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迈向女性主义全球卫生政策:权力、交叉性与变革

Towards a Feminist Global Health Policy: Power, intersectionality, and transformation.

作者信息

Eger Hannah, Chacko Shubha, El-Gamal Salma, Gerlinger Thomas, Kaasch Alexandra, Meudec Marie, Munshi Shehnaz, Naghipour Awa, Rhule Emma, Sandhya Yatirajula Kanaka, Uribe Oriana López

机构信息

School of Public Health, Bielefeld University, Bielefeld, Germany.

Faculty of Sociology, Bielefeld University, Bielefeld, Germany.

出版信息

PLOS Glob Public Health. 2024 Mar 7;4(3):e0002959. doi: 10.1371/journal.pgph.0002959. eCollection 2024.

Abstract

In the realm of global health policy, the intricacies of power dynamics and intersectionality have become increasingly evident. Structurally embedded power hierarchies constitute a significant concern in achieving health for all and demand transformational change. Adopting intersectional feminist approaches potentially mitigates health inequities through more inclusive and responsive health policies. While feminist approaches to foreign and development policies are receiving increasing attention, they are not accorded the importance they deserve in global health policy. This article presents a framework for a Feminist Global Health Policy (FGHP), outlines the objectives and underlying principles and identifies the actors responsible for its meaningful implementation. Recognising that power hierarchies and societal contexts inherently shape research, the proposed framework was developed via a participatory research approach that aligns with feminist principles. Three independent online focus groups were conducted between August and September 2022 with 11 participants affiliated to the global-academic or local-activist level and covering all WHO regions. The qualitative content analysis revealed that a FGHP must be centred on considerations of intersectionality, power and knowledge paradigms to present meaningful alternatives to the current structures. By balancing guiding principles with sensitivity for context-specific adaptations, the framework is designed to be applicable locally and globally, whilst its adoption is intended to advance health equity and reproductive justice, with communities and policymakers identified as the main actors. This study underscores the importance of dismantling power structures by fostering intersectional and participatory approaches for a more equitable global health landscape. The FGHP framework is intended to initiate debate among global health practitioners, policymakers, researchers and communities. Whilst an undeniably intricate and time-consuming process, continuous and collaborative work towards health equity is imperative to translate this vision into practice.

摘要

在全球卫生政策领域,权力动态和交叉性的复杂性日益明显。结构上根深蒂固的权力等级制度是实现全民健康的一个重大问题,需要进行变革性变革。采用交叉性女权主义方法有可能通过更具包容性和响应性的卫生政策来减轻卫生不平等现象。虽然女权主义对外交政策和发展政策的方法受到越来越多的关注,但在全球卫生政策中,它们并未得到应有的重视。本文提出了一个女权主义全球卫生政策(FGHP)框架,概述了目标和基本原则,并确定了负责切实实施该政策的行为主体。认识到权力等级制度和社会背景会固有地影响研究,所提议的框架是通过一种符合女权主义原则的参与性研究方法制定的。2022年8月至9月期间进行了三个独立的在线焦点小组讨论,有11名隶属于全球学术界或当地维权层面的参与者,覆盖世卫组织所有区域。定性内容分析表明,FGHP必须以交叉性、权力和知识范式的考量为中心,以便为当前结构提供有意义的替代方案。通过在指导原则与对因地制宜调整的敏感性之间取得平衡,该框架旨在在本地和全球都适用,同时其采用旨在促进卫生公平和生殖正义,社区和政策制定者被确定为主要行为主体。这项研究强调了通过促进交叉性和参与性方法来拆除权力结构对于实现更公平的全球卫生格局的重要性。FGHP框架旨在引发全球卫生从业者、政策制定者、研究人员和社区之间的辩论。虽然这是一个无疑复杂且耗时的过程,但为实现卫生公平而持续开展合作工作对于将这一愿景转化为实践至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e75/10919653/26af38ffff1d/pgph.0002959.g001.jpg

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