complex context. It is pointed out that the regional level plays both vertical (i.e., as an intermediary between the global and national levels) and horizontal (i.e., interregional) roles. The contributions to the special section develop the conceptual understanding of those interactions and analyze a number of concrete cases, including the African Union, ASEAN, the European Union, SADC, and UNASUR.

Spanish abstract: Esta introducción a la sección especial explora el nexo entre la gobernanza global de la salud y la diplomacia internacional de la salud. En estos espacios dinámicos de gobernanza, se presta especial atención al carácter multi-nivel y multiactor de la gobernanza sanitaria mundial y al funcionamiento de la diplomacia sanitaria en un contexto tan complejo. Se señala que el nivel regional desempeña funciones verticales (es decir, como intermediario entre los niveles mundial y nacional) y horizontales (es decir, interregionales). Las contribuciones en la sección especial desarrollan la comprensión conceptual de esas interacciones, así como analizan una serie de casos concretos, incluyendo la Unión Africana, la ASEAN, la Unión Europea, la SADC y la UNASUR.

French abstract: Cette introduction à la section spéciale explore le lien entre la gouvernance mondiale de la santé et la diplomatie internationale de la santé. Dans ces espaces dynamiques de gouvernance, une attention particulière est accordée au caractère multi-niveaux et multi-acteurs de la gouvernance mondiale de la santé et au fonctionnement de la diplomatie de la santé dans un contexte très complexe. Il est souligné que le niveau régional joue un rôle à la fois vertical (c’est-à-dire en tant qu’intermédiaire entre les niveaux mondial et national) et horizontal (c’est-à-dire interrégional). Les contributions à la section spéciale développent la compréhension conceptuelle de ces interactions et analysent un certain nombre de cas concrets, notamment l’Union africaine, l’ASEAN, l’Union européenne, la SADC et l’UNASUR.

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Naomi J. Andrews, Simon Jackson, Jessica Wardhaugh, Shannon Fogg, Jessica Lynne Pearson, Elizabeth Campbell, Laura Levine Frader, Joshua Cole, Elizabeth A. Foster and Owen White

Silyane Larcher, L’Autre Citoyen: L’idéal républicain et les Antilles après l’esclavage (Paris: Armand Colin, 2014).

Elizabeth Heath, Wine, Sugar, and the Making of Modern France: Global Economic Crisis and the Racialization of French Citizenship, 1870–1910 (Cambridge: Cambridge University Press, 2014).

Rebecca Scales, Radio and the Politics of Sound in Interwar France, 1921–1939 (Cambridge: Cambridge University Press, 2016).

Claire Zalc, Dénaturalisés: Les retraits de nationalité sous Vichy (Paris: Éditions du Seuil, 2016).

Bertram M. Gordon, War Tourism: Second World War France from Defeat and Occupation to the Creation of Heritage (Ithaca: Cornell University Press, 2018).

Shannon L. Fogg, Stealing Home: Looting, Restitution, and Reconstructing Jewish Lives in France, 1942–1947 (Oxford: Oxford University Press, 2017).

Sarah Fishman, From Vichy to the Sexual Revolution: Gender and Family Life in Postwar France (New York: Oxford University Press, 2017).

Frederick Cooper, Citizenship between Empire and Nation: Remaking France and French Africa, 1945–1960 (Princeton: Princeton University Press, 2014).

Jessica Lynne Pearson, The Colonial Politics of Global Health: France and the United Nations in Postwar Africa (Cambridge, MA: Harvard University Press, 2018).

Darcie Fontaine, Decolonizing Christianity: Religion and the End of Empire in France and Algeria (New York: Cambridge University Press, 2016).