The publics of public health in Africa.
The publics of public health in Africa.
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DOI：
10.1080/09581596.2016.1254178
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发表时间：
2017-01-01
影响因子：
2.8
通讯作者：
Montgomery CM
中科院分区：
文献类型：
--
作者：
Kelly AH;MacGregor H;Montgomery CM
我们如何理解当代非洲公共卫生的公共性质？社区参与保健服务、医学研究和疾病控制方案的参数是什么？非洲的公共卫生在多大程度上是由非洲各国政府领导的项目？非洲公众可以通过何种政治进程和审议做法来影响卫生科学研究的优先事项和旨在改善这些公众健康的广泛干预措施？从与非洲科学家，护士，社区成员，临床试验和政策制定者进行的实证研究中汲取见解，这一特殊部分探讨了公众在撒哈拉以南非洲的公共卫生供应和调查中形成的多种方式，其作用和政治影响力。总的来说，这些论文表明，围绕公众是谁以及公众意味着什么的不同想法的争论和谈判如何导致相互冲突的理解的出现，对谁和什么被视为代表公共利益以及接受研究和其他干预措施产生影响。公众参与的民主潜力长期以来一直是发展经济学、道德哲学、媒体研究和政治学关注的问题。最近，让公众参与决策过程的任务已经成为科学和技术专业知识的一个突出问题：当代科学政策强调将公众观点纳入对研究目标和成果的评估中（例如Jasanoff，2010; Stilgoe，Lock，& Wilsdon，2014）。然而，应该纳入哪些人的观点，如何考虑这些观点，以及为了什么目的，这些都是长期引发政策辩论的问题。近年来，社会科学家开始研究欧洲和非洲以外地区以及特定地区之间的科学与社会之间的相互作用（Craddock，Giles-Vernick，&古恩，2010;蒙哥马利，2012）。寻求接地的政治概念，如“公民”，“公共利益”和“代表”在他们不同的地理和历史，学者们指出，围绕健康问题和干预措施形成的社会团结（如凯利和Lezaun，2014;利奇，斯库恩斯，和韦恩，2005;麦格雷戈，2009）。一方面，这些新兴的公众似乎为政府、科学和公民之间的关系提供了一种新的模式，这种模式跨越了地方和全球的鸿沟（Robins & Lieres，2004年），外国捐助者的倾向，全球卫生专业人员和活动家组织将新兴社区视为民主的中心，这可能会削弱国家主权，并与殖民统治和独立后的独裁统治（如Kamat，2004; Lachenal，2011; Nguyen，2010）。此外，随着全球卫生援助的增加，在非洲环境中迅速发展起来的社区组织和非政府组织将自己推销为接近“地方”利益并为这些利益发声，捐助者将“社区”作为纵向干预措施的适当目标，加强了这种宣传（Edstrom和MacGregor，2010年）。
How do we understand the public character of public health in contemporary Africa? What are the parameters of community engagement in health care delivery, medical research and disease control programmes? To what extent is public health in Africa a project led by African Governments? Through what political processes and deliberative practices can African publics influence the priorities of research in health sciences and interventions which aim in broad terms to improve the health of such publics? Drawing insight from empirical research conducted with African scientists, nurses, community members, clinical trialists and policy-makers, this special section examines the multiple ways in which the public comes into being around public health provisioning and investigation in sub-Saharan Africa, its role and political reach. Collectively, these papers show how contestation and negotiation around different ideas about who the public is and what being public means can lead to the emergence of conflicting understandings, with implications for who and what is seen to represent the public interest, and for the acceptance of research and other interventions. The democratic potential of public participation has been a concern of development economics, moral philosophy, media studies and political science for quite some time. More recently, the task of enrolling the public in decision-making processes has become a salient issue for scientific and technological expertise: contemporary science policy emphasises the integration of public views into the assessment of research aims and outcomes (eg Jasanoff, 2010; Stilgoe, Lock, & Wilsdon, 2014). However, whose views should be included, how they are to be taken into account and to what end, are questions that perennially generate policy debate.In recent years, social scientists have begun to investigate interactions between science and society beyond and between specific European and African locations (Craddock, Giles-Vernick, & Gunn, 2010; Montgomery, 2012). Seeking to ground political concepts such as ‘citizenship’,‘public good’and ‘representation’in their diverse geographies and histories, scholars have pointed to the social solidarities that form around health issues and interventions (eg Kelly & Lezaun, 2014; Leach, Scoones, & Wynne, 2005; MacGregor, 2009). While on the one hand, these emergent publics seem to promise a new model for the relationship between government, science and citizen that cross cuts the localglobal divide (Robins & Lieres, 2004), the tendency of foreign donors, global health professionals and activist organisations to regard emergent communities as the locus of democracy potentially undercuts national sovereignty and suggests unsettling parallels with both colonial rule and post-independence autocracy (eg Kamat, 2004; Lachenal, 2011; Nguyen, 2010). Furthermore, community-based organisations and NGOs, which proliferated in African settings in response to increases in global assistance for health, have marketed themselves as close to ‘local’interests and giving voice to these, reinforced by donor constructions of the ‘community’as an appropriate target for vertical interventions (Edstrom & MacGregor, 2010).