University of Khartoum

Interaction between Health Institutions in Knowledge and Medical Practices in South Kordofan / Nuba Mountains

Interaction between Health Institutions in Knowledge and Medical Practices in South Kordofan / Nuba Mountains

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Title: Interaction between Health Institutions in Knowledge and Medical Practices in South Kordofan / Nuba Mountains
Author: Sharif, Mariem Mahjoub Mohamed
Abstract: The objectives of this research are to identify existing health institutions based on their social, economic and political conditions, and to analyse the interaction in knowledge and medical practices between health institutions. It also identifies the challenges for building public health services in pluralistic health care systems under post-war conditions, especially contest over resources. The research area is Heiban Locality in South Kordofan in Nuba Mountains, where a post-war situation (2002-2011) followed a prolonged period of war (1985-2002). The study looks at the interaction of actors involved in health care provision during and after war, and analyses whether this interaction and the subsequent functioning of health institutions have changed into non-violent principles of health governance for the sake of the general population’s well-being.This research uses extended ethnographic case studies and situational analysis based on participant`s observation and narrative interviews. The researcher participated for two months in everyday life at Heiban Health Centre, as well as shortlyvisiting two hospitals, 13 health units and four health centres in Heiban Locality. The researcher conducts and analyses 80 narrative interviews with health practitioners, NGOs members, government officials, patients and their families, including questions about health practices during and after war. In addition, the researcher conducts two focus group discussions with Red Crescent volunteers and medical supply section nurses in Heiban, respectively. Archival documents, governmental and non-governmental reports, as well as secondary literature on health care provision in the study area are consulted for the wider context.The research showed that organizations and individuals involved in health governance in the area differed in terms of demographics, organization, knowledge, practices and spatial reach. Individual health practitioners were related to these plural and diverse health institutions through dynamic processes of interaction that involved the confirmation, crossing and making of boundaries between them and other actors. Examples of boundaries are geographical, temporal and professional boundaries, as well as ethnic identification, commercial andpolitical interests. While this reflected cultural diversity among both practitioners and the population they worked in, the research found that this plurality was not equitably recognised. In addition, these dynamic processes failed to move in a significant and sustainable way beyond violent contest over resources and the complex emergencies that developed during wartime. Because of the continuing dominance of military institutions and militarized political contest, the ad-hoc character of health care provision during ‘peacetime’was further institutionalized, and thereby, the emergencies themselves. War and peace were thus not clearly different periods, but they are blended into each other as continuous, institutionalized emergencies.The challenges identified by this research indicate the difficulties of health care provision in Sudan in general, and in war and post-war areas particularly. The researcher argues that equitable health care, as essential social service, is a prerequisite for future societal integration and peaceful co-existence. Future studies should therefore contribute to the establishment of non-violent principles in health governance and the distribution of resources based on it, since only then health care provision can be considered to contribute to peace-building.
URI: http://khartoumspace.uofk.edu/123456789/26111


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