Introduction Research questions Methods Preliminary Results Themes ...
Valuing knowledge, valuing lives: Who counts in global health Lily Walkover1 1Department
of Social and Behavioral Sciences, University of California, San Francisco, CA
Methods Design: Qualitative study utilizing in-depth interviews and a grounded theory approach.
Introduction In the global economy of health, knowledge is often produced in the global north and distributed to the global south, while resources necessary for health are transferred from the south to the north. Hesperian Health Guides, publisher of Where There Is No Doctor, seeks to reconfigure the global pattern of knowledge production and distribution by working with both lay people and medical professionals to produce books and digital materials that provide accessible instructions to treat basic medical problems, as well as to plan and implement community health programs.
Sample: key Hesperian partners who live and work in developing countries, are involved in Hesperian’s editorial process, and use and adapt Hesperian materials in the field. Data collection: six semi-structured interviews (30-90 minutes), systematically coded and analyzed for emergent themes.
Preliminary Results Themes
Process values, elicits, and integrates different forms of knowledge, inviting wide ownership, uptake, and adaptation
1. Ownership of knowledge production process primarily came through local translations and adaptations 2. Understood as a group process on many levels, contributing to different kinds of community building • Including communities based on shared politics 3. Valuation of and strategic negotiation between community-based and medical knowledges
“We all thought we have to build up the health system… in the mid ‘70s we came across this book Hesperian had, Where There Is No Doctor. Immediately we thought this would be translated into [regional language]. One simple good one, and others, and we did it.”
Focus on: Gathering knowledges Research questions • How do Hesperian and its field partners understand how health knowledge is produced and disseminated across the globe, and how do they perceive their work both within and as a challenge to that system? • How do Hesperian and its partners understand the knowledge and lived experiences of those living in developing countries, and how do they work to access, represent, and distribute that knowledge?
Looking ahead
Different ideas about where valuable knowledge comes from across participants “And we also took help of organizations, of women with disabilities, we asked them what is their opinion, what type of materials they would like to have. So they gave us the suggestion, and once we finished a draft chapter, we requested them to give us feedback. And they gave us very good feedback and so we changed some things… They said that, this is the first time they ever had had anyone came to them to ask their opinion about this type of health books. People thought that if women were disability, they were mentally challenged, and so they never thought that anyone could give feedback.”
Challenges of this model: takes time, connections are longdistance, works through global non-profit system Follow-up questions: • How are books used in the field? • How are they used by people with formal medical training versus community health workers versus people without formal health training?
Integrating knowledges: Metaphors for integration: tapestry, recipe, curation “Rather than taking one position or another, or one perspective or another, I think what we did in those editorial discussions was try to figure out how to weave different elements throughout the chapter, either by stories or activities such that multiple people could see themselves in the chapter.” “… from Hesperian there is flavor from Africa, flavor from Latin America, flavor from Asia.”
ACKNOWLEDGEMENTS
• • • •
Graduate Dean's Health Science Fellowship Professors Janet Shim and Carol Dawson-Rose Hesperian Health Guides Participants
of Social and Behavioral Sciences, University of California, San Francisco, CA
Methods Design: Qualitative study utilizing in-depth interviews and a grounded theory approach.
Introduction In the global economy of health, knowledge is often produced in the global north and distributed to the global south, while resources necessary for health are transferred from the south to the north. Hesperian Health Guides, publisher of Where There Is No Doctor, seeks to reconfigure the global pattern of knowledge production and distribution by working with both lay people and medical professionals to produce books and digital materials that provide accessible instructions to treat basic medical problems, as well as to plan and implement community health programs.
Sample: key Hesperian partners who live and work in developing countries, are involved in Hesperian’s editorial process, and use and adapt Hesperian materials in the field. Data collection: six semi-structured interviews (30-90 minutes), systematically coded and analyzed for emergent themes.
Preliminary Results Themes
Process values, elicits, and integrates different forms of knowledge, inviting wide ownership, uptake, and adaptation
1. Ownership of knowledge production process primarily came through local translations and adaptations 2. Understood as a group process on many levels, contributing to different kinds of community building • Including communities based on shared politics 3. Valuation of and strategic negotiation between community-based and medical knowledges
“We all thought we have to build up the health system… in the mid ‘70s we came across this book Hesperian had, Where There Is No Doctor. Immediately we thought this would be translated into [regional language]. One simple good one, and others, and we did it.”
Focus on: Gathering knowledges Research questions • How do Hesperian and its field partners understand how health knowledge is produced and disseminated across the globe, and how do they perceive their work both within and as a challenge to that system? • How do Hesperian and its partners understand the knowledge and lived experiences of those living in developing countries, and how do they work to access, represent, and distribute that knowledge?
Looking ahead
Different ideas about where valuable knowledge comes from across participants “And we also took help of organizations, of women with disabilities, we asked them what is their opinion, what type of materials they would like to have. So they gave us the suggestion, and once we finished a draft chapter, we requested them to give us feedback. And they gave us very good feedback and so we changed some things… They said that, this is the first time they ever had had anyone came to them to ask their opinion about this type of health books. People thought that if women were disability, they were mentally challenged, and so they never thought that anyone could give feedback.”
Challenges of this model: takes time, connections are longdistance, works through global non-profit system Follow-up questions: • How are books used in the field? • How are they used by people with formal medical training versus community health workers versus people without formal health training?
Integrating knowledges: Metaphors for integration: tapestry, recipe, curation “Rather than taking one position or another, or one perspective or another, I think what we did in those editorial discussions was try to figure out how to weave different elements throughout the chapter, either by stories or activities such that multiple people could see themselves in the chapter.” “… from Hesperian there is flavor from Africa, flavor from Latin America, flavor from Asia.”
ACKNOWLEDGEMENTS
• • • •
Graduate Dean's Health Science Fellowship Professors Janet Shim and Carol Dawson-Rose Hesperian Health Guides Participants
