The rise of non-communicable disease (NCDs) in Mozambique: decolonising gender and global health

Abstract

garantizar que los feminismos africanos contribuyan a la comprensión y la programación futuras, basadas en el género, en torno a las ENT. Lo anterior también debe orientarse a responder a la nueva arremetida y la doble carga representada por las ENT para Mozambique y el África subsahariana en general.

Missing in action: a scoping review of gender as the overlooked component in decolonial discourses

“…Papers that discussed (de)coloniality and engaged with gender covered a range of global health issues, from specific topic areas to broader concerns about governance and knowledge. Six papers focused on sexual and reproductive health and rights19–24 with a further two papers specifically on maternal health,25 26 while five papers focused on mental health,27–31 three papers discussed health in humanitarian settings,30 32 33 two papers focused on planetary health34 35 and one paper focused on non-communicable diseases 36. Five papers had a focus on pandemics, ranging from prevention37 to transmission38 to response,39–41 and one highlighted the challenges surrounding the production and distribution of vaccines 42.…”

“…Five papers had a focus on pandemics, ranging from prevention37 to transmission38 to response,39–41 and one highlighted the challenges surrounding the production and distribution of vaccines 42. Nine papers had a service delivery focus which analysed the impact of (de)coloniality on service provision21 25 39 43 44 and service providers,23 36 45 46 while seven analysed community engagement in research methods40 44 47–50 and programme design 38. Seven papers concentrated on Indigenous health, of which four studied the health of Indigenous peoples39 40 43 46 and three discussed Indigenous conceptions of health 34 37 49…”

“…The Eurocentric worldview which determines, among other things, prevailing paradigms in how the bodies of ‘others’ are viewed, has impacted the way that global health has been, is and might be implemented. 10 papers19 21–23 26 36 44 59 64 71 in our study explored these facets in more detail, illustrating how ‘ethnic stereotypes and gendered racial ideas’ affect programme design, targeted populations and service delivery 19 22 23 59 64. Coloniality, through the legacies imprinted in both postcolonial governance and health systems, continues to produce ripple effects in local implementation efforts.…”

“…Within global health, the continued existence of this hierarchy has significant consequences in research, policy and practice as it reinforces the hegemony of Eurocentric ways of knowing, gatekeeps priority-setting power and silences voices deemed to be inferior in decision-making fora 21 45 55. Even for those seeking to interrogate and challenge gendered inequalities in health, Somerville and Munguambe caution that there is an ever-present risk of falling ‘into the same problematic space of taking as starting point conceptualisations of gender that are born of a theoretical tradition that is firmly Western’, which runs counter to contemporary understandings of gender as a colonial construct and risks creating perceptions of gender equality as a ‘neocolonial imposition’ 36…”

“…Coloniality is an inherently destructive endeavour, predicated on the eradication and replacement of one or many things with a hegemonic ‘default’. Eight papers21 35 36 45 48 55 60 69 discussed how coloniality put into place a hierarchy of knowledge and its gendered dimensions and impacts. This hierarchy of knowledge is a clear extension of the racialised and gendered hierarchy which governed colonial and colonised societies, with white men identified as ‘the only legitimate purveyors’60 of knowledge, a knowledge that is derived from Eurocentric epistemology.…”