Doctoral Dissertation Improvement Grant: Society, Culture, and Maternal Death on the Peripheries of Afghanistan and Tajikistan

研究生Kylea Liese将在Melissa J.Brown博士的指导下，研究在偏远边缘社会产生和影响孕产妇死亡率的文化和社会背景。Liese将在阿富汗和塔吉克斯坦边境两侧进行研究。据报告，阿富汗巴达赫尚地区的孕产妇死亡率是世界上最高的(每10万名活产中有6507人死亡)。与此同时，塔吉克斯坦的全国孕产妇死亡率几乎低了一百倍(65.5/100,000)，2002年至2004年期间，塔吉克斯坦巴达赫尚邦只报告了两名产妇死亡。尽管历史和地理上相似，但周边的塔吉克人和阿富汗人感受到了截然不同的宏观政治变化的影响，这些变化在社会、宗教、政治和经济上使他们与众不同。当国际边界在1925年正式关闭时，边界塔吉克一侧和阿甘一侧的人民成为了完全不同的社会的一部分。Liese的研究将调查产妇死亡率的这些巨大变化与过去一个世纪这些社会力量是如何形成的之间的关系。研究人员将采用定性和定量的方法，超越现有的孕产妇死亡数据，了解妇女的痛苦和生存是如何成为社会动荡长期和深远影响的有价值的指标。在两年的边境两侧研究中，她将使用半结构化访谈、生活史访谈、出生事件观察、当地领导人访谈、口头尸检、参与者观察和实地笔记来收集人种学数据。这些数据将被用来检验关于产妇死亡原因、社会动荡对产妇死亡率的影响以及当地伊斯兰性别和健康结构的三个主要假设。这项研究之所以重要，是因为对周边社区影响孕产妇死亡率的文化和社会因素的人类学研究很少。它还将有助于改善资源有限地区的卫生政策，特别是在孕产妇死亡率上升的原因仍笼罩在神秘之中的地区。这项研究还将有助于社会科学家的教育。

Graduate student Kylea Liese, under the supervision of Dr. Melissa J. Brown, will in investiage the cultural and social contexts that produce and epxlain maternal mortality in remote peripheral societies. Liese will undertake the research on both sides of the Afghanistan and Tajikistan border. The Badakhshan region of Afghanistan has the highest reported maternal mortality ratio in the world (6507 deaths per 100,000 live births) . Meanwhile, the national maternal mortality ratio for Tajikistan is nearly one-hundred times less (65.5/100,000), with only two maternal deaths reported in Tajik Badakhshan between 2002 and 2004. Despite historical and geographic similarities, Tajiks and Afghans on the peripheries have felt the reverberations of starkly different macro-political changes in ways that distinguish them socially, religiously, politically and economically. When the international border officially closed in 1925, the people on the Tajik side and the Aghan sides of the border became part of quite different societies. Liese's research will investigate the relationship between these dramatic variations in rates of maternal mortality and how these social forces have taken shape over the past century. The comparative approach will elucidate how social and cultural factors affect health in otherwise similar populations.The researcher will employ both qualitative and quantitative methods to go beyond the existing maternal mortality data and understand how the suffering and survival of women are valuable indicators of the long-term and far-reaching affects of social upheaval. In two years of research on both sides of the border, she will collect ethnographic data using semistructured interviews, life-history interviews, observations of birth events, local leader interviews, verbal autopsies, participant observation, and fieldnotes. These data will be used to test three major hypotheses concerning the causes of maternal mortality, the effect of social upheaval on maternal mortality in terms of maternal risk, and local Islamic constructions of gender and health. The research is important because there are few anthropological studies of the cultural and social factors affecting maternal mortality in perhipheral communities. It also will contribute to improve health policy in regions with limited resources, particularly where the causes of increasing maternal mortality are still shrouded in mystery. The research also will contribute to the education of a social scientist.