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Accepted Paper:

Evidence-based health policies on male circumcision: access inequity among Latina women in the US  
David Colon Cabrera (Monash Health)

Paper short abstract:

An ethnographic approach to exploring access to prenatal care, specifically information about male circumcision, in non-profit clinics among Latina mothers in the US. This study analyses the effect of evidence-based health policies on service delivery to a migrant and underserved population.

Paper long abstract:

This paper will discuss how anthropology can contribute to understanding the impact of health services on male circumcision (MC) in the United States.

Epidemiological research in the last decade suggests a link between MC and a reduction in HIV transmission among heterosexual males. Consequently, the American Academy of Pediatrics and Centers for Disease Control and Prevention changed their previous policy stances on MC, and now recommend that parents be fully informed of the procedure's benefits.

I conducted my ethnography in three clinics in the suburbs of Washington, DC. I investigated how evidence-based policy making affects service delivery in non-profit clinics serving migrant and uninsured populations; specifically, how discussions about MC occur during prenatal care among Latina mothers.

I found that informed decisions about MC demonstrated inequity. Latina women did not receive information regarding MC from the clinics, and relied on familial and casual networks of information. The clinics' staff did not consistently offer information about MC because of structural factors such as limited resources, lack of time, and their perception that MC was a 'cultural' topic rather than a medical one. Thus, the power of Latinas to make informed decisions was affected by the beliefs and practices of healthcare providers.

As a Latino anthropologist in an environment dominated by Latina employees and clients, I had a privileged position to study this topic. My ethnographic approach allowed me to explore the cultural context of local service access, in a way that epidemiological research and ensuing policy often fail to consider.

Panel Med01
(Un)healthy systems: moral terrains of health equity
  Session 1