16 December 2015

Lives in Times of Conflicts in Burkina Faso

Lise Østergaard, a UCPH PhD-student, is working on a project in Burkina Faso on the "Lives in Times of Conflicts". The project investigates the relationship between state and citizen with a particular focus on how the population uses and relate to the health care system, conflict management, and water resource management. Find abstract of three of her most recent publications below.

Seeing Ebola from a distance: health workers, risk, and uncertainty in rural Burkina Faso

Although no cases of the Ebola virus disease occurred in Burkina Faso during the West African epidemic, it sparked front line health workers' reflections on issues of security, global equity and fairness. Based on an ethnographic study of rural dispensaries in Burkina Faso on the practical and technological means available to maintain a minimum level of safety, this article addresses the issue of hazards and risk at work. These reflections took on a moral dimension mobilizing concerns about health worker ethos and Government responsibilities.
The article argues that the increased awareness of the threat of Ebola has intensified existing tensions between health workers and the Government. Seeing Ebola from a distance entailed that the health workers perceived Ebola as a negative potentiality having immediate effects on their individual and collective reflections on risk acceptability. That made the health workers question, more than ever, the fairness of their Government.'

Find the article in Anthropologie & Santé; 2015: "Ebola vu de loin : les agents de la santé face au risque et à l'incertitude dans les campagnes du Burkina Faso"

Maternal healthcare in context: A qualitative study of women's tactics to improve their experience of public healthcare in rural Burkina Faso

Improving the use of public maternal health facilities to prevent maternal death is a priority in developing countries. Accumulating evidence suggests that a key factor in choosing a facility-based delivery is the collaboration and the communication between healthcare providers and women. This article attempts to provide a fine-grained understanding of health system deficiencies, healthcare provider practices and women's experiences with maternal public healthcare.

This article presents findings from ethnographic research conducted in the Central-East Region of Burkina Faso over a period of eight months (January–August 2013). It is based on monthly interviews with 14 women from village (10) and town (4) and on structured observations of clinical encounters in three primary healthcare facilities (two rural and one urban) (23 days). In addition, 13 health workers were interviewed and 11 focus groups with women from village (6) and town (5) were conducted (48 participants).

Guided by an analytic focus on strategies and tactics and drawing on recent discussions on the notion of ‘biomedical security’, the article explores what tactics women employ in their efforts to maximize their chances of having a positive experience with public maternal healthcare. The synthesis of the cases shows that, in a context of poverty and social insecurity, women employ five tactics: establishing good relations with health workers, being mindful of their ‘health booklet’, attending prenatal care consultations, minimizing the waiting time at the maternity unit and using traditional medicines. In this way, women strive to achieve biomedical security for themselves and their child and to preserve their social reputation. The study reveals difficulty in the collaboration and communication between health workers and women and suggests that greater attention should be paid to social relations between healthcare providers and users.

Trust matters: A narrative literature review of the role of trust in health care systems in sub-Saharan Africa

This article makes a contribution to the debate about health service utilisation and the role of trust in fostering demand for health services in sub-Saharan Africa. It is framed as a narrative literature review based on a thematic analysis of nine empirical, qualitative studies. For the purposes of this article trust is defined as a voluntary course of action, which involves the optimistic expectation that the trustee will do no harm to the trustee and is increasingly perceived as an important influence on health system functioning. The article looks at trust issues in interpersonal, intergroup and institutional situations. The findings of the review point to four elements that are important for trust to develop in health sector relationships: the sensitive use of discretionary power by health workers, perceived empathy by patients of the health workers, the quality of medical care and workplace collegiality. When trust works in health sector encounters, it reduces the social complexity and inherent uneven distribution of power between clients and providers. The article concludes that understanding and supporting trust processes between patients and providers, as well as between co-workers and managers, will improve health sector collaboration and stimulate demand for health care services.

Find the article at Taylor & Francis Online.