Rethinking development interventions through the lens of decoloniality in sub-Saharan Africa: The case of global health

There has been much talk about decolonizing global health lately. The movement, which has arisen in various communities around the world, suggests an interesting critique of the Western dominant model of representations. Building upon the 'decolonial thinking' movement from the perspective of Francophone African philosophers, we comment on its potential for inspiring the field of global healthinterventions. Using existing literature and personal reflections, we reflect on two widely known illustrations of global health interventions implemented in sub-Saharan Africa - distribution of contraceptives and dissemination of Ebola virus prevention and treatment devices - featuring different temporal backdrops. We show how these solutions have most often targeted the superficial dimensions of global health problems, sidestepping the structures and mental models that shape the actions and reactions of African populations. Lastly, we question the ways through which the decolonial approach might indeed offer a credible positioning for rethinking global health interventions.

Deconstructing the notion of "global health research partnerships" across Northern and African contexts

BACKGROUND

Global health conceives the notion of partnership between North and South as central to the foundations of this academic field. Indeed, global health aspires to an equal positioning of Northern and Southern actors. While the notion of partnership may be used to position the field of global health morally, this politicization may mask persisting inequalities in global health. In this paper, we reflect on global health partnerships by revisiting the origins of global health and deconstructing the notion of partnership. We also review promising initiatives that may help to rebalance the relationship.

RESULTS AND DISCUSSION

Historical accounts are helpful in unpacking the genesis of collaborative research between Northerners and Southerners - particularly those coming from the African continent. In the 1980s, the creation of a scientific hub of working relationships based on material differences created a context that was bound to create tensions between the alleged "partners". Today, partnerships provide assistance to underfunded African research institutions, but this assistance is often tied with hypotheses about program priorities that Northern funders require from their Southern collaborators. African researchers are often unable to lead or contribute substantially to publications for lack of scientific writing skills, for instance. Conversely, academics from African countries report frustrations at not being consulted when the main conceptual issues of a research project are discussed. However, in the name of political correctness, these frustrations are not spoken aloud. Fortunately, initiatives that shift paternalistic programs to formally incorporate a mutually beneficial design at their inception with equal input from all stakeholders are becoming increasingly prominent, especially initiatives involving young researchers.

CONCLUSION

Several concrete steps can be undertaken to rethink partnerships. This goes hand in hand with reconceptualizing global health as an academic discipline, mainly through being explicit about past and present inequalities between Northern and Southern universities that this discipline has thus far eluded. Authentic and transformative partnerships are vital to overcome the one-sided nature of many partnerships that can provide a breeding-ground for inequality.

Une politique concernant les données issues d’un programme de recherches interventionnelles en santé mondiale

La recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d’argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant la conduite responsable lors des recherches collaboratives. L’un d’eux est la conservation, l’accès, l’utilisation et la publication des données. Malgré l’existence de multiples politiques et documents phares sur l’éthique et la conduite responsable de la recherche, les chercheurs en recherche interventionnelle sont encore peu outillés pour faire face à ce défi. Dans le contexte d’un programme de recherches interventionnelles réalisées au Burkina Faso, les auteurs souhaitent partager leur expérience dans le développement d’une politique interne concernant leurs données. Après avoir évoqué le contexte global et particulier, l’article présente le processus de formulation et d’adoption de cette politique par les chercheurs d’une équipe interdisciplinaire et internationale (Allemagne, Burkina Faso, Canada, France). Les valeurs qui enchâssent cette politique interne sont la transparence, la prévention, le consensus autour du processus de production, le respect des principes internationaux, l’accès libre aux connaissances produites et la préoccupation pour leur diffusion et utilisation. La politique se présente en plusieurs parties : objet, types et statuts des chercheurs impliqués, conservation des données, accès et utilisation des données, production scientifique et paternité. Les principaux défis rencontrés par les chercheurs pour formuler cette politique sont analysés dans un souci de partage pour susciter un débat rarement abordé. La confiance, la transparence et le respect mutuel doivent être au coeur de tout partenariat scientifique en recherche interventionnelle.

A mixed methods contribution to the study of health public policies: complementarities and difficulties

The use of mixed methods (combining quantitative and qualitative data) is developing in a variety of forms, especially in the health field. Our own research has adopted this perspective from the outset. We have sought all along to innovate in various ways and especially to develop an equal partnership, in the sense of not allowing any single approach to dominate. After briefly describing mixed methods, in this article we explain and illustrate how we have exploited both qualitative and quantitative methods to answer our research questions, ending with a reflective analysis of our experiment.