Global guidelines setting the agenda in local health systems: The case of mother-to-child transmission of HIV

Abstract:
There is a growing body of policy and implementation documents operating on the global health arena which define problems and identify solutions with wide-ranging implications for national health systems and for individual health care seekers. Dorothy Smith (2001) describes how such  ‘global documents’ are constructed through processes of consensus building which suppress divergent perspectives and produce texts that appear as shared and create common ground. From a particular text or document produced at ‘global level’ one may trace sequences of action locally. The paper reflects upon the WHO HIV and infant feeding guidelines as an example of a global policy text that enters into local health care and social settings and mediates, regulates and authorizes people’s practices.  The guidelines are part of the global PMTCT (prevention of mother-to-child transmission) package which can be seen as ‘assemblages of science and technology that circulate globally’ and that interact with local institutions and local moral worlds (Janes and Corbett 2009: 167). HIV transmission through pregnancy, birth, and breastfeeding has been one of the most pressing and ethically sensitive public health issues in global health during the last decades, and the disturbing history of the global PMTCT guidelines seems to speak in a particularly intriguing manner to the increasingly voluminous literature on the dynamics of global guideline and policy production in health. The paper draws upon material collected during the last decade, primarily from Tanzania and Ethiopia.

Janes, C. R., & Corbett, K. K. (2009). Anthropology and global health. Annual Review of Anthropology, 38, 167-183.

Smith, D. E. (2001). Texts and the ontology of organizations and institutions. Studies in Cultures, Organizations and Societies, 7(2), 159-198.

Bionote:
Astrid Blystad is Professor at the Department of Global Public Health and Primary Care / Centre for International Health, University of Bergen (UoB). She has been engaged in research in East Africa for 25 years, including three years of fieldwork in Tanzania. She has published extensively at the interface between reproductive health, policy and gender. Blystad is head of the research group ‘Global Health Anthropology’, Faculty of Medicine and Dentistry, UoB, and has been the coordinator for a number of externally funded research- and competence building projects in East Africa. She was a visiting Professor at the Department of Anthropology, Yale University, 2012-13.

Venue: The Department of Social Anthropology's seminar room, 8th floor, Fosswinckelsgt. 6.

All interested are welcome to all the seminars!

For the spring of 2014 the BSAS series is organized by Bjørn Enge Bertelsen. For further information, please contact Bjorn.Bertelsen@sosantr.uib.no .