This research explored the reasonsfor women’s preferences for cesarean sectionbirths in Pelotas, Brazil. It is argued thatwomen strategize and appropriate both medicalknowledge and the technology of cesareansections as a creative form of responding tolarger public debates (and the practices thatproduced them) on the need for and causes of(de)medicalization. Questioning the reasons whysome women engage more actively in this processthan others elucidates the ways local forms ofpower engage gender, economic and medicalideologies. The current debate on why somewomen prefer c-section deliveries, or indeed ifthey really do at all, has diverted attentionfrom the utility of the technology itself. Thispaper argues that for some women, the effort tomedicalize the birth process represents apractical solution to problems found within themedical system itself. I end by exploring thesocio-biological conditions that have produceda need for the technology.
Format: Journal
Will increased funding for neglected tropical diseases really make poverty history?
On Jan 21, 2012, the UK’s Department for International Development announced a fivefold increase in its support for programmes to control neglected tropical diseases (NTDs). The Department’s press release claimed that the new funding will initially provide 400 million treatments to protect 100 million people from lymphatic filariasis, and to help save 10 million lives that would otherwise be lost to schistosomiasis. Onchocerciasis and dracunculiasis are also to be targeted. Last week, Bill Gates came to London to help renew and expand global commitments.
Self-care and the informal sale of drugs in south Cameroon
Self-care, though the most common of all forms of therapeutic action, has been little studied. This paper describes the context of self-medication with western pharmaceuticals in an area of South Cameroon (in 1980). The identity and appropriateness of these pharmaceuticals are briefly discussed. The paradoxical character of self-medication is emphasised: improvement in the quality of self-medication implies both growth and loss of self reliance, increase and decrease of medicalisation. People in Cameroon, or indeed anywhere in the Third World, find themselves in a ‘double-bind’.
The efficiency of inefficiency
An attempt is made to explain why public health services in South Cameroon function inefficiently. Special attention is given to the distribution of medicines. The root cause of inefficiency is believed to be ‘corruption’, the private use of public goods. It is suggested that some degree of commercialization may solve the present problems and replace the ‘expensive free distribution’ of medicines by a paid distribution of cheap medicines. The research for this article was carried out in 1980 in South Cameroon.
Fast Relief
The experience of time famine in contemporary U.S. culture affects household decisions about self‐care and the use of pharmaceuticals for selfmedication. This article examines the manner in which time demands shape lay interpretations of medicine efficacy and drive increases in medication use for adults as well as children. Medicines, like other time‐saving commodities, appear to shift the time‐power differential in favor of individuals, placing them in control of how time is spent. When there is “no time to be sick,”allopathic medicines become time‐saving devices that enable women to fulfill responsibilities at work or home while they attend to sick children or to being ill themselves. Medicines are used to beat the clock by increasing one’s own capacity to be productive, [self‐medication, domestic health care, United States, time]
The Opacity of Reduction
This article explores the process of consolidating technical and historically contingent ideas about nourishment into seemingly straightforward terms such as vitamins and minerals. I study the adoption of scientific principles of abstraction and reduction as a strategy of nutrition education in three Guatemalan highland sites: an elementary school classroom, a rural clinic, and the obesity outpatient center of Guatemala’s third-largest public hospital. I show that despite its pretense of simplicity, the reductionism of nutritional black-boxing produces confusion. Moreover, dietary education not dependent upon simplified and fixed rules and standards may be more intelligible to people seeking nourishment in their lives.
Negotiating Relevance
What is the relationship between knowledge and practice in research on health, disease and illness? Yoder explains how the majority of public health intervention and communication projects we encounter today are based on social psychology models of behaviour change that assume that changes in beliefs and knowledge precede behavioural changes. This has been the dominant model in health research and intervention in the developing world, informing our approach to almost all critical issues in public health for over fifty years, including HIV/AIDS prevention, improving vaccination rates, breastfeeding, the use of oral rehydration salts, and bed nets to prevent malaria, and today antimicrobial resistance (AMR), among others. Yoder explains that this model of behaviour change is attractive because of the promises they make: “they claim the ability to predict behaviour change from cognitive elements, and scales have been developed to measure these cognitive elements, and they offer ways to intervene through health education” (134).
But does it work? What Yoder explains – based on extensive research and review – is that projects that take this behaviour change model often do not see relevant behaviour changes within the populations intervened upon because 1) This model overemphasizes the role of the individual in maintaining good health; 2) The model claims universality but is mainly based on behavioural models of middle-class Americans; and 3) While the role of social and ecological determinants of health are seen as barriers to ‘good behaviours’, these factors receive comparatively little consideration in behavioural explanation and modelling.
