Theobald Sally, Nhlema-Simwaka Bertha
Liverpool School of Tropical Medicine, International Health, Pembroke Place, Liverpool, Merseyside L3 5QA, UK.
Soc Sci Med. 2008 Sep;67(5):760-70. doi: 10.1016/j.socscimed.2008.02.015. Epub 2008 Apr 9.
The case for research to promote equity in health in resource poor contexts such as Malawi is compelling. In Malawi, nearly half of all the people with tuberculosis cannot afford to access free tuberculosis services. In this scenario, there is a clear need to understand the multiple barriers poor women and men face in accessing services and pilot interventions to address these in a way that engages policy makers, practitioners and communities. This paper provides a critical reflection on our experience as applied social researchers working at the REACH (Research for Equity and Community Health) Trust in Malawi. Our work largely uses qualitative research methodologies as a tool for applied social research to explore the equity dimensions of health services in the country. We argue that a key strength of qualitative research methods and analysis is the ability to bring the perceptions and experiences of marginalised groups to policy makers and practitioners. The focus of this paper is two-fold. The first focus lies in synthesising the opportunities and challenges we have encountered in promoting the use of applied social research, and in particular qualitative research methods, on TB and HIV in Malawi. The second focus is on documenting and reflecting on our experiences of using applied social research to promote gender equity in TB/HIV policy and practice in Malawi. In this paper, we reflect on the strategic frameworks we have used in the Malawian context to try and bring the voices of poor women and men to policy makers and practitioners and hence intensify the research to policy and practice interface.
在马拉维等资源匮乏地区开展促进健康公平的研究,其理由十分充分。在马拉维,近半数结核病患者无力获得免费结核病服务。在这种情况下,显然有必要了解贫困男女在获取服务方面面临的多重障碍,并试点采取干预措施,以一种能让政策制定者、从业者和社区都参与进来的方式来解决这些问题。本文对我们作为在马拉维“拓展(促进公平与社区健康研究)信托基金”工作的应用社会研究人员的经历进行了批判性反思。我们的工作主要采用定性研究方法,作为应用社会研究的一种工具,来探究该国卫生服务的公平维度。我们认为,定性研究方法与分析的一个关键优势在于,能够将边缘化群体的看法和经历传达给政策制定者和从业者。本文有两个重点。第一个重点是综合我们在促进马拉维将应用社会研究,特别是定性研究方法,用于结核病和艾滋病研究方面所遇到的机遇与挑战。第二个重点是记录并反思我们利用应用社会研究在马拉维结核病/艾滋病政策及实践中促进性别平等的经历。在本文中,我们反思了我们在马拉维背景下所采用的战略框架,试图将贫困男女的声音传达给政策制定者和从业者,从而加强研究与政策及实践之间的联系。
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