Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Politics of Global Health > Exam 2 Key Questions > Flashcards

Exam 2 Key Questions Flashcards

1
Q

Colonization vs. coloniality

A

Colonization: direct dominance, ended in mid/late 20th century in Africa
Coloniality: economic/cultural dominance, the power relations that persistently manifest “transnationally and intersubjectively”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Academic dependency

A

reliance on Western research agendas/foreign aid to conduct science

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does academic dependency manifest?

A
  1. Authorship/collaboration trends
  2. Universalizing disciplines (e.g. cancer research mostly western-based, written in English)
  3. Gender imablances in World Health Assembly representation
  4. Racist/colonial tropes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Global Health (Koplan et al.)

A
  • Contested!!
  • goal: improving health and achieving equity for all people worldwide
  • focus: transnational health issues, determinants, solutions
  • level of collaboration: global
  • how interdisciplinary + multidisplinary: very
  • care level: population-based prevention AND individual clinical care
    -overlap w/ public health: can focus on domestic health disparities as well as cross-border issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Public Health (Koplan et al.)

A
  • goal: improving health and achieving equity within a nation or community
  • focus: issues that affect health of particular country or community
  • level of collaboration: nation or community (not global)
  • how interdisciplinary + multidisciplinary: very
  • care level: population-based prevention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

International Health (Koplan et al.)

A
  • goal: helping another country
  • focus: health issues of countries other than one’s own
  • level of collaboration: binational
  • how interdisciplinary + multidisciplinary: not very
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

International Health origins

A
  • Philanthropic organizations (e.g. Rockefeller Foundation
  • Beneficient paternalism
    Saviourism mindset: anything better than nothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Global health class definition

A

“any health issue that concerns many countries or is affected by transnational determinants…or solutions”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Global health vs. public health Fried et al.

A
  • Global health IS public health
  • Both view health holistically (rather than just absence of disease), use population-level policies, international approaches, and seek to address root causes
  • Public health needs a global perspective: pandemics, chronic diseases, comparative health care systems, globalization of health care workforce
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Buyum et al.’s decolonizing agenda

A
  1. Paradigm shift
  2. Leadership shift
  3. Knowledge shift
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Paradigm shift

A

Repoliticise global health by ground-ing it in a health justice framework that acknowledges how colonialism, racism, sexism, capitalism and other harmful ‘-isms’ pose the largest threat to health equity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Leadership shift

A

Leadership at global agenda- setting institutions does not reflect the diversity of people these institutions are intended to serve: recognize leaders in Global South; address gender disparities; more equitable representation in journals, faculty, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Knowledge shift

A

reciprocal knowledge flows b/w Global North and Global South

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the issue/sociological puzzle Mojola seeks to solve?

A

Why are young African women at a much greater risk of contracting HIV compared to same-aged young men?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Previous explanations for young African women’s greater risk of contracting HIV

A
  1. Biophysiological explanations
  2. Proximate explanations
  3. Social-structural approach
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Biophysiological explanations

A
  1. Semen has higher viral load than vaginal fluid
  2. Young women more likely to experience genital trauma → increased risk of infection
    BUT vulnerability for men as well: circumcised men face reduced risks for STIs/HIV
    AND variation in gender disparity across settings cannot be explained
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Proximate explanations

A
  1. How much inflected fluid one is exposed to: younger age of first sex → longer duration of potential exposure
  2. How risky that exposure is: age/number of sexual partners (older partners higher risk)
    BUT cannot explain why young women’s greater HIV risk is replicated across so many diverse settings in sub-Saharan Africa despite different combinations of factors, some of which seem to clealry disadvantage young men more than young women (such as more sexual partners)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Social-structural approach

A
  1. Sexual networks: concurrent partners normalized/accepted (even institutionalized in case of polygamy)
  2. Migration connected to colonialism/industrial flows: Have sex at truck stops along highways while transporting goods along trade routes –> Creates sexual networks for men and women
  3. Regional conflicts (movements of armies)
    BUT this implies risk for both young men and women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mojola’s explanation for young women’s higher HIV risk

A

CONSUMPTION
- modernity and romance synonymous w/ consumption
- constrained access to money –> relationships w/ older employed men (w/ higher HIV rates) to enable continual consumption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mojola’s methods

A

Mixed methods:
1. qualitative interviews w/ teens from randomly selected high schools and in community settings (w/ young, middle-aged, and older adults)
2. ethnographic observations
3. demographic and health survey data anlaysis
- Life-course perspective (transition to adulthood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does Mojola engage in reflexivity and account for her own positionality?

A
  • Kenyan woman (exists w/in demographic category she studies) but highly educated –> “mutual recognition and strangeness”
  • acknowledges that this shapes her dynamic w/ interviewees
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does Mojola de-exoticize the issue?

A
  • Shows “gendered entanglements of love, money, and consumption among women in different settings” (e.g. in US, sending flowers, chocolates, paying for dinner, engagement rings; consumption as symbolic of love)
  • Marriage as means of economic security/social mobility not unique to Afirca (US “breadwinner”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is colonialism part of the issue? (Mojola)

A
  • Labor-migration roles (and “gendered economies” established by colonizers to control locals/maximize resource extraction
  • Urban towns, mining areas, and other works sites dominated by men w/ limited wage while villages/”reserves” were dominated by financially dependent women, visited by men as colonizers allowed
  • Dynamics continue today w/ women often unable to survive w/out a man’s support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is work/the economy part of the issue? (Mojola)

A

Access to money/resources structurally constrained for women –> transactional sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the different types of relationships? (Mojola)

A
  1. Relationships for education: between schoolmates (in same school or in different schools), entirely abstinent, essentially platonic: prelude to relationships for sex
  2. Relationships involving sex: materiality undergirds love, sex entitled girl to ask for gifts or money from boy
26
Q

What logics undergird relationship dynamics for men and women?

A
  • Young men: avoided high-consuming women and those less likely to have other partnerships, sex as proof of masculinity
  • Young women: Being modern woman = going to school and consuming (satisfying ‘needs’), avoiding stressful and poor same-aged partner, prelude to marriage
  • Both: love = sex + provision
27
Q

Transactional sex

A

“intimate relationships where money and gifts are exchanged but in which issues of love and trust are also considered at stake”
- w/ working class men or sugar daddies (found in clubs)

28
Q

Where is agency? (Mojola)

A
  • Women have agency in choosing not to use a condom (contrary to previous literature): see not using as a sign of trust and love
  • Women use a ‘toolkit of strategies’ to gain access to money and consume, transactional sex is one of those
  • Women choose their partners
  • Some women choose the sequential path, school first, consumption later
29
Q

Why do abstinence or condom campaigns fail in this context?

A
  • Condoms signify lack of trust. Women decide not to use them to demonstrate trust and love.
  • Abstinence fails b/c sex is tied to love, provision, and masculinity (social underpinnings); asking a young man to abstain would be asking him not to have a girlfriend, prove his masculinity, or prove his love; asking a young woman to abstain would be asking her to be satisfied w/ what she had, cut off her access to money for her needs, and limit or postpone her transition to marriage since a sexual relationship was often a prelude to marriage
30
Q

What does it mean to recharacterize globalization, according to Mojola, and how does she do so?

A
  • Studying not just global flows but extensive point-to-point connectivity across global spaces – b/w enclaves of resource extraction (mining/oil sites), international NGOs, middle class/elites in cities, global financial institutions, multinational corporations, donors, diasporic Africans, rural and poor Africans
  • Linking seemingly separate sites
  • Avoiding methodological nationalism
31
Q

Constrained choice theory

A
  • Based on US
  • Macro level social policies, meso level community actions, meso level work and family sites → structure individual choices (health behaviors) which are related to biological processes → both structure health outcomes
32
Q

What does Mojola reveal about the relationship between schools and HIV for young women?

A
  1. Shapes the social construction of gendered needs: reinforced norms about what needs are (peer-comparison) and norms of transactional relationships to consume those needs –> increased incentive to engage in transactional sex
  2. School context inadvertently facilitates transactional relationships with older partners: structure of school calendar (time/temporality) releasing girls on timetable that overlapped w/ available men with money (city men visiting relatives over holiday) AND male teachers
  3. Small but dense sexual networks w/in schools can have devastating consequences
33
Q

What did Mojola find about the gendered labor economy and its relationship to HIV/AIDS?

A
  1. Men have greater access to money
  2. Women’s gap b/w income and needs structured by access to labor market: harder to get a job, only “small small jobs” available (bar girls, kiosk ladies, house helpers)
  3. Working women have 2x the HIV rates as non-working young women: less incentive to recalibrate needs BUT not making enough money to meet needs –> find a providing boyfriend to continually replenish needs
34
Q

Socioecology

A
  • Social-structural processes, however global their reach, are ultimately experienced in local spaces; and features of these local spaces constrain, encourage, and even transform those social structures
  • Place = structural (e.g. school) AND environmental (e.g. lake) is an important characteristic for thinking about sexual networks
35
Q

What is Mojola’s socioecological approach?

A
  • Place (structural like school AND environmental like lake) is an important characteristic for thinking about sexual networks
  • Ecological changes to water (pollution impact) shifted fishing industry and sexual behavior: Jaboya relationships (men having families at different beaches) → HIV spread/high partner turnover
36
Q

Cultural entropy

A

The process through which intended meanings and uses of a cultural object fracture into alternative meanings, new practices, failed interactions, and blatant disregard

37
Q

What is cultural entropy in relation to HIV/AIDS intervention campaigns?

A

Ex: women turning condoms into bracelets and selling them
“Objects are disruptive and culture is difficult to tame”

38
Q

Individual HIV/AIDS interventions (Mojola)

A
  1. Take life course perspective to create cohort of HIV-free teenage and young women
  2. Counter logic of partner choice by providing different kinds of knowledge: show girls that their high likelihood of getting HIV is from different age partners
  3. Simple presentation to shift to safer sexual partners (not just abstain); Respects their agency, lets them do cost-benefit analysis, weigh consumption needs/desires against risk of HIV; Insist on HIV testing before sex
  4. Community workshops w/ information for men as well
39
Q

Institutional interventions for HIV/AIDS (Mojola)

A
  1. Sanction teachers to end structural vulnerability
  2. Provide menstrual solutions (common continual need)
  3. Conditional cash transfers + HIV prevalence information
  4. Focus on girls who do not complete high school as they transition to high-risk marriage
  5. Opening up job opportunities: Enable young women to fish
  6. Limited success w/ microfinance programs: Need mentorship built in, does not address root of the issue
    Bandaid - Providing funds w/out addressing why funds need to be provided
    Link microfinance to community development
    Stable ecosystem: controlling pollution
40
Q

TRIPS

A
  • Trade-Related Aspects of Intellectual Property Rights
  • Signed under WTO 1995
  • Obliged all member states to pass laws to improve the protection of patents (previously weak governance of IPR) including those on pharmaceuticals
  • Developing countries opposed b/c it would limit their ability to access patented products critical to national welfare, but agreed for access to Western markets and to avoid sanctions
  • Contained “flexibilities” allowing countries to suspend patents in situations of “national emergency”
41
Q

What happened in Thailand involving antiretrovirals?

A
  • When Thailand first took steps to produce generic medicines in 1999, the US threatened a trade dispute
  • 2006: Thailand’s Governmental pharmaceutical office (GPO) began producing generic HIV/AIDS antiretrovirals; Issued compulsory licenses on three cancer drugs, as well as heart medications
  • Supported by international health advocate organizations, Thailand’s social + political groups; condemned by pharm companies
  • WHO teams affirmed Thailand’s use of compulsory licenses to obtain pharmaceuticals for Thailand’s public health system
42
Q

Critics of Thailand’s use of compulsory licenses (and response)

A
  • Said a national emergency is only permitted for highly communicable diseases (violating “spirit” of Doha Declaration); Thailand argued its own universal health coverage policy justified compulsory licenses since they guarantee access to essential medications
  • Claim that Thailand failed to negotiate w/ pharmaceutical companies to lower prices; Thai officials argued that negotiating w/ pharma is necessary only when patents are broken for commercial use, not public use AND compulsory licenses only way to get pharmaceutical companies to negotiate
43
Q

health social movements

A
  • Collective challenges to medical policy, public health policy and politics, belief systems, research and practice which include an array of formal and informal organizations, supporters, networks of cooperation and media
  • Address a) access to, or provision of, health-care services; b) disease, illness experience, disability and contested illness (what counts as illness); and c) health inequality and inequity based on race, ethnicity gender, class and/or sexuality
44
Q

Role of health social movements in Thailand case

A
  • Health activist network of legal expertise and framed patent debate in moral turns, ensuring public support
  • High-profile philanthropists (e.g. Bill and Melinda Gates) led to publicity and money to strengthen global health advocacy network
45
Q

reactive diffusion

A

“in which policies are modified in the process of diffusion from one state to another”

46
Q

What does reactive diffusion suggest about global norms re: intellectual property?

A
  • Rights granted under the Doha Declaration continued to evolve and spread – w/ Thailand, Brazil, and India taking lead
  • States reinvented global norms about trade agreements: “recursive cycles at national level could affect existing international norms”
47
Q

What are some of the ethical issues involving clinical trials?

A
  • Limited reach of regulatory bodies –> we know little about the quality of research elsewhere
  • Wide disparities in education and SES among participants and disparities in health care systems in other places may jeopardize rights of participants (relative lack of understanding, financial compensation exceeding annual wages, participation only way to access care - will treatment be available post-trial)
  • Lower standards of health care may allow ethically problematic study designs or trials
  • Lack of local IRBs
  • Informed consent: Participants’ understanding of the study is rarely assessed in any country (illiterate + translation increase risk of misunderstanding)
  • Trials rarely focused on problems affecting locals
48
Q

Dr. from Cameroon suggestions re: clinical trials

A
  1. Informed consent: participants must be given relevant info in a way they can understand: local communities involved (i.e. leadership shift)
  2. Standard of care: Control group? Accessibility and affordability? Best care available anywhere or where participant lives?
  3. Ethical review: an effective system is needed, local gov set up independent non-governmental ethical review committees
  4. Researchers need to make every effort to ensure access to treatment post-trial (Treatment individually or at community)
49
Q

Medical Tourism

A
  • Cross-border health-related travel
  • Includes large range of health/medical services
  • Contested term
  • Form of national-branding
50
Q

Medical tourism push factors

A

expensive healthcare in the US, other systemic factors

51
Q

How has medical tourism been promoted? (pull factors)

A
  • Government initiatives (e.g. National State Tourism Agency for Thailand presenting Thailand as global center for sex change operations; Thailand 4.0)
  • Private industry promotion
52
Q

What are the specific embodied health effects of medical tourism in Thailand?

A
  • Crowding-out effect –> lower-quality surgeries
  • Can’t change legal identification card –> humiliation in public hospitals
  • Binary hospital wards –> sometimes treated in hallways or closets
  • Refusal of care (nurses would not bathe after car accident)
  • Institutionalized transgender stereotypes
  • Universal health coverage is not trans-inclusive
53
Q

Crowding-out effect

A

Prices for private clinics have increased ~400%, pushing Thai transgender women into lesser quality clinics (botched surgeries, no anesthesia or bedrest, poor customer relations)

54
Q

What does gendered labor have to do with medical tourism?

A
  • Thai transgender women formed initial demand for gender-affirming surgeries
  • Perform “display work,” becoming brands of medical technologies and LGBTQ-friendliness (walking billboards)
  • “Techno-Professionalism”
55
Q

“Techno-Professionalism”

A
  • Embody new norms of professionalism by using technologies
  • Not just transgender women (Ex: hospital staff wearing gendered uniform and rollerskating around hospital)
  • Labor relations and doctor-patient relations changed
  • Hotel-hospitals
56
Q

Who was Dr. Somchai and what does his experience tell us about medical tourism and health effects?

A
  • Initial patients were Thai transgender women
  • A few foreign patients who heard about him through Thai transgender women
  • Incorporated into larger gov strategy to attract foreign patients during 1997 Asian Financial Crisis
  • Medica publicization –> international demand for his gender-affirming surgeries –> higher prices
  • The Thai transgender women who initiated demand for his surgeries can no longer afford his services, “crowded out” into second-class health care facilities
57
Q

gendered techno-development strategy

A

State-sponsored initiative that:
1) advances technologies and
2) incorporates gendered labor, while also
3) impacting gendered health outcomes
- Medical tourism is a gendered-techno development strategy that advances technologies but relies on gendered labor and impacts health outcomes

58
Q

What is a global assemblage?

A
  • “Due to the multiple institutions, social actors, and policies involved, medical tourism can be viewed as an ___, which incorporates state and private initiatives, technologies, cultural discourses, global trade agreements, and various industries”
  • Supranational, regional, national, local elements (trade agreements, technologies, visa policies, discourses, individuals and collectives, organizations, infrastructures)
59
Q

Kitti’s story (Farber)

A

“For this clinic [Nuun clinic], they don’t use sleep anesthetic but use sleep [medication] and [topical numbness] anesthetic mixed together. Because if we use complete sleep anesthetic, we need to wait for an anesthetist. It wastes time. And there is no [inpatient] admission. We just have two hours of recovery”

60
Q

Policies to alleviate disparities amid medical tourism

A
  1. Reallocate medical tourism profits to public sector → to fund universal health coverage
  2. Regulate medical tourism (WHO? NEw agency? State-level?)
  3. Collect data at national level to understand flows of patients and health care spending

Politics of Global Health (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions