Deciding what matters in everyday maternal health

Maternal health is a key indicator of a country’s progress in improving both health equity and social inequality. At least this is what I read on an almost daily basis, it becomes an opening statement to my grant bids and a mantra I repeat often in the classroom. I do on many levels believe this is true. I have previously, in broader terms argued that the way in which a society treats women, is an overall indicator of oppression and inequality in said society. So it follows suit, maternal health may be one way in which this is reflected. Yet, beyond the grand statement, how do we prove this is so? What kinds of evidence counts, and who gets to say so?

I’m juggling a few (sparsely funded) projects at the moment. Making sure that whatever the outcome of my next contract timeline, I have a CV that reflects I’ve achieved something and that daily academic duties have not torn me too far apart from my research topic of choice. Contract precarity is not something I mean to discuss in this post or this blog at all. But I will make this optimistic point – it is forcing me to focus, tame my possibility tentacles and make sure I have an overall project that not only relates to my current post, but can move with me if I need to. Realistically, that does play a part in deciding which aspects of gender, relationships and health I throw my energies at.

I’ve got the core debates down, I know that MMR is a key yet slippy issue, I’m glad that global health has finally listened to social science and recognised that quantity does not equate to quality in health care provision. I am energised by the standard of amazing work coming out of medical anthropology in terms of challenging metrics, RCTs and the politics of universality. Moreover, I have gained enough in confidence to recognise that I must work with and not against my colleagues in medicine if change is ever likely to occur. My interactions within the institutional realms of health have become as much a source of field data as when I am wandering clueless and happy through the neighbourhoods of urban Chiapas. I am finally hitting on a way to enmesh the rhetoric with the everyday. I have spent enough time in my own fieldnotes to constantly ask of policy – “But what would this mean to …..?” “What would she/they have to say about this claim …?” or “Does this matter to …., what would they say was important”. In other words, my interlocutors have become my method through which I analyse and evaluate the claims of global health.

As the brilliant anthropologist Vincanne Adams and her collaborators argue, new is not always better and time must be taken to evaluate success in a localised sense, before the next big idea springs into action. The ‘slow research’ method (i.e. ethnography) proposed by Adam’s and her colleagues offers a direct challenge to the market demand for innovation in global health research. In this respect I am taking a moment to pause, go back to the beginning of my overlapping projects, and also the drivers behind them. In doing so I will repeat some old questions, to see if I am offered insight and a different perspective. Using my most established field contacts and the written down conversations I have had with them over the years, I begin from today to ask what maternal health is in an ethnographic sense, and moreover what matters to those living through it? My challenge is to define Everyday Maternal Health, at least in a Mexican context and over time find some clarity over local variance and priority – one that can confidently contribute to macro ideas about what women actually, and really need to address the power imbalances in their lives.

Watch this space …



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