The power to set agendas, priorities, and approaches lies largely in the hands of external donors, removing African governments from policy making in areas concerning the health-care needs of their citizens.
Africa has emerged as a prime arena of global health interventions that focus on particular diseases and health emergencies. These are framed increasingly in terms of international concerns about security, human rights, and humanitarian crisis. This presents a stark contrast to the 1960s and '70s, when many newly independent African governments pursued the vision of public health "for all," of comprehensive health care services directed by the state with support from foreign donors. These initiatives often failed, undermined by international politics, structural adjustment, and neoliberal po
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AbstractAcross East Africa, mobile phones and tablets are increasingly sitting in the hands of community health workers, clinicians, managers and patients. They are being used for a widening range of functions from diagnostics to health insurance to treatment advice, generating hopes for new healthcare futures and establishing the region as an emerging hub of experimentation in digital health. Drawing on our on‐going ethnographic and anthropological research in Kenya and Tanzania, this article explores the dynamic, varied, experimental, and increasingly financialised terrain of formal digital health projects. While innovation in digital health is a growing feature of healthcare across the globe, in East Africa it is entering into a region already long characterised by NGOised, fragmented and vertical healthcare systems and heavy dependence on foreign capital. This presents challenges to efforts, including the WHO's Universal Health Coverage agenda, to foster national and equitable public healthcare systems. In exploring these issues, we recognise the power, and often deleterious effects, of financial capital that foregrounds markets in global digital health, but we also open space for a (still critical) recognition of East African‐led digital and data technology movements.
This paper examines a sequence of investigations in parasitology, botany, pharmacology, psychometrics and ethnopsychology focused on Kenyan village children's knowledge of medicinal herbs. We follow this work of making and ordering of knowledge, showing that the different disciplinary perspectives on bodies, medicines, knowledges, children and cultures produced by this research all sought the foundation of knowledge in reference to objective reality, and that they aimed to make the world known in the specific form of distinct and comparable entities with individual properties and capacities. Based on subsequent ethnographic observations of healing in the same village, we outline a different, contrasting modality of knowing, which places ontology above epistemology. Medicinal knowledge and its transformational capacity are here not located within entities but between them; not in objective reality but in effects; `to know' means `to come together' with the implication of having an effect on one another. We use this ethnographic sketch of a different form of knowing as a foil against which to contrast the imaginary that had shaped our previous research. Beyond the stark contrast between herbal village healing and pharmacological laboratory analysis, we expand our argument by moving from natural science to social science, from studies of plants and substances to those of humans, minds and cultures; from laboratories to ethno-psychological tests, cultural models, and eventually econometrics. We suggest that by reiterating a particular scientific imaginary, remaking humans (and non-human beings) as known things, a specific notion of man and a related political economy of knowledge is naturalized. Looking back at our involvement with this sequence of research, we realize that, contrary to our intentions, our inclusion as `social scientists' into a multidisciplinary scientific project may have exacerbated rather than mitigated its potentially problematic effects.
The HIV/AIDS epidemic in sub-Saharan Africa has been addressed and perceived predominantly through the broad perspectives of social and economic theories as well as public health and development discourses. This volume however, focuses on the micro-politics of illness, treatment and death in order to offer innovative insights into the complex processes that shape individual and community responses to AIDS. The contributions describe the dilemmas that families, communities and health professionals face and shed new light on the transformation of social and moral orders in African societies, which have been increasingly marginalised in the context of global modernity
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