Abstract
AbstractThis edited volume treats policy as an ethnographic object. Examining both policy spaces and sites of practice, the chapters illuminate both professionals’ and lay people’s intimate encounters with health policies. By ‘studying up’ and considering the multiplicity of actors and interests involved in global policies for improving maternal and reproductive health, the ten chapters in this volume track the processes and politics of policymaking and the mechanisms of their implementation in diverse contexts in Asia, Africa, Europe and South America. The chapters provide in-depth analyses of the complexities of policy formulation and implementation, the impact of socio-political contexts, as well as issues of local agency, equity and accessibility. Together, they demonstrate the value of ethnography as well as reproduction as a unique site for the generation of rich insights into the working of global health policies and their impacts. Such critical social science research is increasingly recognised as a crucial part of the evidentiary basis upon which people-centred and equitable health policy and systems everywhere are built. This volume will be of interest to scholars working at the intersection of critical global health, medical anthropology, and health policy and systems research, as well as to global public health practitioners.
Highlights
The burgeoning subfield of health policy and systems research views an interpretive and critical inquiry that draws on multiple disciplines, not least anthropology, as essential to understanding and informing effective policy (Gilson et al, 2011; Ghaffar et al, 2016)
Judith Justice’s detailed examination of the planning and implementation of a program to train and disperse Assistant Nurses Midwives throughout the Nepalese countryside (1989) and Brigitte Jordan’s classic critique of training courses for traditional birth attendants in Mexico (1978) both clearly illustrate the lack of consideration of local context in national-level policies meant to improve maternal health care
Taking the local district as her starting point, Magrath maps the dense networks of national and global policies and pressures that exert themselves in local health governance and clinical practice: global policies promoting SBAs and sidelining traditional birth attendant (TBA); pressure on individual nations to reach the Millennium Development Goal on reducing maternal mortality; and the limited financial power and decision space afforded to districts under decentralisation in Indonesia
Summary
Its ten chapters examine global policies for improving maternal and reproductive health, tracking the processes and politics of their making, the mechanisms of their implementation in diverse contexts, and people’s intimate encounters with their consequences and effects. As the book took shape, we sought to bring current medical anthropological research on global maternal and reproductive health into more direct conversation with anthropological studies of policy and with health policy and systems research. Not unlike other global health interventions, maternal and reproductive health policies are often framed by perceived wisdom and evidence that has been generated by a narrow set of research methods, often making it difficult to derive solutions relevant to the local context (Béhague & Storeng, 2008; Olivier de Sardan, Diarra & Moha, 2017). It is a key moment of reckoning for maternal and reproductive health policy, and for global health more broadly
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