How Do You Build a "Culture of Health"? A Critical Analysis of Challenges and Opportunities from Medical Anthropology.

The Robert Wood Johnson Foundation's Culture of Health Action Framework aims to "make health a shared value" and improve population health equity through widespread culture change. The authors draw upon their expertise as anthropologists to identify 3 challenges that they believe must be addressed in order to effectively achieve the health equity and population health improvement goals of the Culture of Health initiative: clarifying and demystifying the concept of "culture," contextualizing "community" within networks of power and inequality, and confronting the crises of trust and solidarity in the contemporary United States. The authors suggest that those who seek to build a "Culture of Health" refine their understanding of how "culture" is experienced, advocate for policies and practices that break down unhealthy consolidations of power, and innovate solutions to building consensus in a divided nation

The community counts: a participatory approach to social audits

Community matters – community responds. Yet many health planners still consider people as passive recipients of programs. Social audits respond to the voice of different stakeholders, including intended beneficiaries, in order to improve health planning and service delivery. The introductory and concluding papers of a special supplement to BioMed Central, discusses the evolution of Centro de Investigación de Enfermedades Tropicales (CIET)’s social audit methods, the lessons learned, and the way forward to the next generation of social audits

La pandemia. Año 2: experiencias diferenciadas, dilemas compartidos y reflexiones múltiples desde la antropología médica en torno a la COVID 19

Hemos invitado a tres especialistas que desde la antropología médica pudieran reflexionar a partir de sus respectivas experiencias y conocimientos situados, aportando sus reflexiones de México, Gran Bretaña, Estados Unidos y la India, todos ellos países profundamente afectados por la pandemia aun si de manera muy diferentes entre sí, y cuyo manejo de ésta se ha orientado en direcciones distintas. Esto nos permite contrastar la diversidad de respuestas oficiales a la crisis sanitaria y económica

The Social and Political Dimensions of the Ebola Response: Global Inequality, Climate Change, and Infectious Disease

The 2014 Ebola crisis has highlighted public-health vulnerabilities in Liberia, Sierra Leone, and Guinea – countries ravaged by extreme poverty, deforestation and mining-related disruption of livelihoods and ecosystems, and bloody civil wars in the cases of Liberia and Sierra Leone. Ebola’s emergence and impact are grounded in the legacy of colonialism and its creation of enduring inequalities within African nations and globally, via neoliberalism and the Washington Consensus. Recent experiences with new and emerging diseases such as SARS and various strains of HN influenzas have demonstrated the effectiveness of a coordinated local and global public health and education-oriented response to contain epidemics. To what extent is international assistance to fight Ebola strengthening local public health and medical capacity in a sustainable way, so that other emerging disease threats, which are accelerating with climate change, may be met successfully? This chapter considers the wide-ranging socio-political, medical, legal and environmental factors that have contributed to the rapid spread of Ebola, with particular emphasis on the politics of the global and public health response and the role of gender, social inequality, colonialism and racism as they relate to the mobilization and establishment of the public health infrastructure required to combat Ebola and other emerging diseases in times of climate change

Alternative medicines for AIDS in resource-poor settings: Insights from exploratory anthropological studies in Asia and Africa

The emergence of alternative medicines for AIDS in Asia and Africa was discussed at a satellite symposium and the parallel session on alternative and traditional treatments of the AIDSImpact meeting, held in Marseille, in July 2007. These medicines are heterogeneous, both in their presentation and in their geographic and cultural origin. The sessions focused on the role of these medications in selected resource poor settings in Africa and Asia now that access to anti-retroviral therapy is increasing. The aims of the sessions were to (1) identify the actors involved in the diffusion of these alternative medicines for HIV/AIDS, (2) explore uses and forms, and the way these medicines are given legitimacy, (3) reflect on underlying processes of globalisation and cultural differentiation, and (4) define priority questions for future research in this area. This article presents the insights generated at the meeting, illustrated with some findings from the case studies (Uganda, Senegal, Benin, Burkina Faso, China and Indonesia) that were presented. These case studies reveal the wide range of actors who are involved in the marketing and supply of alternative medicines. Regulatory mechanisms are weak. The efficacy claims of alternative medicines often reinforce a biomedical paradigm for HIV/AIDS, and fit with a healthy living ideology promoted by AIDS care programs and support groups. The AIDSImpact session concluded that more interdisciplinary research is needed on the experience of people living with HIV/AIDS with these alternative medicines, and on the ways in which these products interact (or not) with anti-retroviral therapy at pharmacological as well as psychosocial levels

Consequences of Kaizen Practices in MSMEs in the Philippines: The Case of the Manufacturing Productivity Extension Program (MPEX)

The Manufacturing Productivity Extension Program (MPEX) is a fully subsidized public-instigated productivity improvement program directed toward the micro, small, and medium enterprise (MSME) sector. While not advertised and packaged as a Kaizen initiative, it has all the elements of the Kaizen philosophy. Based on survey responses from 64 MPEX beneficiaries and 47 non-MPEX beneficiaries, the study showed that MPEX increased the number of product lines implying that Kaizen practice leads to product innovation among firms. Due to data and confounding issues, significant difference in productivity in terms of number of workers and sales per worker was not established. Firm asset size was implied to influence the capability to implement Kaizen. Regulatory compliance and customer demand requirements and entrepreneurial capacity are catalysts for enabling, adopting, and sustaining Kaizen implementation

Suicides, poisons and the materially possible: The positive ambivalence of means restriction and critical–critical global health

Developing an object-oriented perspective on suicide, in this article the author challenges critical global health scholarship and sociological theories of ambivalence by showing how a focus on ‘materially possible’ suicide prevention can offer culturally relevant solutions to a suicide epidemic in a resource-poor setting. Taking the example of pesticide regulation in Sri Lanka, he demonstrates why, in theoretical terms, banning toxic pesticides has coherence in a local poison complex that renders suicide available to people as a cultural practice. While writers in the field of critical global health have been suspicious of ‘magic-bullet’ interventions such as means restriction because such policies reportedly overlook the social complexity of problems such as suicide, the author argues that what is materially possible is often of merit because it renders graspable an otherwise deeply contingent and variegated problem. He further argues that critical global health can view the ambivalent costs and benefits of materially possible, magic-bullet interventions as a positive rather than negative offshoot of global health

Kiyang-yang, a West-African Postwar Idiom of Distress

In 1984, a healing cult for young barren women in southern Guinea Bissau developed into a movement, Kiyang-yang, that shook society to its foundations and had national repercussions. “Idiom of distress” is used here as a heuristic tool to understand how Kiyang-yang was able to link war and post-war-related traumatic stress and suffering on both individual and group levels. An individual experience born from a traumatic origin may be generalized into an idiom that diverse sectors of society could embrace for a range of related reasons. We argue that, for an idiom to be understood and appropriated by others, there has to be resonance at the level of symbolic language and shared experiences as well as at the level of the culturally mediated contingent emotions it communicates. We also argue that through its symbolic references to structural causes of suffering, an idiom of distress entails a danger for those in power. It can continue to exist only if its etiology is not exposed or the social suffering it articulates is not eliminated. We finally argue that idioms of distress are not to be understood as discrete diagnostic categories or as monodimensional expressions of “trauma” that can be addressed

Gender comparisons of fat talk in the United Kingdom and the United States

This study compared different forms of body talk, including "fat talk," among 231 university men and women in central England (UK; n = 93) and the southeastern United States (US; n = 138). A 2 (gender) by 2 (country) repeated measures ANOVA across types of body talk (negative, self-accepting, positive) and additional Chi-square analyses revealed that there were differences across gender and between the UK and US cultures. Specifically, UK and US women were more likely to report frequently hearing or perceiving pressure to engage in fat talk than men. US women and men were also more likely to report pressure to join in self-accepting body talk than UK women and men