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“不是为了巨额利润,而是因为这是正确的”:英印卫生工作者教育和培训出口的有争议的道德经济。

'Not in it for huge profits but because it's right': The contested moral economies of UK-India exports in health worker education and training.

机构信息

Department of International Development, King's College London, London, UK.

Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.

出版信息

Sociol Health Illn. 2024 Feb;46(2):219-235. doi: 10.1111/1467-9566.13700. Epub 2023 Aug 14.

Abstract

While the growth of global markets in health-related services may have significant consequences for healthcare provisioning and training, it has received relatively little attention from the social sciences. This article examines UK-India, and specifically England-India, exports in health worker education and training as one such global market, drawing on sociological scholarship on moral economies to understand how trading in this field is constructed and legitimated by the individuals and organisations involved, what tensions evolve, and what is at stake in them. We employ a qualitative mixed methods approach using publicly available materials on existing UK-India collaborations and primary data from interviews with key stakeholders in India and the UK, including government departments, arms-length bodies, NHS Trusts, trade associations and private providers. Our analysis illustrates the key discursive strategies used to legitimate engagement in these markets, and the complex and contested moral economies unfolding between and across these stakeholders and contexts. Not least, we demonstrate the conflicting moral sentiments and the boundary work required to realise commodification. Situating cross-border trade in health worker education and training in a moral economy framework thus illuminates the social context and moral worlds in which this evolving trade is embedded.

摘要

尽管与健康相关的服务的全球市场的增长可能对医疗保健供应和培训产生重大影响,但它在社会科学领域受到的关注相对较少。本文考察了英国-印度,特别是英格兰-印度,在卫生工作者教育和培训方面的出口,将其作为这样一个全球市场,借鉴关于道德经济的社会学研究,以了解该领域的贸易是如何由相关个人和组织构建和合法化的,出现了哪些紧张关系,以及这些关系存在哪些利害关系。我们采用了定性混合方法,使用了现有的英印合作关系的公开材料和来自印度和英国主要利益相关者的访谈的原始数据,包括政府部门、独立机构、NHS 信托基金、贸易协会和私营供应商。我们的分析说明了用于使这些市场的参与合法化的关键话语策略,以及在这些利益相关者和背景之间以及跨这些利益相关者和背景展开的复杂和有争议的道德经济。我们尤其展示了实现商品化所需的相互冲突的道德情绪和边界工作。因此,将跨境卫生工作者教育和培训贸易置于道德经济框架中,可以阐明这种不断发展的贸易所嵌入的社会背景和道德世界。

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