Paper short abstract:

Recognition of the intersection of health interventions and cultural context seldom account for increasing global diversity. This paper draws on two case examples to consider how anthropology might contribute to the evaluation of health interventions in settings of cultural complexity.

Paper long abstract:

The focus on the interaction of interventions with context has brought renewed attention to culture as 'a fundamental set of defining qualities of community life out of which interventions flow' (Trickett et al 2011). However the 'location of culture' has been a central problematic of anthropological theory with recognition of culture as complex, plural and dynamic. Social scientists have also interrogated the notion of 'communities' as socially or spatially predefined groups into which interventions can be introduced. In high-income contexts notions of 'culture' and 'community' are commonly deployed in the development of interventions targeting ethnic minority groups with little critical interrogation of how these are constituted. More recently researchers in health have highlighted the need to consider the intersection of multiple variables beyond culture and ethnicity, including age, gender, socio-economic status and migration history, with structural factors (Viruell-Fuentes et al 2012). However such diversity has less often been recognised in low-income countries where community settings for health interventions are generally conceived as bound together by cultural 'tradition'. By contrast such settings are also likely to be sites of 'cultural complexity' (Hannerz 1992) as a consequence of long histories of migration, trade, colonialism and cultural exchange, as well as intensifying processes of globalisation. This paper will draw on examples from two contrasting locations of ethnic and religious diversity - Kintampo, Ghana and London, UK - to explore how anthropological perspectives might contribute to the evaluation of health interventions in taking account of such complexity.