Hayley MacGregor: health and the STEPS Centre's pathways approach


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Presentation by Hayley MacGregor at the First Global Symposium on Health Systems Research, 17 November 2010.

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Hayley MacGregor: health and the STEPS Centre's pathways approach

  1. 1. The ESRC STEPS Centre Social Technological and Environmental Pathways to Sustainability
  2. 2. Global challenges in a dynamic world….
  3. 3. STEPS challenges • Linking environmental sustainability with poverty reduction and social justice • Making science and technology work for the poor Conventional approach failures • Separate sectors and disciplines • Assumed stability and certainty • Universalised views • Missing targets, failing the poor www.steps-centre.org
  4. 4. The STEPS approach from singular solution towards multiple pathways • Understanding dynamic patterns & pathways of change • Addressing governance - politics and institutions • New tools and methods for appraisal, deliberation, mobilisation • Building pathways to Sustainability - involving poorer and marginalised people, contributing to their goals • Across food & agriculture, health & disease, water & sanitation www.steps-centre.org
  5. 5. What makes STEPS different • Social and natural scientists working together • Linking development studies with science and technology studies • Interactive research involving citizens and decision- makers • Reflexive approach, appreciating how one’s position affects action • Adaptive approach, dealing with uncertainty and building resilience • Building on the knowledge and perspectives of marginalised people • Integrating research and communication www.steps-centre.org
  6. 6. Initial global projects with partners • Crop disease & innovation: Negotiating maize innovation pathways, Kenya • Urbanisation: Building peri-urban Sustainability, India • Rethinking regulation: Seed, drug and water regulation, China and Argentina • Risk, uncertainty & technology: Responses to technological risks and uncertainties, India & UK • Epidemics: Addressing epidemics, livelihoods and the politics of policy, Africa, Asia, Latin America www.steps-centre.org
  7. 7. Epidemics • Capture public and policy attention • Effective responses a challenge • How to generate sustainable responses that benefit health and wellbeing of all • STEPS work: exploring complex dynamics at play in health/environment interface • Paying attention to short and long term drivers of disease www.steps-centre.org
  8. 8. Dynamic Contexts • Diseases arise in dynamic contexts • STEPS work explores a range of case studies • Concern about rate of emergence of new diseases • Established diseases shifting into new geographic niches • Resistant disease strains • Zoonotic disease and complex human-animal- environment interactions • Changing contexts: a range of drivers and exacerbating factors to keep in mind www.steps-centre.org
  9. 9. Epidemic Narratives • Accounts of the causes and appropriate responses to outbreaks of a disease • Reflect different perspectives eg policy-makers, scientists, local populations • Reflect different ways of framing the issues – affect who is blamed, who gains and who loses from responses • Dominant versus hidden narratives • Interested in how the category of epidemic disease is itself constructed and can shift over time and according to perspective eg HIV and AIDS www.steps-centre.org
  10. 10. Haemorrhagic Fevers • The power of different perspectives on disease (Leach and Hewlett) • Four narratives: 1. Global Outbreak 2. Deadly local disease events 3. Best managed with local cultural practices 4. Requiring longer term insights from both ecology and social science approaches www.steps-centre.org
  11. 11. Implications • The power of dominant narratives to shape responses • Contribution of neglected understandings • Need to pay more attention to interactions between long and shorter term drivers • The importance of integrating different understandings • The methodological challenges of interdisciplinary work www.steps-centre.org