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1. 'Not in it for huge profits but because it's right': The contested moral economies of UK–India exports in health worker education and training.

Author

Merz, Sibille, Hunter, Benjamin, Bisht, Ramila, and Murray, Susan Fairley

Subjects
INTERNATIONAL relations -- Law & legislation, TEACHING, ETHICS, BUSINESS management of health facilities, SCHOLARLY method, RESEARCH methodology, STAKEHOLDER analysis, MEDICAL care, INTERVIEWING, PUBLIC administration, MARKETING, SOCIAL sciences, QUALITATIVE research, NATIONAL health services, CONCEPTUAL structures, SOCIOECONOMIC factors, INTERPROFESSIONAL relations, DESCRIPTIVE statistics, RESEARCH funding, SOCIAL skills, EMPIRICAL research
Abstract

While the growth of global markets in health‐related services may have significant consequences for healthcare provisioning and training, it has received relatively little attention from the social sciences. This article examines UK–India, and specifically England–India, exports in health worker education and training as one such global market, drawing on sociological scholarship on moral economies to understand how trading in this field is constructed and legitimated by the individuals and organisations involved, what tensions evolve, and what is at stake in them. We employ a qualitative mixed methods approach using publicly available materials on existing UK–India collaborations and primary data from interviews with key stakeholders in India and the UK, including government departments, arms‐length bodies, NHS Trusts, trade associations and private providers. Our analysis illustrates the key discursive strategies used to legitimate engagement in these markets, and the complex and contested moral economies unfolding between and across these stakeholders and contexts. Not least, we demonstrate the conflicting moral sentiments and the boundary work required to realise commodification. Situating cross‐border trade in health worker education and training in a moral economy framework thus illuminates the social context and moral worlds in which this evolving trade is embedded. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Action to protect the independence and integrity of global health research

Author

Storeng, Katerini T., Abimbola, Seye, Balabanova, Dina, Mccoy, David, Ridde, Valery, Filippi, Veronique, Roalkvam, Sidsel, Akello, Grace, Parker, Melissa, Palmer, Jennifer, Abejirinde, Ibukun, Adebiyi, Babatope, Affun-Adegbulu, Clara, Ahlgren, Jhon Alvarez, Ahmad, Ayesha, Al-Awlaqi, Sameh, Aloys, Zongo, Amul, Gianna Gayle, Arthur, Joshua, Asaduzzaman, Muhammad, Asgedom, Akeza Awealom, Assarag, Bouchra, Atchessi, Nicole, Atkins, Salla, Badejo, Okikiolu, Baeroe, Kristine, Molleh, Bailah, Bazzano, Alessandra, Behague, Dominique P., Beisel, Uli, Belaid, Loubna, Bernays, Sarah, Bhuiyan, Shafi, Biermann, Olivia, Birungi, Harriet, Blanchet, Karl, Blystad, Astrid, Bodson, Oriane, Bonnet, Emmanuel, Bose, Shibaji, Bozorgmehr, Kayvan, Brear, Michelle, Burgess, Rochelle, Byskov, Jens, Carillon, Severine, Cavallaro, Francesca L., Chabeda, Sophie, Chandler, Clare, Chapman, Rachel, Chikuse, Francis F., Chinwe, Juliana Iwu, Cislaghi, Beniamino, Closser, Svea, Colvin, Christopher J., Cresswell, Jenny, da Cunha Saddi, Fabiana, Daire, Judith, Dalglish, Sarah, de Brouwere, Vincent, de Sardan, Jean-Pierre Olivier, Delvaux, Therese, Desgrees du Lou, Annabel, Diallo, Brahima A., Diarra, Aissa, Dixon, Justin, Doherty, Tanya, Dumont, Alexandre, Eboreime, Ejemai, Engelbrecht, Beth, Erikson, Susan, Faye, Adama, Fischer, Sara, Fournet, Florence, Fox, Ashley M., Francis, Joel Msafiri, Gautier, Lara, George, Asha, Gilson, Lucy, Gimbel, Sarah, Glenn, Jeff, Gopinathan, Unni, Gordeev, Vladimir S., Gradmann, Christoph, Graham, Janice E., Gram, Lu, Greco, Giulia, Grepin, Karen, Guichard, Anne, Gupta, Pragya Tiwari, Guzman, Viveka, Haaland, Marte E. S., Haggblom, Anna, Hagopian, Amy, Hammarberg, Karin, Handschumacher, Pascal, Hann, Katrina, Hasselberg, Marie, Hawkes, Sarah, Howard, Natasha, Hurtig, Anna-Karin, Hussain, Sameera, Hutchinson, Eleanor, Idoteyin, Ezirim, Infanti, Jennifer J., Irwin, Rachel, Islam, Shariful, Joarder, Taufique, John, Preethi, Johnson, Ermel, Johri, Mira, Justice, Judith, Kabore, Charles, Kadio, Kadidiatou, Kamwa, Matthieu, Kelly, Ann H., Kenworthy, Nora, Kittelsen, Sonja, Kloster, Maren Olene, Kocsis, Emily, Koon, Adam, Kumar, Pratap, Lal, Arush, Lange, Isabelle, Lanthorn, Heather, Lees, Shelley, Lexchin, Joel, Lie, Ann Louise, Limenih, Gojjam, Litwin-Davies, Isabel, Lodda, Charles Clarke, Lonnroth, Knut, Manton, John, Manzi, Anatole, Manzoor, Mehr, Marchal, Bruno, Marten, Robert, Matsui, Mitsuaki, Mbewe, Allan, Mc Sween-Cadieux, Esther, McGoey, Linsey, McNeill, Desmond, Mendenhall, Emily, Mendez, Claudio A., Mirzoev, Tolib, Mohammed, Shafiu, Moland, Karen Marie, Molyneux, Sassy, Mumtaz, Zubia, Murray, Susan Fairley, Nambiar, Devaki, Nelson, Erica, Nieto-Sanchez, Claudia, Norheim, Ole Frithjof, Nouvet, Elysee, Obare, Francis, Okungu, Vincent, Onarheim, Kristine Husoy, Ostebo, Marit Tolo, Ouattara, Fatoumata, Ozawa, Sachiko, Pai, Madhukar, Paina, Ligia, Parashar, Rakesh, Paul, Elisabeth, Peeters, Koen, Pennetier, Cedric, Penn-Kekana, Loveday, Peters, David, Pfeiffer, James, Pot, Hanneke, Prashanth, N. S., Preston, Robyn, Puyvallee, Antoine de Bengy, Rahmalia, Annisa, Reid-Henry, Simon, Rodriguez, Daniela C., Ronse, Maya, Sacks, Emma, Samb, Oumar Malle, Sanders, David, Sarkar, Nandini, Sarriot, Eric, Scheel, Inger Brummenaes, Schwarz, Thomas, Scott, Kerry, Seeley, Janet, Seward, Nadine, Shannon, Geordan, Shearer, Jessica, Shelley, Katharine, Sherr, Kenneth, Shiffman, Jeremey, Simard, Frederic, Singh, Neha S., Soors, Werner, Springer, Rusla Anne, Strong, Adrienne, Sundby, Johanne, Taylor, Stephen, Tetui, Moses, Topp, Stephanie M., Tsofa, Benjamin, Turcotte-Tremblay, Anne-Marie, Undie, Chi-Chi, Van Belle, Sara, Van Heteren, Godelieve, van Rensburg, Andre Janse, Sriram, Veena, Venkatapuram, Sridhar, Wagenaar, Bradley H., Wallace, Lauren, Walugembe, David R., Wariri, Oghenebrume, Whiteside, Alan O. B. E., Yakob, Bereket, Zakayo, Scholastica, Zitti, Tony, Zwi, Anthony, Centre population et développement (CEPED - UMR_D 196), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), and Signatories

Subjects
Project commissioning, media_common.quotation_subject, environmental health, Commission, Public administration, 03 medical and health sciences, Politics, 0302 clinical medicine, Political science, Agency (sociology), Global health, 030212 general & internal medicine, media_common, 030503 health policy & services, Health Policy, Public Health, Environmental and Occupational Health, Censorship, 16. Peace & justice, 3. Good health, Negotiation, Editorial, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Human medicine, 0305 other medical science, International development
Abstract

In a recent Viewpoint in the Lancet , some of us shared our experience of censorship in donor-funded evaluation research and warned about a potential trend in which donors and their implementing partners use ethical and methodological arguments to undermine research.1 Reactions to the Viewpoint—and lively debate at the 2018 Global Symposium on Health Systems Research —suggest that similar experiences are common in implementation and policy research commissioned by international donors to study and evaluate large-scale, donor-funded health interventions and programmes, which are primarily implemented in low resource settings. ‘We all have the same stories’, was one of the first comments on the Viewpoint, followed by many private messages divulging instances of personal and institutional pressure, intimidation and censorship following attempts to disseminate unwanted findings. Such pressure comes from major donors and from international non-governmental organisations (NGOs) obliged to have an external assessment but who then maintain a high degree of confidentiality and control. That such experiences are widespread reflects the deeply political nature of the field of ‘global health’ and the interconnections between priority setting, policy making and project implementation, which sit within a broader set of deeply entrenched power structures.2 3 Researchers in this field routinely find themselves working within—and studying—complex power relations and so experience challenges in negotiating their own position between interests of commissioning agencies and funders, implementers and country governments, as well as those of their own research institutions and their partnerships with other researchers spanning high-income, middle-income and low-income countries.4–7 They often receive research funding from major donor agencies like the UK Department of International Development (DFID), the US Agency for International Development (USAID), the Agence Francaise de Developpement (AFD), UNITAID and the Bill and Melinda Gates Foundation,8 who commission evaluations for their own funded projects, even though they have …

Published
2018

6. Cost of abortions in Zambia: A comparison of safe abortion and post abortion care.

Author

Parmar, Divya, Leone, Tiziana, Coast, Ernestina, Murray, Susan Fairley, Hukin, Eleanor, and Vwalika, Bellington

Subjects
ABORTION, ACADEMIC medical centers, INTERVIEWING, MEDICAL care costs, MATERNAL mortality, PATIENT safety, POSTOPERATIVE care, RESEARCH funding, ECONOMICS
Abstract

Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion. [ABSTRACT FROM PUBLISHER]

Published
2017
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7. Understanding health policy change in post-dictatorship Chile (2000-2006) : an Advocacy Coalition Framework analysis

Author

Piffre, Oriana, Baeza, Juan, and Murray, Susan Fairley

Subjects
362.10983
Abstract

This thesis examines the political process of the health reforms enacted in Chile during the Presidency of Ricardo Lagos (2000-2006). The Advocacy Coalition Framework (ACF) is used to answer the question: How were the health reforms during the Lagos administration of 2000-6 achieved within the existing institutional arrangements that were put in place during the authoritarian period? As emphasised by the historical institutionalist literature, Chilean politics, since the return to democracy, has been characterised by inertia and limited transformation. My research seeks to understand how it was possible to bring about policy change in a context in which everything seemed fixed. The contribution of this thesis is twofold: first, examining the health policy reform through the lens of the ACF, this study contributes to expand the theoretical development of this framework. Second, this study contributes to enrich the existent literature about the Chilean case, analysing original data to identify the factors that enable policy change. Focusing on explanations for policy change suggested by the ACF, the findings suggest that health reform was achieved through a path of negotiated agreement. This agreement was facilitated by three main factors: an evolution of coalitions, the strategic mobilisation of resources, and the institutional arrangements inherited from the authoritarian regime. Using a qualitative case study, informed by the international health policy literature, and using the ACF as a theoretical framework, the Chilean case is scrutinised. Evidence was gathered through an appraisal of data collected from a variety of documentary sources, as well as the thematic analysis of transcriptions of congressional hearings and 26 semi-structured elite interviews. Applying ACF allowed me to identify and understand the dynamics of the Chilean health reforms, by examining how actors grouped into coalitions, shared belief systems, and acted strategically to determine the outcome of the reforms.

Published
2016

8. A qualitative study of emergency nurses' experiences of working in a reconfigure major trauma system

Author

Jarman, Heather, Murray, Susan Fairley, and Barriball, Kim Louise

Subjects
362.1
Abstract

This study explores the experiences of emergency nurses working in a new Major Trauma Centre in the UK National Health Service, and how reconfiguration of trauma services has affected perceptions and working practices. Methods: Drawing on the principles of focused ethnography, fieldwork was conducted over 5 months in the Emergency Department (ED) of a newly designated Major Trauma Centre in London. It comprised approximately 53 hours of participant observation, and conversations and semi-structured interviews with 31 nurses. Qualitative thematic analysis was conducted of fieldnotes and interview data. Results: The findings reveal a complex picture of the experiences of emergency nurses within the Major Trauma Centre, with interrelated themes emerging. The first gives an account of how major trauma work has led to a perceived increase in the status and profile of the ED. The second theme explores the draw of trauma and how it is viewed as an exciting component of the nurses‘ work. The third looks at the idea of the „decent‟ trauma patient, examining the hierarchy of interest within trauma work, and the final theme explores ED nurses‘ accounts of their task-orientated roles in looking after trauma patients. Conclusion: The study shows how the value placed on the high profile ‗specialist‘ major trauma work pervades the culture of the department and how the protocol-driven nature of this work fits the immediate patient needs but minimises the ability of nurses to negotiate their professional boundaries in a way they are able to in other areas of their practice. Thus major trauma work is an outwardly exciting but ultimately unsatisfying aspect of the ED nurses‘ work. More importantly, the collectively accepted notion of the major trauma patient as the one with technically demanding complex injuries that can only be catered for by a ―Centre of Excellence‖, risks undermining the value placed on the care of other patients in the ED.

Published
2014

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