Conflict, health care and professional perseverance: A qualitative study in the West Bank

Sousa, Cindy; Hagopian, Amy

doi:10.1080/17441692.2011.574146

Cited by 31 publications

(46 citation statements)

References 20 publications

(11 reference statements)

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“…The need for human resources in the health sectors of Africa (private or public), has appropriately garnered attention from international policy experts, as well as Ministries of Health throughout the region [1-4]. However, Ministries and donors alike remain uncertain about which, if any, targeted investments have the potential to measurably improve the number, retention and distribution of health personnel [5-8].…”

Section: Introductionmentioning

confidence: 99%

Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions

et al. 2011

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BackgroundThe ability of many countries to achieve national health goals such as the Millennium Development Goals remains hindered by inadequate and poorly distributed health personnel, including doctors. The distribution of doctors in Ghana is highly skewed, with a majority serving in two major metropolitan areas (Accra and Kumasi), and inadequate numbers in remote and rural districts. Recent policies increasing health worker salaries have reduced migration of doctors out of Ghana, but made little difference to distribution within the country. This qualitative study was undertaken to understand how practicing doctors and medical leaders in Ghana describe the key factors reducing recruitment and retention of health professionals into remote areas, and to document their proposed policy solutions.MethodsIn-depth interviews were carried out with 84 doctors and medical leaders, including 17 regional medical directors and deputy directors from across Ghana, and 67 doctors currently practicing in 3 regions (Greater Accra, Brong Ahafo, and Upper West); these 3 regions were chosen to represent progressively more remote distances from the capital of Accra.Results and discussionAll participants felt that rural postings must have special career or monetary incentives given the loss of locum (i.e. moonlighting income), the higher workload, and professional isolation of remote assignments. Career 'death' and prolonged rural appointments were a common fear, and proposed policy solutions focused considerably on career incentives, such as guaranteed promotion or a study opportunity after some fixed term of service in a remote or hardship area. There was considerable stress placed on the need for rural doctors to have periodic contact with mentors through rural rotation of specialists, or remote learning centers, and reliable terms of appointment with fixed end-points. Also raised, but given less emphasis, were concerns about the adequacy of clinical equipment in remote facilities, and remote accommodations.ConclusionsIn-depth discussions with doctors suggest that while salary is important, it is career development priorities that are keeping doctors in urban centers. Short-term service in rural areas would be more appealing if it were linked to special mentoring and/or training, and led to career advancement.

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Section: Introductionmentioning

confidence: 99%

Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions

et al. 2011

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“…Oftentimes these contributions focus on the attacks the medical sector faces (Rubenstein 2013;Fouad, Sparrow, et al 2017). This article contributes to the few works currently available on local health workers' considerations, and experiences in times of conflict and political unrest (see also Footer, et al 2014:385;Peterson 2015:6;Sousa and Hagopian 2011;Aciksoz 2016).…”

Section: Introductionmentioning

confidence: 95%

Beyond medical humanitarianism - Politics and humanitarianism in the figure of the Mīdānī physician

Roborgh

2018

Social Science & Medicine

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This article explores the complex position of local physicians at times of political unrest or conflict, conceptualizing local medical voluntarism as a form of collective action. It analyzes the evolving interpretation of medical neutrality among Egyptian physicians who provided medical assistance to injured protesters in the Egyptian uprising (2011-2013). In-depth interviews with 24 medical and non-medical volunteers on their perception of medical neutrality were matched with their mobilization and participation history, showing the extent towards which political considerations influenced their voluntary medical engagement. The results firstly show that revolutionary political considerations played a central role in the physicians' mobilization into medical networks active in the protests, as well as in their interpretation of their medical and non-medical activities. Secondly, I argue that the interpretation of medical neutrality among Egyptian physicians evolved significantly over time. A special type of medical volunteer took shape, the mīdānī physician. This physician openly expresses his/her political convictions and adheres to (self-defined) humanitarian principles through a conscious reconciliation of the two. The article details the increasing difficulty of this task after the revolutionary movement splintered into competing factions and citizens ended up fighting each other instead of authoritarian rule.

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“…Then, in seeking to disentangle the conflicts' pervasive effects on the provision and organization of Gilgit's health services, my work builds on the emerging medical anthropology of clinics in or affected by crisis. In particular, my analysis is informed by ethnographies which foreground the moral economies and proliferative symbolic and structural inequities, neglects and violence inherent to health systems during insecurity and warfare (see Giacaman et al 2005;Hassan-Bitar and Wick 2007;Ifthikhar ud din, Mumtaz and Ataullahjan 2012;Sousa and Hagopian 2011;Varley 2010;Varma 2012). As Pfingst and Rosengarten (2012) and Wick (2008) show for health facilities and services in the at-siege Occupied Palestinian Territories, recent medical ethnographies confirm how during warfare hospitals can be harnessed as sites of biopolitical capital formation or targeted for necropolitical destruction.…”

Section: Introductionmentioning

confidence: 99%

Abandonments, Solidarities and Logics of Care: Hospitals as Sites of Sectarian Conflict in Gilgit-Baltistan

Varley¹

2015

Cult Med Psychiatry

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Using data collected over nearly three years of ethnographic fieldwork in the Gilgit-Baltistan region of northern Pakistan, my paper explores hospital spaces, clinical services and treatment encounters as conduits for the expression and propagation of conflictive Shia-Sunni sectarianism. Where my prior research has investigated the political etiologies (Hamdy in Am Ethnol 35(4):553-569, 2008) associated with Gilgiti women's experiences of childbirth during 'tensions', as Shia-Sunni hostilities are locally known, this paper focuses on healthcare providers' professional and personal navigations of an episode of conflict whose epicentre was at the District Headquarter Hospital, Gilgit-Baltistan's foremost government hospital. Through critical evaluation of the impacts of Shia-Sunni tensions on the social, administrative and clinical practices and consequences of medicine, my paper analyses the complex ways that clinics in crisis serve as zones of contact (Pratt in Profession 91:33-40, 1991) and abandonment (Biehl in Soc Text 68(19):131-149, 2001; Subjectivity: ethnographic investigations, 2007), in which neglect and harm are directed along lines of sectarian affiliation to produce vulnerability, spectacular violence and death for healthcare providers and patients.

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Conflict, health care and professional perseverance: A qualitative study in the West Bank

Cited by 31 publications

References 20 publications

Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions

Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions

Beyond medical humanitarianism - Politics and humanitarianism in the figure of the Mīdānī physician

Abandonments, Solidarities and Logics of Care: Hospitals as Sites of Sectarian Conflict in Gilgit-Baltistan

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