Paper short abstract:

This paper describes activist networks that help women access medical abortion outside formal health care systems and global health projects. Do they count as ‘doing’ global health? Do they expose limitations in the notion of a health system? What are the ethical implications of studying them?

Paper long abstract:

This paper describes activist networks around the world that help women access medical abortion and which are, by necessity and design, outside ‘the system’: outside formal health care systems, outside global health policies and projects; outside the law. Such networks may be clandestine but are often connected to formal systems via black and grey markets for drugs and services.

Medically speaking, an unsafe abortion is one that is performed by an unlicensed or untrained provider or that takes place in an inadequately resourced setting. An estimated 25 million unsafe abortions take place each year – the majority in the global south. For decades, activist networks have been providing information, off-script access to a drug called misoprostol, and accompaniment for women seeking safer, non-surgical abortions. Misoprostol now has a sound evidence base as an abortifacient and a number of organisations have sprung up to disseminate information and the drug itself. Yet many barriers to safe access to misoprostol remain -- especially for women in legally restrictive and low-resource settings (Drabo 2021).

What might medical anthropologists and global health scholars make of these networks outside health care systems? Do they count as ‘doing’ global health? How do they expose the conceits and limitations of the notion of a health system? And what are the ethical implications of studying such networks; is there vulnerability in making them visible? Approaching the empirical and analytical questions raised by activist abortion networks is a task especially well-suited for anthropologists working by the ethnographic method.

Paper short abstract:

By exploring daily food selection criteria and what is considered healthy in rural, urban, and peri-urban Mongolia, I will discuss how anthropological perspectives could contribute to making more tailored and feasible dietary suggestions compatible with long-standing Mongolian values and customs.

Paper long abstract:

What is considered a 'healthy diet' varies across Mongolia. Calories, nutrition, and the concept of a so-called 'balanced meal' or 'healthy diet,' initially developed and promoted outside Mongolia, have become parts of the food selection criteria for many in Ulaanbaatar. Meanwhile, some types of food in dietary recommendations are often considered less fresh and healthy in rural and peri-urban Mongolia. By exploring daily food selection criteria and what is considered healthy in rural, urban, and peri-urban Mongolia, I will discuss how anthropological perspectives could contribute to making more tailored and feasible dietary suggestions compatible with long-standing Mongolian values and customs.

Paper short abstract:

Community-engaged methods are often viewed as providing opportunities for “empowering” local communities and making research relationships more equitable. This paper explores the potential pitfalls of participatory methods and considers co-design as an ethical evolution of such approaches.

Paper long abstract:

Community-engaged, participatory methods can be essential in building stakeholder engagement in global health research and implementation, and they can facilitate community-led initiatives. They can also lead to re-entrenchment of unequal power dynamics and unearned privileges in global health while paying lip-service to equitable engagement. This paper explores the tension within applied medical anthropology in supporting social justice ideologies underpinning contemporary global health in counterbalance to ethical obligations to protect research collaborators, recognizing that the risks of research and global health implementation are not equally shared.

This paper shares experiences from long long-term ethnographic and community-engaged global health work in highland Guatemala. I describe methods undertaken to contribute to efforts of local organizations through community-engaged research, programming, and advocacy. I attempt to unpack how such textbook community-engaged, participatory action research went terribly wrong, tragically culminating in the targeted assassination of a study participant, colleague, and friend. In doing so, I will consider the prospects of moving beyond some of the pitfalls of traditional participatory methods through co design.

Co-design approaches are explored through concrete examples of perinatal care and water quality-testing projects in rural Guatemala built upon community-identified needs and priorities. Co-design has the potential to rebalance power dynamics in global health implementation and build equity in access to resources. The co-design approach can move beyond procedural ethics to position global health work within local moral worlds. However, challenges remain as to whether co-design can be replicated and scaled as a transformative methodological shift for medical anthropology in global health.