Background Increasing clinical trial cost and complexity, as well as a high waste of clinical trial investment over the past decades, have changed the way clinical trial quality is managed. Recent evidence has highlighted that the lack of... more
Background Increasing clinical trial cost and complexity, as well as a high waste of clinical trial investment over the past decades, have changed the way clinical trial quality is managed. Recent evidence has highlighted that the lack of a clear clinical trial quality definition may have contributed to previous inefficiencies. This study aims to support the understanding of what clinical trial quality entails from the perspective of resource-limited settings. Methodology/Principal findings We conducted 46 semi-structured interviews involving investigators, sponsors, and monitors with experience in conducting clinical trials in 27 countries in sub-Saharan Africa. The questionnaire addressed the overall meaning of clinical trial quality and a conclusive clinical trial quality definition, as well as specific aspects of resource-limited settings across the clinical trial process. We held the interviews either in person, via Skype or by phone. They were recorded and transcribed verbatim...
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The main aim of the project was to contribute to a better understanding of health services in developing countries through Swiss Missions by using historical research methods. The research is based on two case studies located in Ghana... more
The main aim of the project was to contribute to a better understanding of health services in developing countries through Swiss Missions by using historical research methods. The research is based on two case studies located in Ghana (Agogo Hospital: Basel Mission) and South Africa (Elim Hospital, Mission Romande). The research team was especially interested in examining the interaction between health care providers and their changing political, social and economic environments. They studied the activities of former Swiss missionary hospitals and the changing conditions under which they delivered various forms of health care. The ultimate aim is to show how history can contribute to the development of sustainable health systems. Historical explanations for the success and failure of health systems can serve to inform today’s decision-makers. The study applied the methodologies of history and social anthropology, as well as (historical) epidemiology in order to examine the effects o...
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‘Medical Anthropology Switzerland’ (MAS) was founded in 1992 (www.medicalanthropology.ch) and is an active committee of the Swiss Ethnological Society. A few years earlier (1989), a small group of ...
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Tanzania and Older people
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Das Altern der Gesellschaften ist nicht mehr nur ein Phänomen der Industriestaaten, sondern in wachsendem Masse auch des Globalen Südens. Der Globale Süden weist im 21. Jahrhundert viele alte Menschen mit zunehmend chronischen Krankheiten... more
Das Altern der Gesellschaften ist nicht mehr nur ein Phänomen der Industriestaaten, sondern in wachsendem Masse auch des Globalen Südens. Der Globale Süden weist im 21. Jahrhundert viele alte Menschen mit zunehmend chronischen Krankheiten und einem erhöhten Pflegebedürfnis auf. Doch sind sowohl die gesellschaftlichen Strukturen als auch die jeweiligen Gesundheitssysteme auf diese Herausforderung vorbereitet
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Tanzania and Older people
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Die Medizinethnologie anerkennt alte Leute im Globalen Suden erst kurzlich als eine wichtige Gesellschaftsgruppe. Neue Transformationen (Demographie, Epidemiologie) auf nationaler Ebene weckten ihr lnteresse. Gekoppelt mit neuen... more
Die Medizinethnologie anerkennt alte Leute im Globalen Suden erst kurzlich als eine wichtige Gesellschaftsgruppe. Neue Transformationen (Demographie, Epidemiologie) auf nationaler Ebene weckten ihr lnteresse. Gekoppelt mit neuen Gesundheitsprofilen fuhren sie zur neuen Herausforderung, namlich der Pflege der vielen al ten Menschen ohne formelle Absicherung und unter Einbezug starker kultureller Normen bezuglich Altenpflege.
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We live in a rapidly urbanising world. According to the 2001 statistics of the United Nations,a the proportion of urban dwellers rose from 30% in 1950 to 47% in 2000 and will probably attain 60% in 2030. Almost 70% of these urban dwellers... more
We live in a rapidly urbanising world. According to the 2001 statistics of the United Nations,a the proportion of urban dwellers rose from 30% in 1950 to 47% in 2000 and will probably attain 60% in 2030. Almost 70% of these urban dwellers live in cities of developing regions. At the current rates of urbanisation, the number of city dwellers in the world will equal that of their rural counterparts by 2007. In the late 1980s, researchers became increasingly concerned about the combined impact of rapid urban growth and economic recession on the health of a majority of people in African and Asian cities. Several books established urban health research with a focus on developing countries as a multidisciplinary field of inquiry (Harpham et al., 1988; Salem &Jeannée, 1989). It is now widely recognised that urbanisation per se is not necessarily bad for health, but it becomes so if urban governments fail to establish and support necessary infrastructure and services to protect citizens from environmental hazards and from social, economic and political insecurity.
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More than 70 per cent of the Angolan population relies on herbal remedies to treat various ailments. Angola is endemic with Human African Trypanosomiasis, a parasitic disease [1]. Though current chemotherapy is available to treat... more
More than 70 per cent of the Angolan population relies on herbal remedies to treat various ailments. Angola is endemic with Human African Trypanosomiasis, a parasitic disease [1]. Though current chemotherapy is available to treat trypanosomiasis, the treatment is long and adherent, which complicates its implementation in remote rural communities. It is supposed that rural population who lacks access to biomedical medication, turns to folk medicine to cure sleeping sickness and its symptoms. There is extensive literature on antitrypanosomal activity of traditionally-used African medicinal plants [2], but to our current knowledge, there has not yet been a study reporting the use of local herbal remedies to heal trypanosomiasis and its symptoms in Angola. We explored the use of herbal remedies by conducting structured and semi-structured interviews within two distinct study populations. The first group comprises 30 patients who were biomedically diagnosed for trypanosomiasis and treated by reference treatment. The second group included 9 traditional practitioners who have already healed sleeping sickness. Out of the patient group, first qualitative results show that almost half of the inquired lay people turns to folk medicine in the management of trypanosomiasis symptoms. From 30 patients, 12 use herbal remedies before visiting a biomedical doctor. Out of these 12, 3 reported improvement of health condition. Out of 9 traditional practitioners interviewed, 31 medicinal plants were cited to heal sleeping sickness. Among them, Vitex madiensis was the most cited medicinal plant. Roots and leaves are the most used plant parts and decoction is the mostly cited mode of preparation. Though species identification is being finalized, the most represented family in species used to manage sleeping sickness is Fabaceae. [1] Simarro, P.P, et al. Negl Trop Dis 2012, 6, e1859 [2] Ibrahim, M.A, et al. J Ethnopharmacology 2014, 154, 26 – 5
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This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experi - ences and forms of treatment and care in the... more
This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experi - ences and forms of treatment and care in the varying locations of Egypt, Tanzania, Brazil and India. By introducing the concept of 'transfiguration', we highlight the highly ambiguous, ever-evolving and increasingly transnational character of these processes in the vastly contested and power-ridden fields of medicine and wellbeing. We also argue that a moral economy approach can figure as a lens to disentangle and disaggregate these different fields' values and practices analytically and to account for the need to reflect systematically on people's struggles for a 'good life' in the context of profit-driven and often highly exclusionary economies and their impacts on health care systems. Against this background, the contri - butions to this special issue ask, through a shared theoretical concern, how medicine, illness experience and medical knowledge production coalesce under the condition of 'excessive' economies in relation to subjectivities , materialities and values . In conclusion, we ask which ethical and political demands arise for anthropologists as novel, strongly politicised and morally loaded fields of research open up; and how we can respond to the challenges of doing research in the capital-intensive fields of medicine and health and act accordingly in our investigations and writings
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Health Care and Morality
Medizin, Gesundheit und Heilung wurden in den letzten Dekaden weltweit durch sich ändernde ökonomi-sche, rechtliche, technologische und politische Konstellationen neu konfiguriert. Nicht nur hat die enge Ver-quickung zwischen Medizin und... more
Medizin, Gesundheit und Heilung wurden in den letzten Dekaden weltweit durch sich ändernde ökonomi-sche, rechtliche, technologische und politische Konstellationen neu konfiguriert. Nicht nur hat die enge Ver-quickung zwischen Medizin und Ökonomie eine Diversifizierung, aber auch Zuspitzung von Therapie-und Gesundheitsmärkten bewirkt. Sie bringt zudem zunehmend Wahlmöglichkeiten und-zwänge, sowie Pro-zesse der Hierarchisierung und Exklusion hervor. Des Weiteren sind Krankheits-und Heilungswege von Dy-namiken der Verrechtlichung und Technisierung geprägt, die zum Beispiel über neue diagnostische und the-rapeutische Verfahren, aber auch im Zuge neu erlassener Gesetze, technischer Standards, (bio-)ethischer Richtlinien oder menschenrechtlicher Konventionen im Alltag individueller Akteure und gesundheitsbezo-gener Institutionen wirkmächtig werden. All diese Neukonfigurationen sind inhärenter Bestandteil einer Vielzahl politischer, sozialer und kultureller Realitäten, die auf lokaler, nat...
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This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experiences and forms of treatment and care in the... more
This special issue explores the deep entanglements between medicine, law, politics, morality and economy in the contemporary world order and asks how these entwinements shape illness experiences and forms of treatment and care in the varying locations of Egypt, Tanzania, Brazil and India. By introducing the concept of ‘transfiguration’, we highlight the highly ambiguous, ever-evolving and increasingly transnational character of these processes in the vastly contested and power-ridden fields of medicine and wellbeing. We also argue that a moral economy approach can figure as a lens to disentangle and disaggregate these different fields’ values and practices analytically and to account for the need to reflect systematically on people’s struggles for a ‘good life’ in the context of profit-driven and often highly exclusionary economies and their impacts on health care systems. Against this background, the contributions to this special issue ask, through a shared theoretical concern, how...
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Die Medizinethnologie anerkennt alte Leute im Globalen Suden erst kurzlich als eine wichtige Gesellschaftsgruppe. Neue Transformationen (Demographie, Epidemiologie) auf nationaler Ebene weckten ihr lnteresse. Gekoppelt mit neuen... more
Die Medizinethnologie anerkennt alte Leute im Globalen Suden erst kurzlich als eine wichtige Gesellschaftsgruppe. Neue Transformationen (Demographie, Epidemiologie) auf nationaler Ebene weckten ihr lnteresse. Gekoppelt mit neuen Gesundheitsprofilen fuhren sie zur neuen Herausforderung, namlich der Pflege der vielen al ten Menschen ohne formelle Absicherung und unter Einbezug starker kultureller Normen bezuglich Altenpflege.
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Background The large health costs associated with preterm births have been well documented in high income countries. Relatively little data on this issue is currently available from developing countries. The aim of this study was to... more
Background The large health costs associated with preterm births have been well documented in high income countries. Relatively little data on this issue is currently available from developing countries. The aim of this study was to assess private and public costs associated with preterm births in Vietnam. Methods This cross-sectional study used medical and financial data from one provincial and one national hospital in Vietnam. Cost data for all infants discharged from the two hospitals in 2017 was collected and analyzed. Results Average total medical cost per child was USD 1643.52 in the national hospital and USD 668.94 in the provincial hospital. Mean medical out-of-pocket expenditure was USD 60 at the national hospital. No medical out-of-pocket expenditure was reported at the provincial hospital when parents complied with national health insurance policies. Substantial out-of-pocket expenditure was incurred by those who bypassed lower-level facilities. Parents seeking care at sp...