What is a Health System? Postcolonial Sensibilities and Health Systems as Objects of Inquiry and Critique

Session Submission Type: Traditional (Closed) Panel

Abstract

What is a health system? How do we locate, bound, identify, and study it? In what sorts of practices, infrastructures, policies, and economies does it adhere? Much work in STS and related fields has taken the health system as an object of study and critique. A powerful actor’s category for representing and organizing service delivery, attention to health systems often also contextualizes and critical examinations of global health. Not only material infrastructures, bureaucratic designations, and networks for distribution, health systems are also colonial artefacts and “contact zones” (Anderson 2014), working to distribute and produce power and difference in the present. Yet while recent anthropological and STS attention has productively explored infrastructures as sites of critical world-making and analysis, less attention has been paid to the work of systems thinking for practitioners, patients, scholars and critics. This panel draws from postcolonial STS approaches to explore the work that systems-thinking about health enables within these accounts. Through examples from Papua New Guinea, Iraq, Mozambique, South Africa, and Haiti, this panel explores the uneven political and therapeutic registries in which health systems inhere. It asks: what do systems and infrastructural thinking about health enable? What other modes of giving care, organizing politics, and producing value exist within and alongside the system? What critical sensibilities do discourses of “the system” facilitate or foreclose?

Sub Unit

• 4S Annual Meeting

Chair

• Ramah McKay, University of Pennsylvania

Discussants

• Omar Al-Dewachi, American University of Beirut

• Bharat Jayram Venkat, University of Oregon

Individual Presentations

• Peripheral critiques, or where is the system? Health systems, urban relations, and trajectories of care - Ramah McKay, University of Pennsylvania

• Relational infrastructures: notes on service delivery from the periphery - Alice Street, University of Edinburgh

• Interrogating Presence and Absence in South Africa’s Cervical Cancer Crisis - Marissa Mika, University College London

• Haitian Researchers and the Production of Authoritative Knowledge - Pierre Minn, Université de Montréal