Global Health and the Village: Transnational Contexts Governing Birth in Northern Uganda

By Sarah Rudrum

© 2021

The accounts of women navigating pregnancy in a post-conflict setting are characterized by widespread poverty, weak infrastructure, and inadequate health services. In investigating maternity care and birth, Global Health and The Village examines a remote rural agrarian region of northern Uganda, a region characterized by a weak healthcare system in the aftermath of decades long armed conflict.

Drawing on extensive original qualitative research, Global Health and The Village brings the complex local and transnational factors governing women’s access to safe maternity care into focus. As well as examining local cultural, social, economic, and health system factors shaping maternity care and birth, Rudrum analyzes the encounter between ambitious global health goals and the local realities of a remote, agrarian, post-conflict community with poor health services. Interrogating how culture and technical problems are framed in international health interventions, it becomes clear that the objectifying and colonizing premises on which interventions are based mean that rather than being "unanticipated," the negative consequences that too often result from international interventions in health are structurally determined.

Continue Reading Read Less

Product Details

  • World Rights
  • Page Count: 192 pages
  • Dimensions: 6.0in x 1.0in x 9.0in
Product Formats

SaveUP TO 9239

Book Formats

SKU# SP005390

  • AVAILABLE DEC 2021

    From: $37.50

    Regular Price: $50.00

    ISBN 9781487504557
  • AVAILABLE DEC 2021

    From: $37.50

    Regular Price: $50.00

Quick Overview

Drawing on extensive original qualitative research, Global Health and The Village brings the complex local and transnational factors governing women’s access to safe maternity care into focus.

Global Health and the Village: Transnational Contexts Governing Birth in Northern Uganda

By Sarah Rudrum

© 2021

The accounts of women navigating pregnancy in a post-conflict setting are characterized by widespread poverty, weak infrastructure, and inadequate health services. In investigating maternity care and birth, Global Health and The Village examines a remote rural agrarian region of northern Uganda, a region characterized by a weak healthcare system in the aftermath of decades long armed conflict.

Drawing on extensive original qualitative research, Global Health and The Village brings the complex local and transnational factors governing women’s access to safe maternity care into focus. As well as examining local cultural, social, economic, and health system factors shaping maternity care and birth, Rudrum analyzes the encounter between ambitious global health goals and the local realities of a remote, agrarian, post-conflict community with poor health services. Interrogating how culture and technical problems are framed in international health interventions, it becomes clear that the objectifying and colonizing premises on which interventions are based mean that rather than being "unanticipated," the negative consequences that too often result from international interventions in health are structurally determined.

Continue Reading Read Less

Product Details

  • World Rights
  • Page Count: 192 pages
  • Dimensions: 6.0in x 1.0in x 9.0in
  • Author Information

    Sarah Rudrum is an associate professor of Sociology at Acadia University.
  • Table of contents

    Contents
    List of Acronyms and Abbreviations
    Glossary of Acholi (Luo) Words
    Acknowledgements

    Chapter One: Introduction to A Crisis in Maternal Health
    Introduction
    Contexts of Care
    Background on the Millennium Development Goals (MDGs)
    Skilled birth attendants (SBAs) and traditional birth attendants (TBAs)
    Policy and social contexts for maternity care and childbirth
    The post-conflict setting
    Methodology and Methods
    Key Institutional Ethnography definitions: Institutions, participants, and work
    Data collection
    Positioning myself as researcher
    Theorizing methods
    Outline

    Chapter Two: Ongoing Social Distress: Care-seeking in a Remote Post-Conflict Context
    Introduction
    Overview of the Conflict in Northern Uganda
    Ongoing Social and Economic Impacts of the War
    Abduction, health and community membership
    The internally displaced persons (IDP) camps
    Ongoing Social Distress: Land Conflicts and Disease Epidemics
    The outbreak of disease
    Agriculture
    Land disputes
    Poverty and lack of infrastructure
    Impacts on study participants
    Conclusion
    Map of Uganda

    Chapter Three: Pregnancy and Daily Life: Health System and Home Factors Shaping Care
    Introduction
    Focused (Goal-Oriented) Antenatal Care (ANC)
    The Message to Attend ANC
    The Provision of Mama Kits
    Formal Health Care Providers
    The setting for formal health care provision
    Clinical officers
    Midwives
    Enrolled comprehensive nurses, registered nurses, nursing assistants, and nurse aides
    Informal Health Care Providers
    Traditional birth attendants (TBAs)
    The village health team (VHT)
    Transportation, Nutrition, and Work
    Transportation
    Lack of capacity to provide care at sub-county health centres
    Nutrition and work

    Chapter Four: Charity and Control: When Help Requires Compliance
    Introduction
    A Reward for Care or a Gift to the Vulnerable? Divergent Ideas the Mama Kit’s Role
    The mama kit as creating and rewarding compliance with ANC
    The mama kits as an incentive or reward for health centre delivery
    The mama kits as supporting and signaling ‘vulnerable’ women
    The mama kits as a gift or charity
    Registration and Distribution of Mama Kits
    Health Centre Staff and Administrators on the Mama Kits’ Role: Helping the Vulnerable, or Motivating Care-seeking?
    “In our setting, who is the most poor?” Perceptions of vulnerability as a distribution criteria
    Health centre staff on the mama kit: ‘Motivating’ women to deliver at a health facility
    The Goals of the Uganda Red Cross
    NGO - Health Centre Partnerships: Problems with Withdrawal and Shortages
    Unpredictable Distribution Affects how Women Perceive Formal Care and Health Workers
    Conclusion

    Chapter Five: Vertical Health: Failures of Compulsory Couples HIV Testing
    Introduction
    Background: Prevalence, Policies, and Practice
    Women’s experiences of male reluctance
    Health Worker Perspectives on Couples HIV Testing During ANC
    Health Worker Strategies for Couples Testing in the Face of Male Reluctance
    “Without a Man We are Not Going to Give you a Card”: Male Refusal as a Barrier to Women’s Care
    Gender, Couples Testing, and Vertical Health
    Gender and Intersectional Power Relationships
    Conclusion

    Chapter Six: Conclusions: Reconceiving the Maternal Health Crisis
    Introduction
    Global goals, Local lives
    Discourses governing care: Choice, tradition and culture
    Limitations
    Conclusion
    References

Related Titles