Social Science Perspectives in Global Health: Insights and Analysis of Issues at the Margins

A special issue of Social Sciences (ISSN 2076-0760).

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 48562

Special Issue Editors

Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury CT2 7FS, UK
Interests: medical anthropology; global health; neglected diseases; conflict; migration; refugees; mental health; non-communicable diseases
Special Issues, Collections and Topics in MDPI journals
Department of International Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA, UK
Interests: health systems strengthening; gender equity; participatory and qualitative research; urban contexts; fragility; neglected tropical diseases
Dr. F. Zeela Zaizay
E-Mail Website
Guest Editor
REDRESS Liberia Office, Garlawulo Building, Congo Town Backroad, 231 Monrovia, Liberia
Interests: health systems strengthening; neglected tropical diseases, disaster relief and management; community engagement and involvement; qualitative research
Dr. Zenawi Zerihun
E-Mail Website
Guest Editor
Department of Psychology, Mekelle University, 231 Mek'ele, Ethiopia
Interests: social learning; gender studies; community engagement; higher education management; behaviour assessment
The George Institute for Global Health, New Delhi 110025, India
Interests: caste; gender; urban poverty; public health and health systems and policy

Special Issue Information

Dear colleagues,

We are calling for papers whose theoretical, methodological, and substantive approaches advance social science approaches to address issues that are frequently marginalised or neglected in global health.  This Special Issue aims to offer a space for health topics, geographical areas, individuals and communities, which are all too often vulnerable and neglected in global health research, policy, and practice. We are interested in social science papers which focus on neglected health areas, neglected communities, and neglected contexts.

We are calling for research that explores and builds the evidence base for health equity and people centred approaches to health systems strengthening in these neglected topic areas. We invite researchers from academic and practitioner communities, and we particularly welcome papers that are led by researchers based in the Global South.

Papers should take forward innovative, inclusive, and participatory approaches, partnering or co-producing with communities and stakeholders whose ideas are often less visible and shared, and in some contexts deliberately silenced.  We are particularly interested in and encourage submission of papers that explore issues in gender equity, disability, justice, intersectionality and/or decolonisation. Papers can be from a specific context or can offer a comparative approach and can also include discussion on the ways in which the COVID-19 pandemic has shaped inequalities and exclusions.

Papers need to be underpinned by social science approaches, knowledge, or methods in global health research.

Suggested topics include (but are not limited to):

  • Focus on equity, people-centred approaches, health systems strengthening and accountability
  • Focus on neglected health areas: neglected and stigmatising diseases
  • Focus on neglected people: communities in underserved or unserved areas, people with disability, migrant workers, adolescents, waste pickers, sex workers, refugees, migrants, displaced communities amongst others whose occupations and status may expose them to vulnerable health environments
  • Focus on neglected contexts: fragile and shock prone contexts, marginalised rural areas and informal settlements/slums, conflict areas
  • Focus on social scientific methodological approaches in global health: co-production/inclusive methodologies/participatory approaches/partnership with marginalised individuals, households, communities and intersectional analysis

Prof. Dr. Lisa Dikomitis
Prof. Dr. Sally Theobald
Dr. F. Zeela Zaizay
Dr. Zenawi Zerihun
Dr. Shrutika Murthy
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Social Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (16 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

18 pages, 313 KiB  
Article
Perceptions of and Attitudes toward COVID-19 Vaccination among Urban Slum Dwellers in Dhaka, Bangladesh
Soc. Sci. 2023, 12(4), 230; https://doi.org/10.3390/socsci12040230 - 13 Apr 2023
Cited by 1 | Viewed by 1865
Abstract
Vaccine hesitancy or low uptake was identified as a major threat to global health by the World Health Organization (WHO) in 2019. Vaccine hesitancy is context-specific and varies across time, place, and socioeconomic groups. In this study, we aimed to understand the perceptions [...] Read more.
Vaccine hesitancy or low uptake was identified as a major threat to global health by the World Health Organization (WHO) in 2019. Vaccine hesitancy is context-specific and varies across time, place, and socioeconomic groups. In this study, we aimed to understand the perceptions of and attitudes toward COVID-19 vaccination through time among urban slum dwellers in Dhaka, Bangladesh. In-depth telephone interviews were conducted between October 2020 and January 2021 with 36 adults (25 females and 11 males) living in three urban slums of Dhaka City, Bangladesh. Follow-up interviews were undertaken in April and August 2021 to capture any shift in the participants’ perceptions. Our findings show that for many there was an initial fear and confusion regarding the COVID-19 vaccine among people living in urban informal settlements; this confusion was soon reduced by the awareness efforts of government and non-government organizations. Women and young people were more interested in being vaccinated as they had had more exposure to the awareness sessions conducted by non-governmental organizations (NGOs) and on social media. However, people living in the slums still faced systemic barriers, such as complicated online vaccine registration and long queues, which led to low uptake of the vaccine despite their increased willingness to be vaccinated. This study highlights the importance of using sources such as NGO workers and television news to debunk myths, disseminate COVID-19 vaccine information, and support adherence to vaccination among urban slum dwellers. Our study underscores the importance of addressing systemic barriers blocking access and understanding community perceptions in order to develop effective communication strategies for vulnerable groups that will then improve the COVID-19 vaccine uptake. Full article
16 pages, 286 KiB  
Article
A Social Cure for COVID-19: Importance of Networks in Combatting Socio-Economic and Emotional Health Challenges in Informal Settlements in Dhaka, Bangladesh
Soc. Sci. 2023, 12(3), 127; https://doi.org/10.3390/socsci12030127 - 24 Feb 2023
Viewed by 1797
Abstract
The Bangladesh government issued a lockdown throughout the country from March–May 2020 in response to the COVID-19. The sudden lockdown caused economic ruptures across the country due to job loss. We conducted a comprehensive analysis of the outbreak through 40 in-depth interviews with [...] Read more.
The Bangladesh government issued a lockdown throughout the country from March–May 2020 in response to the COVID-19. The sudden lockdown caused economic ruptures across the country due to job loss. We conducted a comprehensive analysis of the outbreak through 40 in-depth interviews with men and women living in three Dhaka informal settlements from January to November 2021 to identify gaps to mitigate negative downstream effects of global pandemic policies. In this paper, we explore the critical importance of social networks as coping mechanisms for those who lost livelihood due to COVID-19 lockdown. Due to the congested living conditions in informal settlements, many established residents foster close, trusting relationships, and a strong sense of community. Formal and informal networks in urban slums, whether reciprocal or strategic, played an integral role as a way of coping during times of scarcity. We found limited analysis in public health literature on the resilience of these social networks and its impact on health and wellbeing. Our paper attempts to unpack the ways our respondents drew on their own social networks to combat the socio-economic and emotional health challenges brought on by a lack of adequate formalized support as part of the pandemic response. Full article
17 pages, 1619 KiB  
Article
Community-Based Interventions for the Prevention and Control of Cutaneous Leishmaniasis: A Systematic Review
Soc. Sci. 2022, 11(10), 490; https://doi.org/10.3390/socsci11100490 - 20 Oct 2022
Cited by 1 | Viewed by 2126
Abstract
We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched [...] Read more.
We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD: 1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore, we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access). Full article
Show Figures

Figure 1

21 pages, 3176 KiB  
Article
The Gendered Experience of Close to Community Providers during COVID-19 Response in Fragile Settings: A Multi-Country Analysis
Soc. Sci. 2022, 11(9), 415; https://doi.org/10.3390/socsci11090415 - 11 Sep 2022
Cited by 3 | Viewed by 1789
Abstract
Many countries, and particularly those including fragile contexts, have a shortage of formal health workers and are increasingly looking to close-to-community (CTC) providers to fill the gap. The experiences of CTC providers are shaped by context-embedded gender roles and relations. This qualitative research [...] Read more.
Many countries, and particularly those including fragile contexts, have a shortage of formal health workers and are increasingly looking to close-to-community (CTC) providers to fill the gap. The experiences of CTC providers are shaped by context-embedded gender roles and relations. This qualitative research study in Lebanon, Nepal, Myanmar and Sierra Leone explored the gendered experiences of CTC providers during the COVID-19 pandemic in fragile settings. We used document review, in-depth interviews or focus group discussions with CTC providers, and key informant interviews with local stakeholders to generate in-depth and contextual information. The COVID-19-associated lockdowns and school closures brought additional stresses, with a gendered division of labour acutely felt by women CTC providers. Their work is poorly or not remunerated and is seen as risky. CTC providers are embedded within their communities with a strong willingness to serve. However, they experienced fractures in community trust and were sometimes viewed as a COVID-19 risk. During COVID-19, CTC providers experienced additional responsibilities on top of their routine work and family commitments, shaped by gender, and were not always receiving the support required. Understanding their experience through a gender lens is critical to developing equitable and inclusive approaches to support the COVID-19 response and future crises. Full article
Show Figures

Figure 1

20 pages, 10918 KiB  
Article
Pandemic Portraits—An Intersectional Analysis of the Experiences of People with Disabilities and Caregivers during COVID-19 in Bangladesh and Liberia
Soc. Sci. 2022, 11(9), 378; https://doi.org/10.3390/socsci11090378 - 23 Aug 2022
Cited by 2 | Viewed by 2368
Abstract
COVID-19 significantly affected people with disabilities, with many facing additional barriers in access to services and increased risks of poor health and social outcomes. Focusing on the impact of COVID-19 in the Global South, this study took place in Bangladesh and Liberia, where [...] Read more.
COVID-19 significantly affected people with disabilities, with many facing additional barriers in access to services and increased risks of poor health and social outcomes. Focusing on the impact of COVID-19 in the Global South, this study took place in Bangladesh and Liberia, where 14% and 16% of the population are thought to live with disabilities. However, there is minimal research on the needs and experiences of this population group and how these are shaped by intersecting axes of inequity. Furthermore, disabled people are often excluded from being actively involved in research. To address these evidence gaps, we used the creative participatory method of photovoice remotely to document experiences of COVID-19 through the lens of people with physical and psychosocial disabilities and their caregivers as co-researchers. The findings present themes relating to inaccessibility, social connection, hopes and fears. The nexus between disability and poverty was exacerbated for many in both settings, while psychosocial impacts of COVID-19 included increased stigmatisation and isolation. However, themes of faith, support and adaptability were also highlighted in stories of community care, nature and healing. Photovoice, through imagery and storytelling, was a powerful tool in prioritising the voices of disabled people, adding to an evidence base to inform inclusive pandemic responses. Full article
Show Figures

Figure 1

22 pages, 700 KiB  
Article
Intersecting Systems of Power Shaping Health and Wellbeing of Urban Waste Workers in the Context of COVID-19 in Vijayawada and Guntur, Andhra Pradesh, India
Soc. Sci. 2022, 11(8), 333; https://doi.org/10.3390/socsci11080333 - 28 Jul 2022
Cited by 1 | Viewed by 2359
Abstract
Background: Waste work in India is an undervalued role relegated to historically marginalised communities. The informal nature of their work coupled with lack of state regulation keeps waste workers trapped in poverty. This study aims to understand how intersecting systems and relations of [...] Read more.
Background: Waste work in India is an undervalued role relegated to historically marginalised communities. The informal nature of their work coupled with lack of state regulation keeps waste workers trapped in poverty. This study aims to understand how intersecting systems and relations of power impact the agency of waste workers to shape their health and wellbeing. Methods: We used in-depth interviews, key informant interviews, and focus group discussions to collect primary data from waste worker communities in Vijayawada and Guntur in India. Thematic analysis was used to analyse data using conceptual frameworks relating to wellbeing and power. Results: Inter-generational poverty and lack of access to social determinants of health keeps waste workers trapped in a cycle of debt and poverty. They experience negative wellbeing owing to material and relational deprivations that are sustained by a nexus of power relations, explained using the themes of “power over”, “power to”, “power with”, and “power-within”. Conclusions: The ability of communities to exercise agency is constrained by the power exercised on their lives by the state and society. NGOs play a supportive role for the realisation of rights, but the ability of waste workers to organize and effect change is limited to coping strategies. Full article
Show Figures

Figure 1

22 pages, 3345 KiB  
Article
Leaving No One Behind: A Photovoice Case Study on Vulnerability and Wellbeing of Children Heading Households in Two Informal Settlements in Nairobi
Soc. Sci. 2022, 11(7), 296; https://doi.org/10.3390/socsci11070296 - 11 Jul 2022
Cited by 3 | Viewed by 3618
Abstract
Children heading households (CHH) in urban informal settlements face specific vulnerabilities shaped by limitations on their opportunities and capabilities within the context of urban inequities, which affect their wellbeing. We implemented photovoice research with CHHs to explore the intersections between their vulnerabilities and [...] Read more.
Children heading households (CHH) in urban informal settlements face specific vulnerabilities shaped by limitations on their opportunities and capabilities within the context of urban inequities, which affect their wellbeing. We implemented photovoice research with CHHs to explore the intersections between their vulnerabilities and the social and environmental context of Nairobi’s informal settlements. We enrolled and trained four CHHs living in two urban informal settlements—Korogocho and Viwandani—to utilise smartphones to take photos that reflected their experiences of marginalisation and what can be done to address their vulnerabilities. Further, we conducted in-depth interviews with eight more CHHs. We applied White’s wellbeing framework to analyse data. We observed intersections between the different dimensions of wellbeing, which caused the CHHs tremendous stress that affected their mental health, social interactions, school performance and attendance. Key experiences of marginalisation were lack of adequate food and nutrition, hazardous living conditions and stigma from peers due to the limited livelihood opportunities available to them. Despite the hardships, we documented resilience among CHH. Policy action is required to take action to intervene in the generational transfer of poverty, both to improve the life chances of CHHs who have inherited their parents’ marginalisation, and to prevent further transfer of vulnerabilities to their children. This calls for investing in CHHs’ capacity for sustaining livelihoods to support their current and future independence and wellbeing. Full article
Show Figures

Figure 1

10 pages, 297 KiB  
Article
Differentiated Primary Healthcare in the Pataxó Indigenous Communities in Bahia, Brazil: Polyphonic Ethnography of Healthcare Practices from an Intercultural Perspective
Soc. Sci. 2022, 11(5), 189; https://doi.org/10.3390/socsci11050189 - 25 Apr 2022
Viewed by 1870
Abstract
A lack of culturally appropriate healthcare is a common problem for colonial nations, and this can explain the different patterns of health in indigenous populations worldwide. Our study is the first ethnography realized with the neglected Pataxó indigenous people from the south of [...] Read more.
A lack of culturally appropriate healthcare is a common problem for colonial nations, and this can explain the different patterns of health in indigenous populations worldwide. Our study is the first ethnography realized with the neglected Pataxó indigenous people from the south of the state of Bahia, Brazil, that analyzes the representations and practices of “differentiated” public healthcare. The polysemic conceptualization and polymorphism of the healthcare practices highlight some spontaneous intercultural competences, particularly those of the indigenous professionals, within the hegemony of non-indigenous health knowledge and the lack of awareness of intercultural healthcare. Intercultural training and empowerment still remain a priority. Full article
20 pages, 4366 KiB  
Article
Improving Experiences of the Menopause for Women in Zimbabwe and South Africa: Co-Producing an Information Resource
Soc. Sci. 2022, 11(4), 143; https://doi.org/10.3390/socsci11040143 - 22 Mar 2022
Cited by 3 | Viewed by 4449
Abstract
Women in sub-Saharan Africa report multiple impacts of menopause on daily life and have requested further information to support themselves. This study co-produced contextually relevant resources—booklets and poster—about menopause with women in Zimbabwe and South Africa. The study was conducted in four stages: [...] Read more.
Women in sub-Saharan Africa report multiple impacts of menopause on daily life and have requested further information to support themselves. This study co-produced contextually relevant resources—booklets and poster—about menopause with women in Zimbabwe and South Africa. The study was conducted in four stages: interviews with women about the menopause; the development of prototype information resources; workshops with women to discuss country-specific resources; and the refinement of resources. During the interviews, women explained that they had not received or accessed much information about the menopause and thought the physical and psychological issues associated with the menopause had to be “endured”. Prototype information resources comprised booklets and a poster with contextually relevant images and information. Workshop participants suggested several changes, including the addition of more diverse images and further information about treatments. The resources were refined, translated into several African languages, and endorsed by the Ministry of Health in Zimbabwe and the South African Menopause Society in South Africa. Women will be able to access resources through healthcare clinics, community groups and churches. Working with women and other stakeholders enabled a development that was cognisant of experiences and needs. Work is now needed to improve access to treatments and support for menopause to reduce health inequities. Full article
Show Figures

Figure 1

19 pages, 314 KiB  
Article
Women Construction Workers in Bangladesh: Health, Wellbeing, and Domestic Abuse during the COVID-19 Pandemic
Soc. Sci. 2022, 11(2), 83; https://doi.org/10.3390/socsci11020083 - 18 Feb 2022
Cited by 2 | Viewed by 2794
Abstract
This article draws on in-depth research conducted during the first two years of the COVID-19 pandemic with a group of 35 women who work as construction labourers in Sylhet, northern Bangladesh. We particularly focus on these women’s narratives of economic crisis, domestic abuse, [...] Read more.
This article draws on in-depth research conducted during the first two years of the COVID-19 pandemic with a group of 35 women who work as construction labourers in Sylhet, northern Bangladesh. We particularly focus on these women’s narratives of economic crisis, domestic abuse, coercive control and intimate relations during the pandemic. Here, we consider the ways in which the COVID-19 pandemic between 2020 and 2021 particularly affected this group of women participants as they employed survival strategies to support their families through a time of extreme economic and social crisis. A key issue they raised was the negative impact the pandemic has had on their health and wellbeing, particularly exacerbated by an increase in experiences of intimate partner violence (IPV), more commonly termed domestic abuse or domestic violence in the local context. The violence they faced was not necessarily a new experience for many of these women, but it was intensified by pressures brought to bear on interpersonal relations within their household as a result of lack of access to incomes, rising levels of poverty, and the stresses placed on families trying to survive in a time of extreme socio-economic and health insecurity. Full article
14 pages, 839 KiB  
Article
Socioeconomic Status, Occupational Disease, and Psychological Well-Being: Evidence from People with Pneumoconiosis in China
Soc. Sci. 2022, 11(1), 28; https://doi.org/10.3390/socsci11010028 - 17 Jan 2022
Cited by 3 | Viewed by 2673
Abstract
Background: Pneumoconiosis is one of the most prevalent occupational diseases in China. The present study aims to examine the status, needs, and challenges of people with pneumoconiosis from a socioeconomic perspective and to reveal the mechanisms by which the disease is linked to [...] Read more.
Background: Pneumoconiosis is one of the most prevalent occupational diseases in China. The present study aims to examine the status, needs, and challenges of people with pneumoconiosis from a socioeconomic perspective and to reveal the mechanisms by which the disease is linked to their psychological well-being. This study also examines the association of the social security subsidy to such mechanism. Methods: A questionnaire survey of 1134 respondents from seven cities or districts in China was conducted from 2014 to 2016. Generalized Structural Equation Modeling (GSEM) was employed to complete the analysis using Stata 16. Results: Respondents with poor socioeconomic status engaged longer in dusty work and had higher stages of pneumoconiosis, complications, and aggravation. These, in turn, were linked to their socioeconomic status due to high treatment expenditure and loss of the ability to work, which were negatively associated with their psychological well-being. Social security assistance and subsidies could help improve their socioeconomic status. Conclusions: This study provides evidence for the mechanism of social factors linking to physical health and further to psychological well-being among people with pneumoconiosis. Social security assistance and subsidies should be urgently provided for them to improve their socioeconomic status and their psychological well-being. Full article
Show Figures

Figure 1

20 pages, 317 KiB  
Article
Chronic Kidney Disease of Uncertain Etiology in Sri Lanka: Curing between Medicine and Traditional Culture
Soc. Sci. 2022, 11(1), 20; https://doi.org/10.3390/socsci11010020 - 11 Jan 2022
Cited by 2 | Viewed by 3639
Abstract
Chronic Kidney Disease of unknown origin (CKDu) has appeared across Sri Lanka’s North Central Province (NCP) since the 1990s as an epidemic, unexplained by conventional associated risk factors. During the past few decades, a large number of studies attempted to determine the unknown [...] Read more.
Chronic Kidney Disease of unknown origin (CKDu) has appeared across Sri Lanka’s North Central Province (NCP) since the 1990s as an epidemic, unexplained by conventional associated risk factors. During the past few decades, a large number of studies attempted to determine the unknown etiology of CKDu. Despite these investigations, no concrete conclusions were developed, though a number of contradictory hypotheses emerged. The present ethnographic study was carried out in two endemic areas, labelled as “CKDu hotspots”, and illuminates how curing takes place between biomedicine and traditional cultural practices. Our ethnographic study thoroughly scrutinized three decades of lived experience, lay-perceptions and local discourses on CKDu. We used a qualitative study design with a transcendental phenomenological approach and employed a mixture of ethnographic methods. Data collection techniques included participant observation, in-depth interviews, focus group discussions and key informant interviews. Data was analysed by using an interpretive thematic analysis model. Findings revealed that lay people have constructed a popular discourse on CKDu, and we explored their views on the origin, etiology and prevalence of CKDu in their locality over the past few decades. Patients’ narratives revealed that there were currently a number of gaps in service delivery. These were mainly due to distant relationships between healthcare providers and CKDu patients. Lay people in affected communities were marginalized throughout the investigation process to determine the unknown etiology, their involvement marginalized to merely acting as objects for scientific instigation. The affected communities strongly believed that CKDu was a recent phenomenon resulting from the mismanagement of the natural environment due to social and lifestyle changes. These findings highlight local dynamics of healthcare seeking behaviours which demand complementary medicine system, particularly given the number of limitations in the biomedical system. Empirical evidence generated from this study suggests a conceptual shift to an ethno-medical model to address CKDu. Improving cultural competency and communication skills among healthcare providers in public health are crucial in order to apply a “bio-psychosocial perspective” in healthcare delivery system and bridging the gap between hospital and the community. Full article
12 pages, 240 KiB  
Article
Speaking to Power: The Problem of Enabling Subaltern Voices to Be Heard. A Case Study Concerned with Using the Arts to Engage with the Issue of Maternal Mortality in Western Kenya
Soc. Sci. 2021, 10(12), 471; https://doi.org/10.3390/socsci10120471 - 08 Dec 2021
Viewed by 2228
Abstract
In the context of consistently poor provision of state maternity services to impoverished women in western Kenya over many decades, this article discusses the use of arts in relation to researching subaltern perspectives and enabling subaltern voices to be heard by the powerful. [...] Read more.
In the context of consistently poor provision of state maternity services to impoverished women in western Kenya over many decades, this article discusses the use of arts in relation to researching subaltern perspectives and enabling subaltern voices to be heard by the powerful. The argument is made that behaviour change agendas are almost always top down, while requirements for the authorities to engage with subaltern voices are minimal and frequently resisted. Case studies are offered of two artistic interventions—a play and a documentary film, made in 2018 and 2019 respectively, which sought to engage medical authorities and the middle classes regarding the consequences of the, sometimes very weak, implementation of Kenya’s excellent policies in relation to maternal health for the poor. In conclusion, the question of how to more effectively enable the powerless to speak to power is discussed. Full article
16 pages, 302 KiB  
Article
An Ethnographic Perspective of Well-Being, Salutogenesis and Meaning Making among Refugees and Asylum Seekers in the Gambia and the United Kingdom
Soc. Sci. 2021, 10(9), 324; https://doi.org/10.3390/socsci10090324 - 27 Aug 2021
Cited by 1 | Viewed by 3410
Abstract
Research on refugees and asylum seekers largely focuses on the negative impacts that forced migration has on well-being. Though most individuals do not experience poor long-term mental health because of forced migration, less attention has been given to what factors promote positive well-being. [...] Read more.
Research on refugees and asylum seekers largely focuses on the negative impacts that forced migration has on well-being. Though most individuals do not experience poor long-term mental health because of forced migration, less attention has been given to what factors promote positive well-being. Using an ethnographic approach, I elucidate how the concept of salutogenesis can be applied to African refugees and asylum seekers living in the greater Serrekunda area of the Gambia and in Newcastle-upon-Tyne in the United Kingdom. Specifically, I explore what resources impact on the sense of coherence construct and its three components—comprehensibility, manageability and meaningfulness—and how these are embedded in everyday discussions and understandings. In total, I spent twenty months conducting ethnographic fieldwork between the two sites and conducted forty individual interviews. Amongst my interlocutors, the three most common resources that people spoke positively about, particularly as it relates to meaning making, are work, education and religion. Further research in this area is crucial in order to identify, promote and strengthen those factors facilitating positive well-being amongst those who have been forcibly displaced. Full article

Review

Jump to: Research, Other

21 pages, 1053 KiB  
Review
Barriers and Enablers to Health-Seeking for People Affected by Severe Stigmatising Skin Diseases (SSSDs): A Scoping Review
Soc. Sci. 2022, 11(8), 332; https://doi.org/10.3390/socsci11080332 - 27 Jul 2022
Viewed by 2877
Abstract
People affected by severe stigmatising skin diseases (SSSDs) often live in the poorest communities, within the poorest countries, and experience a range of barriers to seeking timely, quality care. This scoping review analyses the available literature on health-seeking for patients affected by SSSDs, [...] Read more.
People affected by severe stigmatising skin diseases (SSSDs) often live in the poorest communities, within the poorest countries, and experience a range of barriers to seeking timely, quality care. This scoping review analyses the available literature on health-seeking for patients affected by SSSDs, to identify enablers and barriers to health-seeking. We searched MEDLINE complete, CINAHL, Global Health databases for suitable articles published between 2010 and 2020. Search strings were compiled for health-seeking, SSSDs and lower middle-income countries (LMIC). Our search returned 1004 studies from across three databases. Of these, 136 potentially relevant studies were identified and full texts were reviewed for eligibility against the inclusion criteria, leading to the inclusion of 55 studies. Thematic narrative analysis was used, with results framed around the Levesque framework to analyse barriers and enablers to health-seeking along the continuum of the patient pathway. This scoping review has revealed barriers across the patient pathway, from both supply and demand aspects of health services. Spiritual beliefs emerged strongly relating to care-seeking and underlying stigma. Curative care was a focus for the majority of studies, but few papers emphasised holistic care (such as physical rehabilitation and psychosocial support). From our analysis, greater community engagement is needed to reduce barriers along the patient-care pathway. Full article
Show Figures

Figure 1

Other

Jump to: Research, Review

15 pages, 352 KiB  
Perspective
Can the Sick Speak? Global Health Governance and Health Subalternity
Soc. Sci. 2022, 11(9), 417; https://doi.org/10.3390/socsci11090417 - 13 Sep 2022
Cited by 4 | Viewed by 4188
Abstract
Global Health Governance (GHG) uses a set of financial, normative, and epistemic arguments to retain and amplify its influence. During the COVID-19 pandemic, the GHG regime used its own successes and failures to prescribe more of itself while demanding further resources. However, the [...] Read more.
Global Health Governance (GHG) uses a set of financial, normative, and epistemic arguments to retain and amplify its influence. During the COVID-19 pandemic, the GHG regime used its own successes and failures to prescribe more of itself while demanding further resources. However, the consistent failures of this form governance and its appeasement to a dominant neoliberal ideology lead to the following question: Is the global health governance regime failing at its goal of improving health or succeeding at other political and ideological goals that necessitate such failures? Using concepts and ideas from social theory and post-colonial studies; I examine the definitions, epistemic basis, and drivers of GHG and propose certain conditions for the legitimacy of a global health governance system. Examining historical and current cases, I find that the GHG regime currently fails to fulfil such conditions of legitimacy and instead creates spaces that limit rather than help many populations it purports to serve. Those spaces of sickness confine people and reduce them into a state of health subalternity. In being health subalterns, people’s voices are neither sought nor heard in formulating the policies that determine their health. Finally, I argue that research and policymaking on global health should not be confined to the current accepted frameworks that assumes legitimacy and benevolence of GHG, and propose steps to establish an alternative, emancipatory model of understanding and governing global health. Full article
Back to TopTop