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- Convenor:
-
Colin Millard
(Queen Mary, University of London)
- Location:
- JUB-G31
- Start time:
- 9 September, 2015 at
Time zone: Europe/London
- Session slots:
- 1
Short Abstract:
This panel aims to understand the role of networks in influencing and implementing global health programmes and policy.
Long Abstract:
This panel aims to understand the role of networks in influencing and implementing global health programmes and policy. The panel will examine the role of a diverse range of actors including (but not limited to) civil society (NGOs, professional associations, and individuals), government agencies, intergovernmental agencies, funding bodies, research bodies, academic institutions and pharmaceutical companies. The panel invites papers on global health networks which have been variously called global health assemblages, pharmaceutical nexuses, communities of practice, and global health partnerships. The panel aims to enrich anthropological theoretical approaches to global health networks.
Accepted papers:
Session 1Colin Millard (Queen Mary, University of London)
Paper short abstract:
The paper uses assemblage theory to examine social networks promoting misoprostol for postpartum haemorrhage
Paper long abstract:
Misoprostol was added to the WHO Model Essential Medicine List (EML) for the prevention of postpartum haemorrhage (PPH) in 2011.The ideal is that the decision to add a medicine to the List is based on science following the procedures of Evidence Based Medicine. In 2012 and independent review of the evidence for the use of misoprostol for PPH, which included the studies that formed the basis of the WHO EML Committee decision, found it deficient in a number of areas; the trials had serious limitations in the study design, did not show evidence of efficacy, and confirmed misoprostol related side effects (Chu et al 2012). It is clear that along with its life as a scientific object misoprostol also has a life within a complex social field, and the addition of misoprostol to the WHO EML in 2011 was deeply connected to wider social, political and economic conditions. This paper aims to understand the nature and influence of this network and assess how it developed. The network was global in scope and involved a diverse range of activists. It is an example of a global health assemblage, a transnational public health pattern which has become increasingly common in the last few decades. This paper will use assemblage theory to analyse the development of the components of the network as 'regimes of value'. It will document how they have coalesced and emerged into a specific social form which has had a major impact on health policy.
Petra Sevcikova (Queen Mary College, University of London)
Paper short abstract:
The paper uses assemblage theory to examine the country-level network of CSOs that contributed to health policy change and roll-out of misoprostol for postpartum haemorrhage across Uganda
Paper long abstract:
Misoprostol for postpartum haemorrhage (PPH) has been promoted by Civil Society Organizations (CSOs) since the early 2000s. Yet, CSOs’ role in improving access to misoprostol and shaping health policy at global and national level is not well understood. In Uganda, misoprostol was introduced with technical and financial support by five CSOs in 2008 (Atukunda et al. 2015). All were part of a larger global assemblage of groups working on maternal health (Millard et al. 2015). In this paper we use global assemblage theory to understand this country-level expression of global networks. We analyse CSOs’ aims, activities, and their position, specific experience, and ties with the pharma industry and funders within global networks that contributed to the policy change and subsequent roll-out of misoprostol across Uganda. Policy documents, procurement data and key informant interviews with government officials, healthcare providers, and CSOs in four districts of Uganda were collected within the Accessing Medicines in Africa and South Asia project (2010-2013).
Laban Musinguzi (Makerere University)
Paper short abstract:
Social networks of friendships and family relations influence a range of outcomes for community members. The paper shows how social networks influenced and negotiated within the context of externally initiated programs impact on health outcomes for members.
Paper long abstract:
Whereas documentation of Village Savings and Loans Associations (VSLAs) programs in several African countries exists, little is known about their impact beyond increased access to income for members. Too often studies have portrayed VSLAs as spaces for financial inclusion of the poor, improved livelihood and a source of social capital for their members. The aim of this paper is to show that the value (or lack of it) of membership in VSLAs is not confined to financial benefits, but rather the social networks of friendships and social relations that predate the introduction of VSLAs. Based on ethnography of VSLAs conducted between 2012 and 2014 in Luwero district, Uganda; this paper examines women participants' experiences in VSLAs showing the influence of a diverse range of social networks on how they make decisions concerning health and get assistance from members. The findings show that VSLAs accord the space within which women exercise agency in exploiting the social resources that inhere in social networks in their community. Such resources although non-medical achieve health outcomes for the members. This nexus is critical for health promotion. The findings underscore the need to understand the influence of social networks of friendships and family relations negotiated within externally initiated programs such as VSLAs on health outcomes.