Anthropology & Medicine最新文献

This paper examines the changing terrain of accessing health and illness guidance and information through the lens of social media, specifically It argues how Instagram, has increasingly become an unregulated -public health platform in today's digital society. Drawing on extensive empirical interview data from two research projects before and during the COVID-19 pandemic, which explored how users showcased and performed health and illness on Instagram, this paper demonstrates how Instagram has became an important forum from which to perform proactive health practices, as well as to legitimate ill health through making healthy behaviours visible, as well as invisible illnesses like disease, COVID-19, and mental health conditions. Over time and through continuous sharing of this content may contribute to increased understanding or even a de-stigmatisation of such illnesses or chronic conditions. With the social media market currently valued at 49.9 billion, and influencer spending around 4.9 billion, the value, reach and direct impact of this 'attention economy' on public health should not be underestimated. Instagram serves as a forum for these practices and helps legitimize ill health by making both healthy behaviours and -invisible illnesses visible. This visibility can contribute to increased understanding and de-stigmatization of chronic conditions and mental health issues. The paper argues that Instagram has evolved into an informal, unregulated public health platform.

This paper discusses the afterlives of MOS@N, a mobile health (mHealth) intervention which, between 2014 and 2018, monitored maternal and child health in the district of Nouna, in rural Burkina Faso. The paper documents the work of "godmothers," who were hired and equipped with mobile phones to keep track of pregnant women, and accompany them for medical consultations. As is the case with the majority of mHealth projects in Sub-Saharan Africa, MOS@N was a pilot. This paper examines some of the enduring effects of practices of testing and demoing which were designed as temporary. Indeed, three years after MOS@N was shut down, godmothers are still doing care work. This work is now carried mostly on a voluntary basis and implies the constant repair of decaying technology, which undermines some of the original purposes of MOS@N, and (re)produces gendered forms of social obligation. Ultimately, the paper explores the remnants of a settled intervention, and how they may help us challenge imaginations of global health futures.

As projects seeking to provide digitized tools in health care and medicine are gaining ground at an accelerating pace, imaginations and incipient formations of digital health have acquired a new political urgency. These projects promise to revolutionize health care and medicine. However, efforts to institutionalize digital technologies in health are often fraught with difficulties that cause them to stall during implementation. We explore digital health technologies with respect to how they are aspired to, designed, used, and resisted. Our central argument is that the spread of digital health technologies has set in motion complex processes around the production, extraction, circulation, and economic valorization of data. These processes reconfigure multiple sets of relationships between people, between human bodies, and machines, and between actors in health care and the diverse institutional landscapes they inhabit. We explore these processes in three interrelated and geographically dispersed fields: (a) imaginaries of health and well-being; (b) new geographies of care; and (c) the datafication and (dis-)embodiment of health. This special issue brings into creative tension case studies from across geographical locations and thematic areas. Taken together, they draw attention to the question of how digital health technologies are situated in making and shaping the future of health care. By foregrounding anthropological perspectives, this Special Issue pushes the epistemological boundaries of the emerging scholarship on digital health technologies and global health. At the same time, it argues for a closer engagement of medical anthropologists and sociologists with processes of digitization in health.

The practices surrounding pregnancy ends and pregnancy remains shift and change depending on the cultural and historical context. Based on ethnographic research in one group NHS Hospital organisation in England, the paper explores what practices around pregnancy remains reveal about the values afforded the material in different contexts by different actors and the moments when these intersect. It argues that framing miscarriage as bereavement helps to structure caregiving in clinical settings and that clinical practices produce foetal personhood in ways that may not be in keeping with women's notions of their pregnancy material. It illustrates that hospital practices contain notions of value which become legitimated as the appropriate approach with consequences for normativity. This may lead to women feeling isolated and abnormal when their approach is at odds with that of the clinic. Through an exploration of how women encounter and negotiate disposal practices, the paper argues that current practice requires revision to flexibly respond to diversity but also shifting meaning and values attributed to these experiences and materials.

The potentials of digital health to improve health outcomes by empowering patients with more control over their health data have transformed into threats of criminalization in the post-Roe era, threats that are creating serious, and at times deadly, harms to patients and the providers that care for them. While patients' health data are increasingly used to criminalize healthcare, data activists, legislators, and lawyers are engaged in radical caretaking strategies to protect health data, patients, and abortion care providers.

This paper examines the aspirations, imaginaries and utopias of designers of an AI-based mental health app in India. By looking at automated therapy as both technological fix and sociotechnical object, I ask, What can we learn from engaging with psy technologists' imaginaries and practices of health care futures? What are the assumptions they encode in the app? How does automated therapy reconfigure the geographies and temporalities of care? While automated therapy as instantiated by Wysa provides, I argue, a modest mental health intervention, the scalar aspirations of designers are anything but small. The paper proceeds in three steps. First, it turns to designers' imaginaries of what it means to care for current mental health needs in digitally saturated lifeworlds and how they inscribe them into the app. It identifies nonjudgmental listening, anonymity, acceptance, reframing, and agency as key ideas encoded in Wysa's sociotechnical algorithms, along with a congruence between entrepreneurial and encoded ethics of care. Second, it situates automated therapy within anthropological scholarship on 'little' technical devices in global health to argue that automated therapy devices such as Wysa articulate dreams for minimalist interventions with macro effects. Finally, it explores the new geographies and temporalities of care that automated therapy spurs, tracing the ways the app bridges various spatial and temporal gaps and obstacles of human therapy and upends common global health pathways. This paper contributes to recent scholarship on aspirations, dreams and utopias and on digitization and datafication in global health.

Based on ethnographic research in northern Ghana, this article explores the complex logistics of blood and the ways in which the availability of blood has been transformed through the introduction of drones. We explore how drone services affect this ecosystem of supply and contribute to reshaping the practices of physicians, nurses, facility pharmacists and stock managers, as well as the expectations and experiences of patients and their families. Situated at the interface of medical anthropology, critical studies of infrastructure and anthropological studies of digital innovations in healthcare, our paper attends to the emerging anthropological research on medical logistics as a means of connecting people with medical resources. It demonstrates the fundamentally ambivalent nature of technological innovation: on the one hand, drones have fueled health workers' hopes and transformed access to blood. On the other hand, their introduction has also led to connectivity without stock. In line with STS scholarship, we highlight the important role of the physical properties of objects such as blood in shaping their circulation.

This paper examines a digital platform used in the primary health sector in a state in Eastern India. Within a 'regime of tactility,' it is supposed to redefine the state's presence in rural areas, not only by attending to patients but also by screening the population and establishing health databases. While the health workers who operate the digital platform represent the state in 'the peripheries,' the state itself exhibits mistrust towards them and monitors their performance through the platform. Based on long-term ethnographic research, the manuscript analyses the use of digital health technologies as technologies of accountability. The competitive nature of monitoring techniques leads to an ever-higher number of digital consultations, which projects the image of a caring and efficient state. However, the paper also explores the unintended consequences of this politics by display on the provision of healthcare. Even though digital technologies and the managerial form of governance they engender promise to touch people's lives, they lead to intangible forms of care while leaving untouched pressing structural issues that India's health sector has been facing for decades.

This paper traces how the meaning of symptoms and the positioning of selves are entangled and discursively constructed in therapeutic conversations between parents and therapists at a pain clinic for children and young people (age 8 to 18) with recurrent or chronic pain or other somatic symptoms with no established biophysical pathology. Based on data material from an ethnographic fieldwork it is examined how the selves of respectively children/young people and their parents are discursively positioned in conversational encounters and the role positioning of selves play in the context of establishing and negotiating the symptoms' meaning. The bearer of medically unexplained symptoms is oftentimes subjected to moral assessments. In this paper it will be shown that parents, in the institutional setting of the pain clinic, enter the negotiation of moral assessments assigned to their children, and that these moral assessments not only concern the sufferers' selves but also the selves of the parents. The overall argument is that dialogues between parents and therapists concerning the meaning and source of their children's symptoms are simultaneously negotiations in which not only the sufferers'  but also their parents' moral positions are at stake.

In recent decades, policy makers around the world have been working on implementing various technologies into healthcare, and the Covid19 pandemic fueled this process. The specialized technological solutions for telecare - the use of technologies for care at a distance - are often adopted by users in different ways than intended, or are abandoned if the users cannot find applications that are meaningful to them. However, beyond specialized healthcare technologies, people are incorporating mundane digital technologies into their (health)care practices. In this paper, we draw on ethnographic research on the use of everyday digital technologies in Indian families where migrating children who are professional nurses care for their aging parents at a distance. Our findings show that 1) remote elder care is enacted through frequent calling which further fosters trust, necessary to provide healthcare remotely; 2) the motivation for older adults to engage with digital technologies is grounded in the value of family and affect which is consequential also for health; 3) technologies, too, require care-work in the form of everyday maintenance; and 4) in-person visits from children remain important, indicating that hybrid interaction is optimal for good care at a distance. We conclude that taking these findings into account may contribute to a more successful implementation of formal telecare systems.