Medicalised maternities, markets and moralities in Bangladesh: Building academic foundations and transforming debates

孟加拉国的医疗生育、市场和道德：建立学术基础并改变辩论

• 批准号: ES/Y010299/1
• 负责人: Janet Perkins
• 金额: $ 13.88万
• 依托单位: University of Edinburgh
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FY010299%2F1
• 关键词: Medicalised; maternities; markets; moralities; Bangladesh

My PhD research explored recent transformations towards medicalised childbirth, marketisation of maternal health services, and new moralities of care in Bangladesh. Well into the 2000s, the vast majority of women in the country gave birth at home in the presence of non-professionalised attendants. However, recent years have witnessed rapid shifts toward highly medicalised practices during pregnancy and birth. Remarkably, by 2016, while half of women gave birth at home according to 'traditional' practices, over 30% of women gave birth through caesarean (NIPORT, icddr,b and MEASURE, 2019). Advanced biomedical forms of pregnancy and birth care, i.e., caesarean and ultrasonograms, are primarily made available through a minimally regulated healthcare market which today places such technologies within reach of women of all social classes living in even the most remote areas. My PhD research sought to make sense of these transformations, including how they reshape ideas of 'good care' among women and families, generate new medico-social landscapes, and are negotiated within and reconfigure moral orientations. This work has important implications for Bangladesh and contexts throughout the Global South.This fellowship will allow me to consolidate my findings and maximise my research impact. I will generate substantial research outputs based on my PhD research, thereby laying the foundation for a successful career as an academic anthropologist. It will allow me to transform academic and policy debates related to maternal health technologies and health markets in the global South to accommodate nuanced accounts of the situatedness of such therapeutic landscapes. The following four objectives of this fellowship will work synergistically to achieve these aims:1) Consolidate findings: Return to my PhD field site and spend one month in private health clinics to generate ethnographic data. This will allow me to test and finetune my initial findings for developing research outputs. 2) Position myself as a scholar in anthropology at the forefront of debates on health markets and maternal health technologies: Develop a book proposal from my PhD thesis and submit it to a leading academic press, e.g., Cornell, Stanford, Duke or Cambridge, and transform my thesis into an academic monograph. By the end of the fellowship, I intend to have a publication-ready monograph draft moving towards publication under contract. I will also prepare and submit at least one manuscript to a leading peer-reviewed anthropology journal, e.g., the American Ethnologist and/or Cultural Anthropology, and present my research during at least one large social science conference in UK/Europe (e.g., EASA or ASA).3) Transform policy debates: Currently, policy debates related to the technologisation and commodification of pregnancy and birth care in Bangladesh tend to be urban-centric, essentialise women as unnecessarily and problematically overusing commodified maternal health technologies and carry a negative valence toward the private health sector as exploitative and compromising clinical quality in the interest of maximising profits according to capitalist logics. Building on over a decade of work in Bangladesh as a global health practicioner and PhD researcher, I will leverage my in-country networks to organise two workshops with Bangladeshi collaborators. These will bring together public health officials, private health actors, development partners and researchers to exchange knowledge and push debates past reified discourses. Based on the workshops, we will draft and publish an op-ed in a national newspaper to move policy and public debates past urban-centric discourses that essentialise private health care provision and women's motivations for seeking private health services. 4) Expand my teaching skillset: Expand the breadth of my teaching skillset through co-convening, in a limited scope, the Anthropology of Global Health course.

我的博士研究探讨了孟加拉国最近向医疗分娩、孕产妇保健服务市场化以及新的护理道德的转变。进入 2000 年代，该国绝大多数妇女在非专业护理人员在场的情况下在家中分娩。然而，近年来，怀孕和分娩期间的做法迅速转向高度医疗化。值得注意的是，到 2016 年，一半的妇女按照“传统”做法在家分娩，而超过 30% 的妇女通过剖腹产分娩（NIPORT、icddr,b 和 MEASURE，2019 年）。先进的生物医学形式的怀孕和分娩护理，即剖腹产和超声波检查，主要是通过最低限度监管的医疗保健市场提供的，如今，这些技术使生活在最偏远地区的所有社会阶层的妇女都能接触到这些技术。我的博士研究试图理解这些转变，包括它们如何重塑妇女和家庭的“良好护理”观念，产生新的医学社会景观，以及如何在道德取向中进行协商和重新配置。这项工作对孟加拉国和整个南方国家具有重要影响。这项研究金将使我能够巩固我的发现并最大限度地发挥我的研究影响。我将根据我的博士研究产生大量的研究成果，从而为作为一名学术人类学家的成功职业生涯奠定基础。它将让我能够改变与南半球孕产妇保健技术和保健市场相关的学术和政策辩论，以适应对此类治疗景观的情境的细致入微的描述。该奖学金的以下四个目标将协同作用以实现这些目标：1）巩固研究结果：返回我的博士现场并在私人健康诊所度过一个月以生成人种学数据。这将使我能够测试和微调我的初步发现，以开发研究成果。 2) 将自己定位为处于健康市场和孕产妇健康技术辩论最前沿的人类学学者：根据我的博士论文制定书籍提案，并将其提交给领先的学术出版社，例如康奈尔大学、斯坦福大学、杜克大学或剑桥大学，以及将我的论文变成学术专着。在研究金结束时，我打算准备一份可供出版的专着草案，并根据合同进行出版。我还将准备至少一份手稿并将其提交给领先的同行评审人类学期刊，例如《美国民族学家》和/或《文化人类学》，并在英国/欧洲至少一次大型社会科学会议（例如，欧洲航空安全局）上展示我的研究成果或 ASA).3) 转变政策辩论：目前，与孟加拉国怀孕和生育护理技术化和商品化相关的政策辩论往往以城市为中心，将妇女视为重要的不必要和有问题地过度使用商品化的孕产妇保健技术，并对私营卫生部门产生负面影响，因为根据资本主义逻辑，为了实现利润最大化，私营卫生部门进行剥削并损害临床质量。基于在孟加拉国作为全球卫生从业者和博士研究员十多年的工作，我将利用我的国内网络与孟加拉国合作者组织两次研讨会。这些活动将把公共卫生官员、私人卫生行为者、发展伙伴和研究人员聚集在一起，交流知识，推动辩论超越具体化的讨论。在研讨会的基础上，我们将在全国性报纸上起草并发表一篇专栏文章，以推动政策和公共辩论超越以城市为中心的讨论，这些讨论强调私人医疗保健的提供和妇女寻求私人医疗服务的动机。 4) 扩展我的教学技能：通过在有限范围内共同举办全球健康人类学课程，扩展我的教学技能的广度。