When Diabetes Confronts HIV: Biological Sub-citizenship at a Public Hospital in Nairobi, Kenya.

When Diabetes Confronts HIV: Biological Sub-citizenship at a Public Hospital in Nairobi, Kenya.
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DOI:
10.1111/maq.12476
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发表时间:
2018-12
影响因子:
2.2
通讯作者:
Ndetei D
Ndetei D
中科院分区:
法学3区
文献类型:
--
作者:
Bosire E;Mendenhall E;Omondi GB;Ndetei D

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本文探讨了国际捐助政策如何培养一种形式的生物亚公民的糖尿病患者在肯尼亚。我们在内罗毕的一家公立医院诊所采访了100名患者,其中一半被诊断为糖尿病。我们专注于三个小插曲,说明我们的研究参与者如何不同地感知和体验与其他疾病相比,糖尿病的生活和寻求治疗和护理,特别关注艾滋病毒。我们认为,生物亚公民身份,艾滋病毒感染者有一致和全面的免费医疗服务,糖尿病患者必须自掏腰包进行检测和治疗,阻碍了糖尿病检测和治疗。一旦确诊,许多人由于自己无力支付而被系统地排除在医疗保健系统之外。我们认为,从国际捐助资金的系统性排斥创造了一种形式的生物亚公民的基础上,新自由主义的经济政策,破坏其他公共卫生保护,如全民初级卫生保健。
This article investigates how international donor policies cultivate a form of biological sub-citizenship for those with diabetes in Kenya. We interviewed 100 patients at a public hospital clinic in Nairobi, half with a diabetes diagnosis. We focus on three vignettes that illustrate how our study participants differentially perceived and experienced living with and seeking treatment and care for diabetes compared to other conditions, with a special focus on HIV. We argue that biological sub-citizenship, where those with HIV have consistent and comprehensive free medical care and those with diabetes must pay out-of-pocket for testing and treatment, impedes diabetes testing and treatment. Once diagnosed, many are then systematically excluded from the health care system due to their own inability to pay. We argue that the systematic exclusion from international donor money creates a form of biological sub-citizenship based on neoliberal economic policies that undermine other public health protections, such as universal primary health care.
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