Posted on 10 November 2015
Universal health coverage is one of the greatest unfulfilled ambitions in global health. This Wellcome Trust Seed Award-funded project, which will be led by Dr João Nunes, uses the case of community health workers (CHWs) as an entry-point into an investigation of past and present obstacles to, as well as existing potential for, the implementation of universal coverage. It explores the role played by CHWs in efforts to realise this elusive goal, focusing in particular on the case of Brazil.
CHWs have been invoked amongst global policymakers as a unique mechanism for the improvement of health systems, enhancing equity by bringing services to those previously excluded while also enhancing democracy by mediating marginalised groups’ perspectives through to decision-making processes. In recent years, Brazil has provided a model that has been turned to by national and international policymakers to guide health system reform in middle-income and emerging states, and as such represents a case in need of further systematic study.
This Political Science-centred and historically-rooted project will follow two workstreams. Dr Nunes (P-I) will study the CHW in the context of existing political tensions in health governance. Using historical and contemporary sources, he will explore how the CHW emerged out of an increased focus on health as a site of collective concern and political intervention – a public dimension that in recent years has clashed with global trends towards privatization and economic efficiency in healthcare provision. Dr Medcalf (Co-I) will study how CHWs were represented by the World Health Organization (WHO) through film and photographs in the run up to Alma Ata and afterwards. Focusing initially on Brazil and the PAHO region – but with a remit to compare with other regions – Medcalf will utilise photographic negatives, contact sheets, field notes, correspondence between editors and mission reports.
The project will begin on 1st Janurary 2016. It will offer a unique opportunity to learn from the experience of regions that so far have been considered passive recipients of ideas and practices from the developed world. Stay tuned for project updates throughout 2016.
Useful Websites: Wellcome Trust: www.wellcome.ac.uk Wellcome Trust Seed Awards: www.wellcome.ac.uk/Funding/Humanities-and-social-science/Funding-schemes/Seed-Awards/index University of York Department of Politics: www.york.ac.uk/politics/ University of York Department of History: www.york.ac.uk/history Centre for Global Health Histories:www.york.ac.uk/history/global-health-histories