Paper short abstract:

With a focus on a community fitness association, this paper attends to the formation of health-conscious subjectivities in a changing health landscape. Locating new informal networks of care within histories of mutual aid, it approaches (healthy) future-making as a relational and embodied process.

Paper long abstract:

The African continent is undergoing what global health observers describe as an "epidemiological transition", as "non-communicable diseases" that were once predominantly found in industrialized nations increasingly also afflict communities across the global South. In Mozambique, the rise in overweight-related health issues has coincided with the emergence of a thriving fitness industry. Aside from the initiatives of fitness entrepreneurs who are seizing new livelihood opportunities, the changing health landscape has also inspired the formation of grassroots collectives aimed at getting people to exercise in the name of health. Bringing together mainly older women suffering from overweight-related health issues who meet on a regular basis in outdoor public spaces, these collectives also provide support in times of bereavement and illness, not to mention diversion and high sociality. Based on ethnographic research on the community fitness association So Porque Somos (Just Because We Are) which operates in a popular neighborhood of the city of Inhambane, this paper attends to the formation of health-conscious subjectivities in a changing health landscape. Locating these informal networks of care within longer histories of mutual aid, it approaches (healthy) future-making as a relational and embodied process.

Paper short abstract:

As FemTech enterprises increasingly ‘disrupt’ sexual and reproductive healthcare provision in Kenya, this paper asks how digital infrastructures, data flows, and commodified ‘reproductive futures’ are imagined and dispersed across Nairobi's tech-ecosystem and informal settlements' networks of care.

Paper long abstract:

The recent emergence of Female Technology (FemTech), a growing digital health market specifically aimed at women’s sexual and reproductive health (SRH), poses novel questions about control and power over women’s bodies – and their respective data. While smartphone apps, wearables, and digital diagnostic devices expeditiously collect, analyse and store personal data, concerns about modes of surveillance, the ownership, and the value of health data become more relevant than ever. FemTech solutions seem particularly attractive for low-resource contexts in which access to healthcare facilities and women’s SRH services remain limited whilst techno-optimism is thriving. Intensified by the COVID-19 pandemic and its exacerbation of SRH inequalities in Sub-Saharan Africa, the pandemic contributed to pervasive shifts to digitalise and privatise healthcare delivery across Kenya - where private enterprises are increasingly filling the void of healthcare provision through increasingly digitised networks of care. This article is based on 8-months of ethnographic fieldwork among HealthTech startups in Kenya’s tech-ecosystem ‘Silicon Savannah’ and healthcare practitioners/patients in private health clinics across Nairobi’s informal settlements in 2020 and 2021. It traces commodification practices targeting healthcare disparities and socio-economic inequalities in a new data-specific context. By drawing attention to capitalist relations of power and their intersection across race, class, and gender, it investigates how data becomes an essential commodity of expansion through processes of extraction. It contributes insights into the creation of novel markets around women’s Bodies of Data and the digital networks of care they circulate in.

Paper short abstract:

Young women from the north of Ghana jointly organise certain aspects of their livelihood provision, such as work, finances, and housing in order to secure one another when seasonally migrating to Accra. These informal social security networks are in close relation to their shared place of origin.

Paper long abstract:

In the past decades the feminization of mobility and migration in West Africa have been on the rise with a high share of rural-urban migration routes. Possible explanations are the lack of economic opportunities in the region of origin and a notion of accessing social spheres outside intra-household roles. Often so women find themselves in particularly vulnerable circumstances when migrating, which makes social security strategies exceptionally important. Therefore, I investigate such coping mechanisms using the example of young women, who migrate seasonally for a couple of months from the rural north of Ghana to Accra to work as so-called kayayei (head-porters) to raise money.

Young women from the same place of origin jointly organize work, shelter, and finances in small groups. However, the kayayei normally interrupt their stay for the duration of the harvesting season in the north, only to return to Accra again afterward. As part of the informal working sector, kayayei are largely excluded from formal social security schemes, because they are tied to their informal occupation. Hence, kayayei mostly rely on informal social security networks and relations. Determining not only the social status and positionality informal social security networks are also part of strategic actions toward economic investments, consumptions, and obligations. However, the vast majority of literature falls short in acknowledging the embeddedness in translocal networks and the importance of such in terms of ensuring informal security.

Paper short abstract:

How do women's networks negotiate and reinvent practices of care and mutual support? How can everyday economics be approached as a tool for imagining and creating gifts and futures by challenging and destabilizing standards, parameters, metrics and norms of "Economics" in a strict sense?

Paper long abstract:

Based on ethnographic research among young people and their families on Santiago Island, this proposal presents analytical reflections on support and care networks among Cape Verdean women of different generations, both in rural and urban contexts. Mutual aid practices, historically consolidated in Cape Verdean society under the name of "djunta mon" (joining hands), are mobilized by women in their daily lives and in the achievement of their life and family projects. These practices, when performed by women, establish a strong relationship with an ethic of care and a sense of collectivity. In the sharing of tasks and care, these women create, share and mantain experiences, knowledge, techniques, memories, and worldviews. As a result of flexible family arrangements that include consanguineous and related people, caregiving also has a communitarian character. Care is understood here as a complex weave of creating and sustaining life and living that can take differentiated and mobile forms, connecting different spheres and entities, both human and non-human, as well as institutions, groups, and individuals. Most of the processes that move families and communities pass through the hands of women who come together in the creation and maintenance of a daily economy. In this regard, such an everyday economy will be approached as a tool for imagination and creation of presents and futures by challenging and destabilizing standards, parameters, metrics and norms of "Economics" in a strict sense, as well as negotiates and reinvents practices and networks of care and mutual support.

Paper short abstract:

Drawing on my lived realities as an unmarried Shona woman and intervening in the nascent field of singles studies, I explore circumstances around women’s singlehood and the associated burden of care. This offers critical insights into the broader gendered, cultural and economic dynamics of care work

Paper long abstract:

Existing scholarship on women and care work in Africa has often focused on married women in heterosexual couplings. In this paper, I make an intervention in the field of critical singles studies. Although recognizing the multifaceted informal care work done by married women in heteropatriarchal African contexts, I complicate and nuance this idea by drawing attention to and analyzing my lived realities as an unmarried Shona woman. I foreground my voice and lived experiences as a Shona woman who is not married and think through the specific kinds of informal care work demanded, explicitly and implicitly, of single unmarried women. Of particular interest, I want to think through how my identity and lived realities, as an exemplar of a single unmarried woman, show that multifaceted care work (affective, financial) is often demanded of unmarried women because they do not have families of their own. I examine how being a single, unmarried, and ‘childless’ woman implies that a woman such as myself is by default at the entire disposal of the extended family, which continues to play a pivotal role in Shona communities in Zimbabwe. Exploring circumstances around women’s singlehood and the associated burden of ‘care’, in the broad sense, offers critical insights into the changes in their professional, relational, romantic, and sexual lives, and thus also in the broader gendered, cultural, social and economic dynamics in which these shifts are embedded.

Paper short abstract:

This paper explores how struggles and future uncertainties surrounding access to health care foster the creation and maintaining of different relationships and networks of care and support through digital and mobile technologies within the realm of Kenya´s national health insurance and outside it.

Paper long abstract:

Over the last decade, the Kenya government has continued to expand the country’s national health insurance (National Hospital Insurance Fund, NHIF) to include those in the informal sector, the elderly people, and vulnerable populations. Recently, the government has even resulted to coercive measures in persuading its citizens to become members or pay premiums to the NHIF. The Kenyan state portrays the national health insurance as a national collective and frames it within the language of inclusion, common good, equity, financial protection and state responsibility to care. Meanwhile, the national health insurance does not offer reliable access to healthcare. In many cases, patients and health workers navigate both mundane and persistent complexities, disappointments, frustrations and failure of the national health insurance through different kinds of solidarities, even beyond ethnic, kinship-based, and patronage networks. The increasing digitization of Kenya’s economy through mobile money technology over the last decade has transformed these forms of solidarities/networks of care in different ways. Based on ethnographic fieldwork in Kenya, this paper explores how struggles and future uncertainties surrounding access to health care have fostered the creation and maintaining of different relationships and networks of care and support through digital and mobile technologies within the realm of the health insurance and outside it. Membership to these solidarities is not a straightforward one, which complicates their future and that of the insurance, but also triggers questions about the kinds of care produced and maintained in the process.

Paper short abstract:

Drawing on ethnographic fieldwork carried out in southwestern Ghana, the paper explores the articulations of informal networks of mental health care (developed both within and beyond institutional services) and neoliberal processes of privatisation, health commodification, and growing inequalities.

Paper long abstract:

Drawing on ethnographic research carried out between 2013 and 2022 in Nzemaland (rural southwestern Ghana), this paper focuses on the ways in which informal networks of mental health care articulate with neoliberal processes of privatisation and growing inequalities. These processes have been a feature of the Ghanaian public health system in recent decades, with the introduction in 1985 of user charges that resulted in substantially reduced access to health services for the poorer sections of the population. The launching of a voluntary prepayment financing mechanism (National Health Insurance Scheme) in the early 2000s was aimed at overcoming this failure and achieving universal health coverage. Prices of enrolment and the ineffectiveness of exemption criteria and processes, however, continue to be major factors in preventing poor people from accessing public health. Interestingly, mental health care should be an exception in this context, being technically ‘free to everyone’ – to the point where it is not even covered by the NHIS. The therapeutic itineraries of patients (and caregivers) I met in Nzemaland, however, were profoundly informed by a de facto (micro and macro) commodification of mental health that often made institutional care unavailable and/or unaffordable. In this scenario marked by scarcity, informal networks of care emerge as crucial: not only largely visible and often discussed religious resources like prayer camps, but also more concealed practices such as informal drug supply and pharmaceutical gifts and debts performed by nurses in the interstices of (an often 'impossible') formal healthcare service provision.

Paper short abstract:

The presentation will describe insurance associations in the Ethiopian diaspora of the US. It will focus on the ‘solidarity from below’ (Featherstone) that is the bases of their organization and the contribution that these networks make to the future of the Ethiopian diaspora in the US.

Paper long abstract:

Insurance associations are important networks of care and solidarity in Ethiopia. They focus above all on the financing and organization of the burials of their members. Even in the Ethiopian diaspora, in countries with diversified formal insurances, these networks are organized and adapted to local requirements and needs.

The presentation will describe the formation and current development of insurance associations in the Ethiopian diaspora of the US. It will focus on two aspects of these care networks. First, the ‘solidarity from below’ (Featherstone) that is the bases of their organization and second the contribution that these networks make to the future of the Ethiopian diaspora in the US. Especially in the burial place vs. posthumous transnationalism of members of the diaspora, the future orientation of the diaspora becomes apparent.

Paper short abstract:

What is “social security” and when are “times of security”? This presentation looks into the cultural underpinnings of formal life insurances in Namibia, arguing that they not only redirect financial flows but also impact informal care networks, notions of solidarity, and concepts of time.

Paper long abstract:

Social security is a burning issue in Africa. Less than 20% of the population in Sub-Saharan Africa is said to be covered by at least one social benefit. While facing a constant increase in economic and ecological threats, the challenges of the future become most apparent with regard to social protection. What is “social security” meant to be and when are “times of security”? Three scenarios are to be distinguished: the introduction of social welfare schemes by nation states (such as pension funds, medical care, and financial transfers), informal credit associations (ROSCAS), and formal insurances (life and non-life) offered mostly by globally operating companies.

Based on intensive fieldwork among customers and insurance agents in Namibia, this presentation looks into the cultural underpinnings of formal social insurances. Funeral and life covers turned out to be a much favored financial alternative in particular to the growing middle class where informal care networks have become either porous or overstraining, and own resources are sought to be protected. It is argued that there is more to formal insurances than redirecting financial flows into insurances and banks as a means of creating security for the wealthy and not-so-well-offs. The promise of caring for the future (possibly after the death of the policyholder) may contest informal care networks, the notion of solidarity, and concepts of time.

Paper short abstract:

Social networks are paramount to offering assistance in (future) times of need. Within networks circulate “credits and debts, and entrustments and obligations”. African middle classes gain options to secure their livelihoods outside social networks transforming logics of solidarity and care.

Paper long abstract:

Studies on the vulnerable in Africa show that social networks are paramount to offering assistance in (future) times of need. Within networks circulate “credits and debts, and entrustments and obligations” (Shipton 2007). The family network, neighbours, church communities, and money-saving associations are resources to share good times and cushion times of hardship. This paper aims to unpack the middle classes' access and usage of social networks as well as their attitude towards them.

With increased access to government social security programmes and private commercial insurance, the African middle classes gain options to secure their livelihoods outside social networks. Social security is partly institutionalised and outsourced. But networks have not lost in value, they are of importance to the middle classes. My case study from Kenya highlights that networks “open doors”, prevent social fall, establish middle-class spaces, and follow self-making projects. Some neighbourhood gatherings look like shareholder meetings, some wealthier churches teach morals of self-help and outsource financial assistance. While some family networks have to make decisions about whom to sponsor: Those with high potential and those carrying high risks for the network. And often middle-class interlocutors appear as providers and mentors; positions that signal social standing and fellowship. In short, the middle classes are in a constant negotiation process about which networks are to be maintained and which ones have to be rejected to avoid overburdening debts and a gain in status. These logics challenge the romanticised idea of the good and caring solidarity webs.

Paper short abstract:

The article examines various moments in the operation of an illegal support network formed by business people in one of the Kibera slum's streets. It indicates that the existence of this network creates a sense of ontological security for its members and their sense of stability toward the future.

Paper long abstract:

More than 60% of the urban population in Africa lives in slums. In these places, conditions originally conceptualized as temporary, i.e., a state of peculiar uncertainty, are part of daily life. Functioning there is made possible by a variety of informal support networks that ultimately keep these places stable for decades. The purpose of this article is to explore the moments of imagining, constructing, negotiating and contesting such complex networks.

The support network created by Kibera residents running their businesses on one of the streets of the slum was used as an example. In addition to official business, some of them also run illegal ones, which forces them to establish relationships with government officials beyond the slum's borders. Together, they create a circulation of goods (steal and sell the same resource over and over again) that allows them to exist in the reality of the "here and now," while maintaining the status quo of the slum. Support, however, goes beyond the business sphere and is reflected in the system of mutual private care.

The findings are based on more than two years of participatory observation. They indicate that the different moments of existence of the network studied, create for its members a relative sense of ontological security in their sense of stability towards an imagined future. The article contributes to the broader discussion of social networks in insecure areas of Africa and other parts of the Global South by deconstructing the network and highlighting the role of time perception.

Paper short abstract:

Norms of care are legally enforced during famine in South Sudan through chiefs’ hunger courts. The hunger courts enforce norms of care through public shaming. However, this reduces communities’ ability to include memories of famine in their futures, and detracts from an anti-famine politics.

Paper long abstract:

The last half-century has brought new experiences of famine to parts of Africa. Ongoing wars and climate change threaten to further increase those who are confronted by famine. A small but rich literature has highlighted the centrality of social networks and caring among communities who survive through famine. However, there has been a neglect of attention to how these caring norms are socially, and sometimes also legally, enforced. This paper discusses the widespread use of hunger courts in famine-prone regions of South Sudan. Hunger courts are chiefs’ courts that redistribute food to the hungriest during times of acute food insecurity. Therefore, they legally enforce solidarity and certain norms of care for the most vulnerable. The hunger courts’ main sanction to enforce these norms of care is to publicly shame those who have not provided for their families. However, the caring norms enforced by these courts have proved rigid despite the changing causes and characteristics of acute hunger. In this context, this shame also reduces the social space to remember famine and mourn for those who died during times of famine. This impacts family and community histories, and burial practices, and makes futures where past famines are almost invisible in shared and communal memory. This detracts from people's and communities' abilities to develop an active anti-famine politics. The paper is based on ethnographic and qualitative research in South Sudan since 2010.

Paper short abstract:

This paper takes a relational approach and explores the way residents, clan councillors and government officials experience and partake in care practices in Kisoro District, Uganda.

Paper long abstract:

In Uganda, as in many African countries, the provision of care is divided between a multitude of different actors, ranging from the Ugandan state to NGOs or local grassroots organizations to all kinds of informal self-help groups with which people try to protect themselves against various risks. In Kisoro District, an important group of care givers are the so called clan councils. Clan councils take up important roles in providing social welfare services to rural villagers. They aid in medical care, arrange burials, borrow loans, provide security and settle the majority of small disputes in the District. Although not officially recognized by the Ugandan state, they are often popularly seen as the starting point of local government. Their semi-official status gives them an aura of legitimate authority that allows them to compete with and co-exist next to the Ugandan state in providing welfare services. While tensions have existed for some time between the Ugandan state and clan councils, discussions about the role of the state as (health)care provider have flared up again since the start of the Covid pandemic in early 2020. Questions arise to what extent the state still has a prominent role in providing social welfare. In this paper I take a relational approach and study how residents, clan councillors and government officials take part in webs of social (power) relationships. I explore the way in which meanings and practices of care influence people’s understanding of ‘the state’ and shape local governance practices in Kisoro District.

Paper short abstract:

Parental migration creates a care gap in the lives of left-behind children. This tends to impact positively or negatively on their educational outcome. However, this impact depends largely on the care network of these children and the support system they receive. Kin support is more effective.

Paper long abstract:

Social relations are transforming over the years from the collective communal living to individualist self-centered living in response to changing global trends. In spite of the gradual decline in African traditional social support systems from communities and extended families in most parts of Africa, there is limited studies on the role of support systems from social network on educational performance of children. The phenomenon is even worse among children left-behind by international migrants considering the role of education on the social development of children. This paper discusses the role of social networks in ameliorating the adverse effects of parental absence on educational performance of left-behind children in Ghana. Using quantitative and qualitative data from eight basic schools in Greater Accra and Bono Regions of Ghana, the study involves 227 participants and respondents. They comprise 213 basic school children from both migrant and non-migrant households, 8 basic school teachers and 6 caregivers of left-behind children from the ages of 10 to 16 years. The paper found that though left-behind children received both formal and informal care, it argues that informal care especially from kin networks is more effective compared to other forms of care networks. This paper therefore recommends that conscious efforts should be made to maintain the African cultural norms and structures of kin support system particularly at a time where community mutual support is diminishing and extended families are becoming less supportive with growing interest in nucleated families.

Paper short abstract:

Through the demographic change and weakening of traditional systems, the care situation for older adults in Africa is becoming a huge concern. We discuss social support structures for elderly people in Ghana. Our inferences are based on qualitative research between 2019 and 2022.

Paper long abstract:

It is the extended family that has been the backbone of older adults. However, care and protection of the elderly, contemporarily, has experienced drastic ramifications. Through colonialism, neoliberalist globalisation and related factors the family system is weakening and cannot always be relied upon. Not only the changing understanding and living of the family construct, the increasing consumption-oriented lifestyle but also climatic conditions and changes in nature influence (daily) life of older adults, their positions within the family and society as well as co-create of social challenges they face. In this contribution, we explore the lived experiences of elderly and consider care networks for them in Ghana. We draw on our qualitative research conducted between 2019 and 2022 with older adults and their caretakers in rural communities as well as government institutions and non-governmental organisations. Findings show that existing governmental support programmes targeting elderly are insufficient. Challenges include limited awareness and information among older people, as well as unfavourable structures and implementations. In some cases, this leads to the failure to reach those in need or to their exclusion. There is a great need for solutions that enable people to grow old in dignity under current and future conditions. Societal diversity and site-specific characteristics require multifaceted pathways. Extended families are exploring creative solutions; however, individual compromises must be made. In addition, new forms of care emerge beyond the family and state. These include local groups as well as broader networks. Thereby, the idea of small contributions from many is often applied.