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Accepted Paper:
Accountabilit(ies) in the Making: An Ethnographic Inquiry Into the Health Information Infrastructure for Malawi's Antiretroviral Therapy Scale-up
Chia-Shuo Tang (Amsterdam Institute for Social Science Research)
Paper short abstract:
Drawing on multi-site ethnographic fieldwork about donor-funded health information system building projects in Malawi, I conceptualize mundane audit technologies as socially constructed and maintained infrastructures. I explore the techno-social networks that undergird accountability routines.
Paper long abstract:
Anthropological research on audit culture in global health has been centered around the proliferation of performance-based indicators and the consequential health data vacuuming from low- and middle-income countries (LMICs). Taking such interest in neoliberal governmentality as a point of departure, I propose an alternative approach to audit and accountability practices in global health. Instead of only examining audit protocols and how they are mobilized to produce accountable subjects, I pay attention to mundane audit tools and how they are placed across diverse social settings to enable the accumulation of standardized data. To understand the very fabrics of the techno-social networks that undergird accountability routines, I adopt Aihwa Ong and Stephen Collier's notion of global assemblage as the main analytical framework to explore large-scale data management systems as accountability infrastructures. Drawing on multi-site ethnographic fieldwork about donor-funded health information system strengthening projects in Malawi, this paper highlights three features of the socially produced accountability in LMICs under complex global health partnerships: (1) The process of building enumerative technologies involves highly contingent and diverse global connections. (2) The networks that support project-based data infrastructures are socially fragile due to its patchiness. (3) There exists a culture of improvisation among health workers to (partially) stabilize documentation procedures in local facilities. This paper illustrates the methodological usefulness of researching the social life of mundane audit tools. Such focus on the multiplicity behind audit expansion allows anthropologists to rethink the politics of accountability production beyond its normative effects.
Beyond 'audit cultures'? New critical approaches to accountability, responsibility, and metrics I
Session 1 Monday 21 June, 2021, -