Search

COVID-19 brings uncertainties and new precarities for communities and researchers, altering and amplifying relational vulnerabilities (vulnerabilities which emerge from relationships of unequal power and place those less powerful at risk of abuse and violence). Research approaches have changed too, with increasing use of remote data collection methods. These multiple changes necessitate new or adapted safeguarding responses. This practice piece shares practical learnings and resources on safeguarding from the Accountability for Informal Urban Equity hub, which uses participatory action research, aiming to catalyse change in approaches to enhancing accountability and improving the health and well-being of marginalised people living and working in informal urban spaces in Bangladesh, India, Kenya and Sierra Leone. We outline three new challenges that emerged in the context of the pandemic (1): exacerbated relational vulnerabilities and dilemmas for researchers in responding to increased reports of different forms of violence coupled with support services that were limited prior to the pandemic becoming barely functional or non-existent in some research sites, (2) the increased use of virtual and remote research methods, with implications for safeguarding and (3) new stress, anxiety and vulnerabilities experienced by researchers. We then outline our learning and recommended action points for addressing emerging challenges, linking practice to the mnemonic ‘the four Rs: recognise, respond, report, refer’. COVID-19 has intensified safeguarding risks. We stress the importance of communities, researchers and co-researchers engaging in dialogue and ongoing discussions of power and positionality, which are important to foster co-learning and co-production of safeguarding processes.

This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, used on its own, is not enough to understand the complexities of sanitation, hygiene, water, and health. It explores pastoralists’ views and perspectives on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.

East Africa is a hotspot for foodborne diseases, including infection by nontyphoidal Salmonella (NTS), a zoonotic pathogen that may originate from livestock. Urbanization and increased demand for animal protein drive intensification of livestock production and food processing, creating risks and opportunities for food safety. We built a probabilistic mathematical model, informed by prior beliefs and dedicated stakeholder interviews and microbiological research, to describe sources and prevalence of NTS along the beef supply chain in Moshi, Tanzania. The supply chain was conceptualized using a bow tie model, with terminal livestock markets as pinch point, and a forked pathway postmarket to compare traditional and emerging supply chains. NTS was detected in 36 (7.7%) of 467 samples throughout the supply chain. After combining prior belief and observational data, marginal estimates of true NTS prevalence were 4% in feces of cattle entering the beef supply and 20% in raw meat at butcheries. Based on our model and sensitivity analyses, true NTS prevalence was not significantly different between supply chains. Environmental contamination, associated with butchers and vendors, was estimated to be the most likely source of NTS in meat for human consumption. The model provides a framework for assessing the origin and propagation of NTS along meat supply chains. It can be used to inform decision making when economic factors cause changes in beef production and consumption, such as where to target interventions to reduce risks to consumers. Through sensitivity and value of information analyses, the model also helps to prioritize investment in additional research.

IntroductionApproximately 34.8% of the Ugandan population is adolescents. The national teenage pregnancy rate is 25% and in Kibuku district, 17.6% of adolescents aged 12–19 years have begun child bearing. Adolescents mothers are vulnerable to many maternal health challenges including; stigma, unfriendly services and early marriages. The community score card (CSC) is a social accountability tool that can be used to point out challenges faced by the community in service delivery and utilization and ultimately address them. In this paper we aimed to document the challenges faced by adolescents during pregnancy, delivery and postnatal period and the extent to which the community score card could address these challenges.MethodsThis qualitative study utilized in-depth interviews conducted in August 2018 among 15 purposively selected adolescent women who had given birth 2 years prior to the study and had attended CSC meetings. The study was conducted in six sub counties of Kibuku district where the CSC intervention was implemented. Research assistants transcribed the audio-recorded interviews verbatim, and data was analyzed manually using the framework analysis approach.FindingsThis study found five major maternal health challenges faced by adolescents during pregnancy namely; psychosocial challenges, physical abuse, denial of basic human rights, unfriendly adolescent services, lack of legal and cultural protection, and lack of birth preparedness. The CSC addressed general maternal and new born health issues of the community as a whole rather than specific adolescent health related maternal health challenges.ConclusionThe maternal health challenges faced by adolescents in Kibuku have a cultural, legal, social and health service dimension. There is therefore need to look at a multi-faceted approach to holistically address them. CSCs that are targeted at the entire community are unlikely to address specific needs of vulnerable groups such as adolescents. To address the maternal health challenges of adolescents, there is need to have separate meetings with adolescents, targeted mobilization for adolescents to attend meetings and deliberate inclusion of their maternal health challenges into the CSC.

Safeguarding is rapidly rising up the international development agenda, yet literature on safeguarding in related research is limited. This paper shares processes and practice relating to safeguarding within an international research consortium (the ARISE hub, known as ARISE). ARISE aims to enhance accountability and improve the health and well-being of marginalised people living and working in informal urban spaces in low-income and middle-income countries (Bangladesh, India, Kenya and Sierra Leone). Our manuscript is divided into three key sections. We start by discussing the importance of safeguarding in global health research and consider how thinking about vulnerability as a relational concept (shaped by unequal power relations and structural violence) can help locate fluid and context specific safeguarding risks within broader social systems. We then discuss the different steps undertaken in ARISE to develop a shared approach to safeguarding: sharing institutional guidelines and practice; facilitating a participatory process to agree a working definition of safeguarding and joint understandings of vulnerabilities, risks and mitigation strategies and share experiences; developing action plans for safeguarding. This is followed by reflection on our key learnings including how safeguarding, ethics and health and safety concerns overlap; the challenges of referral and support for safeguarding concerns within frequently underserved informal urban spaces; and the importance of reflective practice and critical thinking about power, judgement and positionality and the ownership of the global narrative surrounding safeguarding. We finish by situating our learning within debates on decolonising science and argue for the importance of an iterative, ongoing learning journey that is critical, reflective and inclusive of vulnerable people.

Urbanisation is associated with changes in consumption patterns and food production processes. These patterns and processes can increase or decrease the risks of outbreaks of foodborne diseases and are generally accompanied by changes in food safety policies and regulations about food handling. This affects consumers, as well as people economically engaged in the food value chain. This study looks at Tanzania&rsquo, s red meat value chain&mdash, which in its totality involves about one third of the population&mdash, and focuses on the knowledge, attitudes and reported practices of operators of butcheries and eateries with regards to meat safety in an urban and in a rural environment. We interviewed 64 operators about their experiences with foodborne diseases and their explanations and expectations around meat safety, with a particular emphasis on how they understood their own actions regarding food safety risks vis-&agrave, vis regulations. We found operators of eateries emphasising their own agency in keeping meat safe, whereas operators of butcheries&mdash, whose products are more closely inspected&mdash, relied more on official inspections. Looking towards meat safety in the future, interviewees in rural areas were, relative to their urban counterparts, more optimistic, which we attribute to rural operators&rsquo, shorter and relatively unmediated value chains.

Background There is considerable optimism in mHealth's potential to overcome health system deficiencies, yet gender inequalities can weaken attempts to scale-up mHealth initiatives. We report on the gendered experiences of an mHealth intervention, in Southern Ethiopia, realised by the all-female cadre of Health Extension Workers (HEWs). Methodology Following the introduction of the mHealth intervention, in-depth interviews (n = 19) and focus group discussions (n = 8) with HEWs, supervisors and community leaders were undertaken to understand whether technology acted as an empowering tool for HEWs. Data was analysed iteratively using thematic analysis informed by a socio-ecological model, then assessed against the World Health Organisation's gender responsive assessment scale. Results HEWs reported experiencing: improved status after the intervention; respect from community members and were smartphone gatekeepers in their households. HEWs working alone at health posts felt smartphones provided additional support. Conversely, smartphones introduced new power dynamics between HEWs, impacting the distribution of labour. There were also negative cost implications for the HEWs, which warrant further exploration. Conclusion MHealth has the potential to improve community health service delivery and the experiences of HEWs who deliver it. The introduction of this technology requires exploration to ensure that new gender and power relations transform, rather than disadvantage, women. Keywords communities, e-health, gender.

Purpose Bats provide many ecosystem services and have intrinsic value. They also act as host reservoirs for some viruses. Several studies have linked zoonotic diseases to bats, raising questions about the risks bats pose, especially to people living close to bat roosts. Through a series of case studies undertaken in three communities, the purpose of this paper is to explore the various ways in which framings and perceptions of bats can influence a potential spillover of bat-borne viruses to humans in Ghana. It assesses the social, cultural and economic factors that drive human-bat interactions and posits that understanding the socio-economic contexts in which human-bat interactions occur is key to the success of future communication strategies. Design/methodology/approach Primary data collection methods included participatory landscape mappings, transect walks, focus group discussions and questionnaire surveys. Findings Perceptions of bats vary and are influenced by personal beliefs, the perceived economic benefits derived from bats and the location of bat roosts. Activities that put people at risk include bat hunting, butchering and consumption of poorly prepared bat meat. Those who live and work close to bat roosts, and bat hunters, for example, are more at risk of bat-borne zoonotic disease spillover. Disease risk perceptions were generally low, with high levels of uncertainty, indicating the need for clearer information about personal protective practices. Originality/value The results of the study may well inform future risk communication strategies as well as help in developing effective responses to zoonotic disease risk, disease outbreaks and the conservation of bats in communities.

Bats are known to be a natural reservoir for a lot of disease pathogens and can spread several diseases. All 11 genera of fruit bat found in West Africa are found in Ghana, and human–bat interactions are common. However, there is a dearth of knowledge about the socio-cultural factors that shape these interactions. This paper explores the socio-cultural factors that bring humans into contact with bats. Data were obtained through focus group discussions and in-depth interviews. The findings indicate that gender, religious affiliation, and belief systems influence the interaction between humans and bats. We conclude that the hunting and consumption patterns of bats have farreaching consequences for the transmission of bat-borne zoonotic diseases. Educational campaigns, therefore, should be intensified and, in particular, target groups that are most at risk of contracting bat-borne zoonotic diseases.

Background Globally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper aims to examine the implications of digital health on access to health care in Bangladesh, considering who uses electronic devices to access health information and services and why. Objective This study aims to understand how access to health care and related information through electronic means (digital health) is affected by sociodemographic determinants (ie, age, gender, education, socioeconomic status, and personal and household ownership of mobile phones) in a semiurban community in Bangladesh. Methods A cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February 2017 and March 2017) were conducted to understand (1) who owns electronic devices; (2) who, among the owners, uses these to access health information and services and why; (3) the awareness of electronic sources of health information; and (4) the role of intermediaries (family members or peers who helped to look for health information using electronic devices). Results A total of 90.3% (771/854) of households (471/854, 55.2% of respondents) owned electronic devices, mostly mobile phones. Among these, 7.2% (34/471) used them to access health information or services. Middle-aged (35-54 years), female, less (or not) educated, and poorer people used these devices the least (α=.05, α is the level of significance). The lack of awareness, discomfort, differences with regular care-seeking habits, lack of understanding and skills, and proximity to a health facility were the main reasons for not using devices to access digital health. Conclusions Although influenced by sociodemographic traits, access to digital health is not merely related to device ownership and technical skill. Rather, it is a combination of general health literacy, phone ownership, material resources, and technical skill as well as social recognition of health needs and inequity. This study’s findings should serve as a basis for better integrating technology within the health system and ensuring equitable access to health care.

BACKGROUND Globally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper aims to examine the implications of digital health on access to health care in Bangladesh, considering who uses electronic devices to access health information and services and why. OBJECTIVE This study aims to understand how access to health care and related information through electronic means (digital health) is affected by sociodemographic determinants (ie, age, gender, education, socioeconomic status, and personal and household ownership of mobile phones) in a semiurban community in Bangladesh. METHODS A cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February 2017 and March 2017) were conducted to understand (1) who owns electronic devices; (2) who, among the owners, uses these to access health information and services and why; (3) the awareness of electronic sources of health information; and (4) the role of intermediaries (family members or peers who helped to look for health information using electronic devices). RESULTS A total of 90.3% (771/854) of households (471/854, 55.2% of respondents) owned electronic devices, mostly mobile phones. Among these, 7.2% (34/471) used them to access health information or services. Middle-aged (35-54 years), female, less (or not) educated, and poorer people used these devices the least (α=.05, α is the level of significance). The lack of awareness, discomfort, differences with regular care-seeking habits, lack of understanding and skills, and proximity to a health facility were the main reasons for not using devices to access digital health. CONCLUSIONS Although influenced by sociodemographic traits, access to digital health is not merely related to device ownership and technical skill. Rather, it is a combination of general health literacy, phone ownership, material resources, and technical skill as well as social recognition of health needs and inequity. This study’s findings should serve as a basis for better integrating technology within the health system and ensuring equitable access to health care.

This research was funded by the Biotechnology and Biological Sciences Research Council, the Department for International Development, the Economic and Social Research Council, the Medical Research Council, the Natural Environment Research Council, and the Defence Science and Technology Laboratory, under the UK Zoonoses and Emerging Livestock Systems Initiative (BB/L017679/1 and BB/L018926/1). BACKGROUND: With increasing demand for red meat in Tanzania comes heightened potential for zoonotic infections in animals and humans that disproportionately affect poor communities. A range of frontline government employees work to protect public health, providing services for people engaged in animal-based livelihoods (livestock owners and butchers), and enforcing meat safety and food premises standards. In contrast to literature which emphasises the inadequacy of extension support and food safety policy implementation in low- and middle-income countries, this paper foregrounds the 'street-level diplomacy' deployed by frontline actors operating in challenging contexts. METHODS: This research is based on semi-structured interviews with 61 government employees, including livestock extension officers/meat inspectors and health officers, across 10 randomly-selected rural and urban wards. RESULTS: Frontline actors combined formal and informal strategies including the leveraging of formal policy texts and relationships with other state employees, remaining flexible and recognising that poverty constrained people's ability to comply with health regulations. They emphasised the need to work with livestock keepers and butchers to build their knowledge to self-regulate and to work collaboratively to ensure meat safety. Remaining adaptive and being hesitant to act punitively unless absolutely necessary cultivated trust and positive relations, making those engaged in animal-based livelihoods more open to learning from and cooperating with extension officers and inspectors. This may result in higher levels of meat safety than might be the case if frontline actors stringently enforced regulations. CONCLUSION: The current tendency to view frontline actors' partial enforcement of meat safety regulations as a failure obscures the creative and proactive ways in which they seek to ensure meat safety in a context of limited resources. Their application of 'street-level diplomacy' enables them to be sensitive to local socio-economic realities, to respect local social norms and expectations and to build support for health safety interventions when necessary. More explicitly acknowledging the role of trust and positive state-society relations and the diplomatic skills deployed by frontline actors as a formal part of their inspection duties offers new perspectives and enhanced understandings on the complicated nature of their work and what might be done to support them. Publisher PDF

Transmission of zoonotic pathogens from bats to humans through direct and indirect contact with bats raises public apprehension about living close to bats. In the township of Ve Golokuati in Ghana, several “camps” of Epomophorus gambianus roost in fruit trees that provide ecosystems services for residents. This study explored human-bat interaction in the township and the potential risks of disease transmission from bats to humans. Data were derived through questionnaire administration and participatory appraisal approach involving focus group discussions, participatory landscape mapping, and transect walk. The study found that most human activities within the township, such as petty-trading, domestic chores, and children’s outdoor recreation, exposed people to bats. Though there have been no reported cases of disease spillover from bats to humans from the perspective of residents and from medical records, respondents whose activities brought them closer to bats within the township were found to be more likely to experience fevers than those who do not interact with bats frequently. The study recommends education of community members about the potential risks involved in human-bat interactions and makes suggestions for reducing the frequent interactions with and exposure to bats by humans.

Asbestos mining is banned in many parts of the world, and promoted in others. This article examines the effects of asbestos mining in South Africa, 30 years after the mines closed. Focusing on mining communities, it explores the political struggles that the communities have engaged in to address environmental threats, rehabilitate land, and secure compensation for their ill-health. Drawing on the concept of ‘bio-citizenship’, and reviewing national policies introduced to protect South Africans against asbestos exposure, this article shows how different forms of compensation (for illness contracted during employment versus pollution and illness from residential proximity to asbestos mines) shape and inform degrees of belonging and of citizenship.

Global risks of zoonotic disease are high on policy agendas. Increasingly, Africa is seen as a ‘hotspot’, with likely disease spillovers from animals to humans. This paper explores the social dynamics of disease exposure, demonstrating how risks are not generalised, but are related to occupation, gender, class and other dimensions of social difference. Through case studies of Lassa Fever in Sierra Leone, Henipah virus in Ghana, Rift Valley Fever in Kenya and Trypanosomiasis in Zimbabwe, the paper proposes a social difference space–time framework to assist the understanding of and response to zoonotic diseases within a ‘One Health’ approach.

Background Gender is often neglected in health systems, yet health systems are not gender neutral. Within health systems research, gender analysis seeks to understand how gender power relations create inequities in access to resources, the distribution of labour and roles, social norms and values, and decision-making. This paper synthesises findings from nine studies focusing on four health systems domains, namely human resources, service delivery, governance and financing. It provides examples of how a gendered and/or intersectional gender approach can be applied by researchers in a range of low- and middle-income settings (Cambodia, Zimbabwe, Uganda, India, China, Nigeria and Tanzania) to issues across the health system and demonstrates that these types of analysis can uncover new and novel ways of viewing seemingly intractable problems. Methods The research used a combination of mixed, quantitative, qualitative and participatory methods, demonstrating the applicability of diverse research methods for gender and intersectional analysis. Within each study, the researchers adapted and applied a variety of gender and intersectional tools to assist with data collection and analysis, including different gender frameworks. Some researchers used participatory tools, such as photovoice and life histories, to prompt deeper and more personal reflections on gender norms from respondents, whereas others used conventional qualitative methods (in-depth interviews, focus group discussion). Findings from across the studies were reviewed and key themes were extracted and summarised. Results Five core themes that cut across the different projects were identified and are reported in this paper as follows: the intersection of gender with other social stratifiers; the importance of male involvement; the influence of gendered social norms on health system structures and processes; reliance on (often female) unpaid carers within the health system; and the role of gender within policy and practice. These themes indicate the relevance of and need for gender analysis within health systems research. Conclusion The implications of the diverse examples of gender and health systems research highlighted indicate that policy-makers, health practitioners and others interested in enhancing health system research and delivery have solid grounds to advance their enquiry and that one-size-fits-all heath interventions that ignore gender and intersectionality dimensions require caution. It is essential that we build upon these insights in our efforts and commitment to move towards greater equity both locally and globally.

This article poses questions, challenges, and dilemmas for health system researchers striving to better understand how gender shapes accountability mechanisms, by critically examining the relationship between accountability and gender in health systems. It raises three key considerations, namely that: (1) power and inequities are centre stage: power relations are critical to both gender and accountability, and accountability mechanisms can transform health systems to be more gender-equitable; (2) intersectionality analyses are necessary: gender is only one dimension of marginalisation and intersects with other social stratifiers to create different experiences of vulnerability; we need to take account of how these stratifiers collectively shape accountability; and (3) empowerment processes that address gender inequities are a prerequisite for bringing about accountability. We suggest that holistic approaches to understanding health systems inequities and accountability mechanisms are needed to transform gendered power inequities, impact on the gendered dimensions of ill health, and enhance health system functioning.

Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services.

This research was supported by the UK Biotechnology and Biological Sciences Research Council (BB/J010367/1) and the UK Zoonoses and Emerging Livestock Systems Initiative (BB/L017679/1, BB/L018926/1 and BB/L018845/1) (S.C., J.E.B.H., J.S., J.B., A.D., J.A.C., W.A.d.G., R.R.K., T.K., D.T.H., B.T.M., E.S.S., L.W.). The Wellcome Trust provided supported for K.H. and A.L. (095787/Z/11/Z) and K.J.A. (096400/Z/11/Z). The US National Institutes of Health provided support for J.A.C. (R01AI121378) and M.P.R. (R01AI121378, K23AI116869). Emerging zoonoses with pandemic potential are a stated priority for the global health security agenda, but endemic zoonoses also have a major societal impact in low-resource settings. Although many endemic zoonoses can be treated, timely diagnosis and appropriate clinical management of human cases is often challenging. Preventive ‘One Health’ interventions, e.g. interventions in animal populations that generate human health benefits, may provide a useful approach to overcoming some of these challenges. Effective strategies, such as animal vaccination, already exist for the prevention, control and elimination of many endemic zoonoses, including rabies, and several livestock zoonoses (e.g. brucellosis, leptospirosis, Q fever) that are important causes of human febrile illness and livestock productivity losses in low- and middle-income countries. We make the case that, for these diseases, One Health interventions have the potential to be more effective and generate more equitable benefits for human health and livelihoods, particularly in rural areas, than approaches that rely exclusively on treatment of human cases. We hypothesize that applying One Health interventions to tackle these health challenges will help to build trust, community engagement and cross-sectoral collaboration, which will in turn strengthen the capacity of fragile health systems to respond to the threat of emerging zoonoses and other future health challenges. One Health interventions thus have the potential to align the ongoing needs of disadvantaged communities with the concerns of the broader global community, providing a pragmatic and equitable approach to meeting the global goals for sustainable development and supporting the global health security agenda. Publisher PDF

This article explores new, under-researched genres of sex education for adolescents in sub-Saharan Africa resulting from access to the internet through mobile phones. It examines the history of developing online health information platforms tailored for youth through the experiences of digital developers and the reflections of users. Unlike traditional sources of sex education, the internet offers portability, anonymity, informality, ‘personalised’ responses, and the ability to interact with peers who are not local or part of face-to-face networks. This article draws on a literature review, complemented by qualitative and quantitative material generated by Every1Mobile in its production of online health communities for young people. We found massive enthusiasm for online sex education in Africa but little knowledge about how young people use, perceive and respond to this. We recommend that practitioners, funders and researchers invest more in understanding not only the many fantastic opportunities associated with digital sexual and reproductive health and rights (SRHR) information, but also the interwoven contradictions, challenges and potential for misuse.

In this introduction, we discuss some of the common issues and experiences expressed in the seven articles of this IDS Bulletin . This issue is a platform for IDS PhD researchers to reflect on their fieldwork experiences, including research‐related challenges, as well as cultural and personal encounters along the way. The authors also develop theoretically‐informed arguments about their research findings. As editors, we offer further reflections on the importance of fieldwork as part of the transformative experience of ‘doing a PhD’ in Development Studies. We suggest that the collection of articles in this IDS Bulletin represents a vision for the future of Development Studies research in which the human, relational and public work elements of research are emphasised throughout the contested process of working for change.

Objective: This paper examines questions of risk, regulation, and responsibility in relation to asbestos lodged in UK social housing. Background: Despite extensive health and safety legislation protecting against industrial exposure, very little regulatory attention is given to asbestos present in domestic homes. Conclusion: The paper argues that this lack of regulatory oversight, combined with the informal, contractual, and small-scale work undertaken in domestic homes weakens the basic premise of occupational health and safety, namely that rational decision-making, technical measures, and individual safety behavior lead concerned parties (workers, employers, and others) to minimize risk and exposure. The paper focuses on UK council or social housing, examining how local housing authorities — as landlords — have a duty to provide housing, to protect and to care for residents, but points out that these obligations do not extend to health and safety legislation in relation to DIY undertaken by residents. At the same time, only conventional occupational health and safety, based on rationality, identification, containment, and protective measures, cover itinerant workmen entering these homes. Focusing on asbestos and the way things work in reality, this paper thus explores the degree to which official health and safety regulation can safeguard maintenance and other workers in council homes. It simultaneously examines how councils advise and protect tenants as they occupy and shape their homes. In so doing, this paper challenges the notion of risk as an objective, scientific, and effective measure. In contrast, it demonstrates the ways in which occupational risk — and the choice of appropriate response — is more likely situational and determined by wide-ranging and often contradictory factors.

Many serious emerging zoonotic infections have recently arisen from bats, including Ebola, Marburg, SARS-coronavirus, Hendra, Nipah, and a number of rabies and rabies-related viruses, consistent with the overall observation that wildlife are an important source of emerging zoonoses for the human population. Mechanisms underlying the recognized association between ecosystem health and human health remain poorly understood and responding appropriately to the ecological, social and economic conditions that facilitate disease emergence and transmission represents a substantial societal challenge. In the context of disease emergence from wildlife, wildlife and habitat should be conserved, which in turn will preserve vital ecosystem structure and function, which has broader implications for human wellbeing and environmental sustainability, while simultaneously minimizing the spillover of pathogens from wild animals into human beings. In this review, we propose a novel framework for the holistic and interdisciplinary investigation of zoonotic disease emergence and its drivers, using the spillover of bat pathogens as a case study. This study has been developed to gain a detailed interdisciplinary understanding, and it combines cutting-edge perspectives from both natural and social sciences, linked to policy impacts on public health, land use and conservation.

Summary This paper examines asbestos issues, mobilisation and citizenship in India. It shows how asbestos has been considered as a tool for Indian economic growth and modernisation and explores the scientific debates around its ‘safe’ use. In seeking to locate experiences of citizenship within a globalised context, this research has focused on anti-asbestos mobilisation and protest in cosmopolitan cities as well as more decentralised contexts. It argues that the state's narrow definition of asbestos diseases enables it to officially document the lack of asbestos diseases experienced by Indian workers. This process, which defines sufferers as politically invisible and inconsequential, accompanied by the 30 year delay between exposure and the onset of disease, hinders anti-asbestos organisations as there is no constituency to be mobilised. Parallel (and partially interrelated) grassroots asbestos movements which are more worker-orientated are, however, marginalised from the transnational protests. The paper argues that mobilisation around identity issues thus creates different contexts in India, in which activists are simultaneously both intimately connected and enormously distant to different aspects of the mobilisation process. In addition, while geographic and political differences are compressed through transnational mobilisation; class, regional and educational differences are expanded.

This article examines citizen mobilisation and activism in relation to asbestos disease and litigation. Although the litigation of Cape (plc), a British company mining asbestos in South Africa, has been seen as a success story in which local activists worked alongside international lawyers and environmental campaigners to force Cape (plc) to pay compensation to 7,500 former employees with asbestos-related diseases, many claimants experienced this case as a bitter defeat. The article explores these divergent interpretations of the same litigation case, focusing on the experiences of two towns in the Northern Cape, South Africa, namely Prieska and Griquatown and on the claimants' perspectives. The literature on social movements, political mobilisation, ethnic identity and millenarian movements is drawn upon in relation to the everyday economic and cultural experiences of people in these Northern Cape towns. In contrasting the relative isolation experienced by Griquatown residents with the networking and mob...

This paper presents a conceptual approach for discussing health information seeking among poor households in Africa and Asia. This approach is part of a larger research endeavor aimed at understanding how health systems are adapting, with possibilities and constraints emerging. These health systems can be found in a context of the changing relationships between states, markets and civil society in low and middle income countries. The paper starts from an understanding of the health sector as a “health knowledge economy”, organized to provide people with access to knowledge and advice. The use of the term “health knowledge economy” draws attention to the ways the health sector is part of a broader knowledge economy changing the way individuals and households obtain and use specialist information. The paper integrates an actor centric approach with the theory of planned behavior. It seeks to identify the actors engaged in the health knowledge economy as a precursor to longer term studies on the uptake of innovations integrating health services with mobile phones, commonly designated as mHealth, contributing to an understanding of the potential vulnerabilities of poor people, and highlighting possible dangers if providers of health information and advice are strongly influenced by interest groups.

The 1996 South African census made provision for people to be white, African, coloured, or other. Various Griqua organisations challenged this categorisation and demanded the right of their constit...

This paper explores domestic violence in the rural location of Griquatown, South Africa. Although academics have long recognised that structural and cultural factors influence people's experience of domestic violence, not much has been written about the manner in which this happens. This paper explores how personal relationships intersect with broader cultural and structural forces and, in so doing, shape people's experience of domestic violence. This paper focuses on the life of one individual in order to demonstrate the multi-faceted context in which domestic violence takes shape. By bringing together individual choices, self-representation, personal relations, ethnic identity and societal demands, this paper illustrates how domestic violence is contingent upon, or mitigated by, broader societal processes that impinge on or moderate the behaviour of individuals and their spouses. It argues that domestic violence is an on-going process which results at the intersection between men's and women's personal ...

L'A. examine la relation des femmes Griqua avec leurs maisons au cours du XX eme siecle, dans le contexte historique, economique et culturel. Sur la base de donnees d'archives, elle affirme que le lien entre les femmes et les maisons en Afrique du Sud resulte d'une interaction complexe entre les origines khoi pre-coloniales, la christianisation par les missionnaires et la politique gouvernementale du logement au temps de l'apartheid. Les recherches ethnographiques mettent en evidence la maniere dont les femmes ont rituellement mis en avant le lien qui les unit aux maisons pendant la seconde moitie du XX eme siecle, sans pour autant parvenir a maintenir cette predominance dans la vie quotidienne. L'examen des rituels, des genres et de l'habitat en relation avec les objets materiels et l'espace donne des indications sur la facon dont differents rituels executes a Griquatown facilitent a la fois l'expression d'une identite Griqua clairement affirmee et les interactions multiethniques au jour le jour.

The politics of coloured people in twentieth-century South Africa have generally been characterised as marginal from mainstream South African events. Correspondingly, attempts to initiate political developments along cultural or ethnic lines - emphasising Mama or Griqua identity, for example - have been noted primarily for their divisive and factional composition. Such writings focus on overt political action. They highlight either leaders’ involvement with, or opposition to, state structures; or the internal, often petty and frustrated conflicts between leaders, but fail to explain the marginalisation of coloured politics. But this emphasis on ‘the political’ removes from our gaze other, more productive avenues for understanding the identity of mixed-race people in South Africa. Political activity, for the Griqua, cannot be evaluated except through the lens of Christianity. Since religion promises to fulfil people's ambitions through redemption in the afterlife, Griqua-Christian ideas about overt political quests and active campaigning against discrimination - on either an individual or societal level - tended to be deemed unnecessary. As it was God who ultimately meted out punishments or rewards, Griqua people's energies were better used worshipping him. Nonetheless, these same Griqua people lived in the profane world in which - at least during the apartheid era - they were officially classified as ‘coloured’. Their struggles, based primarily on the need for official ethnic recognition as Griqua, were, in effect, political struggles. This partly Griqua, partly coloured identity enabled them considerable political flexibility and produced the complex social patterns explored below. A further distinction underpinning the Griqua-coloured ambiguity was that between inkommers (newcomers) and boorlings (people born to Griqua-town).

This paper examines the intersection between environmental pollution and people’s acknowledgements of, and responses to, health issues in Karhera, a former agricultural village situated between the rapidly expanding cities of New Delhi (India’s capital) and Ghaziabad (an industrial district in Uttar Pradesh). A relational place-based view is integrated with an interpretive approach, highlighting the significance of place, people’s emic experiences, and the creation of meaning through social interactions. Research included surveying 1788 households, in-depth interviews, participatory mapping exercises, and a review of media articles on environment, pollution, and health. Karhera experiences both domestic pollution, through the use of domestic waste water, or gandapani, for vegetable irrigation, and industrial pollution through factories’ emissions into both the air and water. The paper shows that there is no uniform articulation of any environment/health threats associated with gandapani. Some people take preventative actions to avoid exposure while others do not acknowledge health implications. By contrast, industrial pollution is widely noted and frequently commented upon, but little collective action addresses this. The paper explores how the characteristics of Karhera, its heterogeneous population, diverse forms of environmental pollution, and broader governance processes, limit the potential for citizen action against pollution.

Interdisciplinary research on zoonotic disease has tended to focus on ‘risk’ of disease transmission as a conceptual common denominator. With reference to endemic zoonoses at the livestock–human interface, we argue for considering a broader sweep of disciplinary insights from anthropology and other social sciences in interdisciplinary dialogue, in particular cross-cultural perspectives on human–animal engagement. We consider diverse worldviews where human–animal encounters are perceived of in terms of the kinds of social relations they generate, and the notion of culture is extended to the ‘natural’ world. This has implications for how animals are valued, treated and prioritized. Thinking differently with and about animals and about species' boundaries could enable ways of addressing zoonotic diseases which have closer integration with people's own cultural norms. If we can bring this kind of knowledge into One Health debates, we find ourselves with a multiplicity of worldviews, where bounded categories such as human:animal and nature:culture cannot be assumed. This might in turn influence our scientific ways of seeing our own disciplinary cultures, and generate novel ways of understanding zoonoses and constructing solutions.This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’.

Paternalism as a mechanism of control has been used on South African farms since the seventeenth century. This paper explores the gendered nature of paternalism on grape farms in the Western Cape in the contemporary period and illustrates the contradictory and convoluted manner in which paternalism is played out. Control is not always the preserve of the farmer and other residents can exert control and put into effect paternalistic notions of support or denial. Women living on farms have a variety of ways in which they either make demands on the famer or avoid contact with him. This paper examines the complex and often hidden aspect of female interaction that occurs within paternalism and shows how women at particular points in the life‐cycle are far less vulnerable to paternalistic authority than women at other points.