School of Health and Psychological Sciences, City, University of London, UK.
UCL Arts and Sciences Department, University College London, UK.
Soc Sci Med. 2022 May;301:114955. doi: 10.1016/j.socscimed.2022.114955. Epub 2022 Apr 1.
As global health research seeks to decolonialise, democratise, and become more culturally engaging, researchers are increasingly employing participatory and co-productive methods. Working from post-structural perspectives, this meta-ethnographic review explores how such health research in Nepal engages with the epistemological, methodological, and ethical questions it encounters. Five databases including Nepali NepJOL were searched for studies from inception to March 2021. The review included seven studies covering women's group co-production, interviews guided by photo-elicitation, observational methods to explore maternal and child health, mental health, and environmental determinants of health. This meta-ethnography identified that, against the background of a pluralist heritage of health practices, global collaborations involving Nepali researchers and practitioners used participatory research methodology to work with the local populations to improve health and co-production seek primarily to promote Western biomedical and psychosocial interventions. Both advantages and disadvantages were acknowledged. Empirical verification and global acceptance of Western biomedical and psychosocial knowledge were seen as beneficial. Moreover, Western biomedicine was perceived by some as more effective than some local practices in improving health; nevertheless, Nepal faces many challenges that neither can address alone. For participatory and co-productive approaches to become epistemologically enculturated within Nepali health research, researchers need to co-develop more local models and methods which are culturally sensitive and appropriate. Meaningful and effective participatory research can promote active involvement of people who deliver as well as people who use the community-based health care support. These are crucial to optimise sustainable change that global health research partnerships set out to achieve. This meta-ethnography recommends that researchers engage at a deeper level with the epistemological differences between themselves and the communities with whom they seek partnership. Cross-cultural research teams should discuss and address the power differentials which might affect them.
随着全球健康研究寻求去殖民化、民主化并变得更具文化吸引力，研究人员越来越多地采用参与式和共同生产方法。本文从后结构主义的角度探讨了尼泊尔的此类健康研究如何应对其遇到的认识论、方法论和伦理问题。从五个数据库（包括尼泊尔 NepJOL）中搜索了从开始到 2021 年 3 月的研究。该综述包括七项研究，涵盖了妇女团体的共同生产、照片启发式访谈、观察方法以探讨母婴健康、心理健康和健康的环境决定因素。这项元民族志研究发现，在健康实践的多元主义遗产背景下，涉及尼泊尔研究人员和从业者的全球合作利用参与式研究方法与当地居民合作改善健康，共同生产主要旨在促进西方生物医学和心理社会干预。既承认了优势，也承认了劣势。人们认为，验证和接受西方生物医学和心理社会知识具有全球优势。此外，一些人认为，西方医学在改善健康方面比一些当地做法更有效；然而，尼泊尔面临着许多挑战，单凭任何一方都无法解决。为了使参与式和共同生产方法在尼泊尔健康研究中具有认识论的文化适应性，研究人员需要共同开发更具文化敏感性和适宜性的当地模式和方法。有意义和有效的参与式研究可以促进提供和使用社区为基础的医疗保健支持的人们的积极参与。这些对于优化全球健康研究伙伴关系旨在实现的可持续变革至关重要。这项元民族志研究建议研究人员在更深层次上参与他们自己和他们寻求合作的社区之间的认识论差异。跨文化研究团队应该讨论和解决可能影响他们的权力差异。
