Storeng Katerini T, Béhague Dominique P
Center for Development and the Environment, University of Oslo, London School of Hygiene and Tropical Medicine.
Med Anthropol Q. 2014 Jun;28(2):260-79. doi: 10.1111/maq.12072. Epub 2014 Mar 6.
Based on an ethnography of the international Safe Motherhood Initiative (SMI), this article charts the rise of evidence-based advocacy (EBA), a term global-level maternal health advocates have used to indicate the use of scientific evidence to bolster the SMI's authority in the global health arena. EBA represents a shift in the SMI's priorities and tactics over the past two decades, from a call to promote poor women's health on the grounds of feminism and social justice (entailing broad-scale action) to the enumeration of much more narrowly defined practices to avert maternal deaths whose outcomes and cost effectiveness can be measured and evaluated. Though linked to the growth of an audit- and business-oriented ethos, we draw from anthropological theory of global forms to argue that EBA-or "playing the numbers game"-profoundly affects nearly every facet of evidence production, bringing about ambivalent reactions and a contested technocratic narrowing of the SMI's policy agenda.
基于对国际安全孕产倡议（SMI）的人种志研究，本文梳理了循证宣传（EBA）的兴起。全球层面的孕产妇健康倡导者用这个术语来表示利用科学证据增强SMI在全球卫生领域的权威性。循证宣传代表了SMI在过去二十年里优先事项和策略的转变，从基于女权主义和社会正义呼吁促进贫困妇女健康（需要大规模行动），转变为列举定义更狭窄的预防孕产妇死亡的做法，这些做法的结果和成本效益可以衡量和评估。尽管与以审计和商业为导向的风气增长有关，但我们借鉴全球形式的人类学理论认为，循证宣传——或“玩数字游戏”——深刻影响证据生产的几乎每个方面，引发矛盾反应，并导致SMI政策议程在技术官僚层面上出现有争议的狭隘化。
