权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Shock tactics: urban health futures in the wake of Ebola

冲击策略：埃博拉之后的城市健康未来

基本信息

批准号：
ES/R000158/1
负责人：
Ann Wilkinson
金额：
$ 34.44万
依托单位：
Institute of Development Studies
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2018
资助国家：
英国
起止时间：
2018 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FR000158%2F1
关键词：
Shock tactics urban health futures

项目摘要

This research will address the interconnected challenges of rising urbanisation and vulnerability to infectious disease. From acute epidemics to slower onset issues such as antibiotic resistance, the world is facing a resurgence of infectious disease challenges. Far from being a thing of the past, these diseases have the potential to spread extensively in densely populated urban settings and to 'go global'. A major implication emerging from crises like Ebola (2014-15) and Zika (2015-16) is that dramatic inequities and pockets of severe neglect in public health standards leave us all vulnerable. Though their burdens fall most acutely on the poor, they also increase the potential for unmanageable crises with broader demographic impacts. Of particular concern are rapidly growing urban settlements which have played a role in exacerbating recent epidemics and where sanitary conditions pose an increasingly intractable challenge to health and development in many cities across the world.The majority of the world's population already live in urban environments and numbers are predicted to rise dramatically. A large and growing proportion of these urban residents live in informal slum-like settlements. We know very little about how health systems are organised in these rapidly changing contexts, except that they are highly informal and old rules and approaches do not apply. The Ebola epidemic in particular revealed glaring gaps in evidence and understanding of these environments and populations, with fatal consequences. Indeed, it revealed there were pervasive misunderstandings and misrepresentations in policy circles which make interventions for both epidemic control and for basic public health difficult. Yet Ebola has also created a window of opportunity, both to understand the health challenges in informal settlements better and as the impetus to do things differently. This research will focus on health in informal settlements in Freetown, Sierra Leone, in the aftermath of Ebola. It will explore if and how such a major epidemic is changing the game and what lessons can be drawn for other contexts. To be able to know this we need a much deeper understanding of the social, political and economic relationships which surround urban health systems and which will determine the opportunities for change. Although aspects of the political and social determinants of urban health have been broadly characterized, less is known about the logics and practices of health in informal settlements from the perspectives and experiences of local community members - for example urban residents' own understandings of transmission, or socially embedded hygiene practices. It is equally unclear how such local norms and practices do or do not connect to policy understandings of these contexts, and to what effect. As such, the objectives of this research project are: 1. To elucidate the social and political processes and practices of health systems and disease control in informal urban settlements, as represented and experienced by different actors, using ethnographic and participatory methods to understand and incorporate residents' own perspectives and practices; 2. To identify institutional arrangements emerging in Sierra Leone post-Ebola which have the potential for improving or worsening health in informal urban settlements;3. To contribute to health systems strengthening and to epidemic preparedness and control in urban areas by integrating perspectives from medical anthropology, urban studies, and public health.The project will be a collaboration between a UK anthropologist with over 7 years' experience in Sierra Leone and a new urban research centre based in Freetown. The combination of in-country experience and local partnerships provides a unique platform to develop cutting edge perspectives on urban health, informed by a deep understanding of the city and of global health politics and practice.

这项研究将解决日益城市化和传染病脆弱性的相互关联的挑战。从急性流行病到抗生素耐药性等发病较慢的问题，世界正面临着传染病挑战的死灰复燃。这些疾病非但没有成为过去，反而有可能在人口密集的城市环境中广泛传播，并“走向全球”。埃博拉（2014-15年）和寨卡（2015-16年）等危机的一个主要影响是，公共卫生标准方面的严重不平等和严重忽视使我们所有人都很脆弱。虽然这些负担最沉重地落在穷人身上，但也增加了发生无法控制的危机的可能性，对人口产生更广泛的影响。特别令人关切的是，迅速增长的城市住区加剧了最近的流行病，卫生条件对世界各地许多城市的健康和发展构成日益棘手的挑战，世界上大多数人口已经生活在城市环境中，预计这一数字将急剧上升。这些城市居民中有很大一部分居住在非正式的贫民窟式住区，而且这一比例还在不断增加。我们对卫生系统如何在这些迅速变化的环境中组织起来知之甚少，只知道它们是高度非正式的，旧的规则和方法不适用。尤其是埃博拉疫情，暴露出对这些环境和人群的证据和理解存在明显差距，并造成致命后果。事实上，它揭示了政策界普遍存在的误解和错误陈述，这使得流行病控制和基本公共卫生的干预措施都很困难。然而，埃博拉也创造了一个机会之窗，既可以更好地了解非正规住区的健康挑战，也可以推动以不同的方式做事。这项研究将侧重于塞拉利昂弗里敦非正规住区在埃博拉疫情后的健康状况。它将探讨这种重大流行病是否以及如何改变游戏规则，以及可以为其他情况吸取哪些教训。为了了解这一点，我们需要更深入地了解围绕城市卫生系统的社会、政治和经济关系，这些关系将决定变革的机会。虽然城市健康的政治和社会决定因素的各个方面已经得到广泛的描述，但从当地社区成员的角度和经验-例如城市居民自己对传播的理解，或社会上根深蒂固的卫生习惯-对非正规住区健康的逻辑和做法了解较少。同样不清楚的是，这些地方规范和做法如何与对这些背景的政策理解相联系，以及产生何种影响。因此，本研究项目的目标是：1。阐明不同行为者所代表和经历的非正规城市住区卫生系统和疾病控制的社会和政治进程和实践，使用民族志和参与性方法来理解和纳入居民自己的观点和实践; 2.确定塞拉利昂在埃博拉后出现的有可能改善或恶化非正规城市住区健康状况的体制安排;3.通过整合医学人类学、城市研究和公共卫生的观点，为加强城市地区的卫生系统和预防和控制流行病作出贡献。该项目将是一位在塞拉利昂有7年以上经验的英国人类学家与弗里敦一个新的城市研究中心之间的合作。国内经验和当地伙伴关系的结合提供了一个独特的平台，以发展对城市健康的前沿观点，通过对城市和全球卫生政策和实践的深刻理解。