The ‘us and them divide’: A qualitative study of student experiences of global health education through the lens of ‘inclusivity’

Abstract

The Global Health (GH) field is characterised by stark inequalities, including a strong over-representation of GH leaders from/trained in high-income countries (HICs). There are no empirical studies exploring how experiences of GH education in HICs could have a role in reproducing, or potentially challenging, these inequalities. We address this by qualitatively analysing student and alum experiences of a one-year GH Bachelor of Science course at a research-intensive UK university (April 2019 and April 2020). Drawing from educational literature, we mobilise the concept of inclusivity to access participants' course experiences, and the concept of ‘tensionality’ to situate the ‘lived’ context of the GH classroom. We also situate this context within broader theories of a Western or foreign ‘gaze’, the concept of ‘cognitive’ or ‘epistemic’ (in)justice and field of critical pedagogy. We find that the underpinning inequalities in GH, the ways in which communities that are the “object of study” are re-presented and their frequent absence (non-representation), creates a tension experienced by all students, regardless of their identities. However, the inclusive/non-inclusive dichotomy is not a simple one. GH education can be experienced as simultaneously empowering and alienating. The paper identifies the most promising curricular and pedagogic principles and concludes that GH educators must embrace the underpinning ‘tensionality’ of GH education. Whilst doing so is insufficient to resolve tensions and inequalities, it can enhance educational by modelling simple action to acknowledge cognitive injustice, gesturing towards pluriversality and engaging practically with the potential of the GH education sector to impact inequalities in the field.