Doctoral Dissertation Research: An Institutional Ethnography of the Social Dynamics of a Bureaucracy in Historical Context

博士论文研究:历史背景下官僚社会动态的制度民族志

基本信息

  • 批准号:
    1459486
  • 负责人:
  • 金额:
    $ 0.45万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
    Standard Grant
  • 财政年份:
    2015
  • 资助国家:
    美国
  • 起止时间:
    2015-02-15 至 2016-05-31
  • 项目状态:
    已结题

项目摘要

All institutions display social and bureaucratic dynamics that affect how the institutions function. In the United States, health care provisioning institutions are particularly important because they comprise the majority of care facilities for the American public. The goal of the research funded by this award is to identify organizational factors that affect health care provisioning outcomes but are not necessarily directly related to technical expertise. The research will be undertaken by Adrienne Strong, a doctoral student at Washington University St. Louis, who works under the guidance of medical anthropologist, Dr. Carolyn Sargent. Strong has chosen to focus on the bureaucratic, institutional, and social dynamics that contribute to maternal deaths in biomedical care settings, because this is an area where the United States is known to lag behind other Western nations. She will conduct the research as an in-depth institutional ethnography of a hospital in the Rukwa region of Tanzania. Because the region has high rates of maternal mortality, the links between outcomes on the one hand and institutional structures and processes on the other will be easier to identify than they would in the United States where a single institution would provide too few events to study. In addition, understanding the social and bureaucratic dynamics of health care facilities in Africa is important for being able to stem the rising tide of globally significant infectious disease epidemics.Strong will collect data on sequences of events at the hospital, and on historical, institutional, and political economic structures that shape maternal risk. She will employ a variety of qualitative research methods, including in-depth interviews with government officials, health administrators, nurses and doctors, traditional birth attendants, and pregnant women and their families. She also will observe at the hospital; hold group discussions with women and community leaders; and conduct a work empowerment survey of health care providers. She will concentrate on four topics: 1) How institutional factors and strategies of health care providers shape obstetric emergencies; 2) Sequences of events preceding a woman's arrival at the hospital during an obstetric emergency; 3) How life events, social relations, and other community factors influence maternal health; and 4) Connections between historical processes and the current functioning of the health care system. Similar methods can be used in the United States to identify new sites for intervention to interrupt the pathway to maternal death once the underlying processes are identified. Strong's data will allow her to analyze communication (among medical professionals, between staff and patients, between women and their families or communities); health care provider morale and motivation; and administrator strategies and goals. Understanding these factors will complement the extensive previous research on the clinical and community causes of maternal death. This will contribute to social scientific understanding of the workings of bureaucratic institutions in general as well as low-cost solutions for improving health care in particular. Public health policies everywhere encourage women to give birth in biomedical care facilities. Strong's research will generate novel insight into the sequences of events leading to deaths in these settings from the unique perspectives of the providers, administrators, patients, and their communities. Understanding the social and organizational workings of health care institutions will help to develop avenues for improving their quality and efficiency.
所有机构都显示出影响机构运作的社会和官僚动态。在美国,医疗保健提供机构特别重要,因为它们构成了美国公众的大部分医疗设施。该奖项资助的研究的目标是确定影响医疗保健提供结果的组织因素,但不一定与技术专长直接相关。这项研究将由华盛顿大学圣路易斯分校的博士生阿德里安娜·斯特朗承担,她在医学人类学家卡罗琳·萨金特博士的指导下工作。斯特朗选择关注导致生物医学护理环境中孕产妇死亡的官僚、机构和社会动态,因为这是美国落后于其他西方国家的一个领域。她将在坦桑尼亚的鲁夸河地区的一家医院进行深入的机构民族志研究。由于该区域的孕产妇死亡率很高,与美国相比,更容易确定结果与体制结构和进程之间的联系,因为美国的单一机构提供的活动太少,无法进行研究。此外,了解非洲卫生保健设施的社会和官僚动态对于能够阻止全球重大传染病流行的上升趋势非常重要。斯特朗将收集医院事件序列以及形成孕产妇风险的历史,制度和政治经济结构的数据。她将采用各种定性研究方法,包括深入采访政府官员,卫生管理人员,护士和医生,传统助产士,孕妇及其家人。她还将在医院观察;与妇女和社区领袖举行小组讨论;并对医疗保健提供者进行工作授权调查。她将集中在四个主题:1)体制因素和战略的卫生保健提供者如何塑造产科急诊; 2)事件的顺序之前,一个女人的到达医院在产科急诊; 3)生活事件,社会关系和其他社区因素如何影响产妇健康;和4)历史进程和当前的卫生保健系统的运作之间的联系。在美国,可以使用类似的方法来确定新的干预地点,一旦确定了潜在的过程,就可以中断孕产妇死亡的途径。斯特朗的数据将使她能够分析沟通(医疗专业人员之间,工作人员与患者之间,妇女与其家庭或社区之间);医疗保健提供者的士气和动机;以及管理者的策略和目标。了解这些因素将补充以前对孕产妇死亡的临床和社区原因的广泛研究。这将有助于从社会科学的角度理解官僚机构的运作,特别是改善医疗保健的低成本解决方案。各地的公共卫生政策鼓励妇女在生物医学护理设施中分娩。斯特朗的研究将从提供者、管理者、患者及其社区的独特视角,对这些环境中导致死亡的事件序列产生新的见解。了解卫生保健机构的社会和组织运作将有助于开发提高其质量和效率的途径。

项目成果

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Carolyn Sargent其他文献

Disease, Risk, and Contagion: French Colonial and Postcolonial Constructions of “African” Bodies
  • DOI:
    10.1007/s11673-014-9578-4
  • 发表时间:
    2014-10-08
  • 期刊:
  • 影响因子:
    1.500
  • 作者:
    Carolyn Sargent;Stéphanie Larchanché
  • 通讯作者:
    Stéphanie Larchanché
Austerity and its implications for immigrant health in France
  • DOI:
    10.1016/j.socscimed.2017.05.007
  • 发表时间:
    2017-08-01
  • 期刊:
  • 影响因子:
  • 作者:
    Carolyn Sargent;Laurence Kotobi
  • 通讯作者:
    Laurence Kotobi
Morgan Clarke, Islam and new kinship: reproductive technology and the shariah in Lebanon
Ways of knowing about birth in three cultures.
了解三种文化中出生的方式。
  • DOI:
    10.1525/maq.1996.10.2.02a00070
  • 发表时间:
    1996
  • 期刊:
  • 影响因子:
    2.2
  • 作者:
    Carolyn Sargent;Grace Bascope
  • 通讯作者:
    Grace Bascope
Transformations in maternity services in Jamaica.
牙买加产妇服务的变革。

Carolyn Sargent的其他文献

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{{ truncateString('Carolyn Sargent', 18)}}的其他基金

The Influence of Sociality in Cancer Treatment Decision-Making
社会性对癌症治疗决策的影响
  • 批准号:
    1354336
  • 财政年份:
    2014
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
DOCTORAL DISSERTATION RESEARCH: Negotiating Destigmatization Processes among Women with Childbirth-Related Injuries
博士论文研究:与分娩相关伤害的妇女协商去污名化过程
  • 批准号:
    1243775
  • 财政年份:
    2013
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation Research: Ethnographic Research on Knowledge Production and Applied Theatre in Post-Apartheid South Africa
博士论文研究:后种族隔离南非知识生产和应用戏剧的民族志研究
  • 批准号:
    1019652
  • 财政年份:
    2010
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation Improvement Grant: Sociocultural Analysis of Expectation and Decision Making by the Critically Ill
博士论文改进补助金:危重病人的期望和决策的社会文化分析
  • 批准号:
    0851557
  • 财政年份:
    2009
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation Improvement Grant: Spirit Possession, Disease Classification, and Emergent Infectious Disease in Benin, West Africa
博士论文改进补助金:西非贝宁的精神附体、疾病分类和突发传染病
  • 批准号:
    0822556
  • 财政年份:
    2008
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation Improvement Grant: Stigma, HIV/AIDS and the "Wretched New Class of Untouchables" in India
博士论文改进补助金:耻辱、艾滋病毒/艾滋病和印度“可怜的新阶层贱民”
  • 批准号:
    0650455
  • 财政年份:
    2007
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation Improvement Grant: The Cultural Politics of Immigrant Health Among West African Households in Paris, France
博士论文改进补助金:法国巴黎西非家庭移民健康的文化政治
  • 批准号:
    0650072
  • 财政年份:
    2007
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation Improvement Grant: Surgery and Society in Caracas, Venezuela
博士论文改进补助金:委内瑞拉加拉加斯的外科与社会
  • 批准号:
    0612570
  • 财政年份:
    2006
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation: Living With Disabilities in Ecuador
博士论文:厄瓜多尔的残疾人生活
  • 批准号:
    0350079
  • 财政年份:
    2004
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant
Doctoral Dissertation: Tuberculosis and Gender in the Philippines
博士论文:菲律宾的结核病与性别
  • 批准号:
    0130281
  • 财政年份:
    2002
  • 资助金额:
    $ 0.45万
  • 项目类别:
    Standard Grant

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博士论文研究:新法律学说如何塑造人类与环境的关系
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