Svea Closser
Datos Biográficos
| ID | 126002 |
|---|---|
| NOMBRE | Svea Closser |
| NOMBRES | Svea |
| APELLIDO | Closser |
| FIRMA | CLOSSER S |
| AFILIACIONES | Johns Hopkins University |
| ORCID | 0000-0001-8337-9957 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 40 |
| TOTAL DE CITAS | 78 |
| TOTAL COMO AUTOR | 40 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2010 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 5 |
Non-communicable disease care in peri-urban Nepal
Non-communicable diseases (NCDs) are a growing public health challenge in Nepal, driven by hypertension, diabetes, and smoking, and contributing substantially to morbidity and mortality. Access to equitable and affordable care remains limited, particularly in community settings. Task-sharing with Female Community Health Volunteers (FCHVs), a national cadre of volunteer community health workers primarily engaged in maternal and child health, offer…
Urban community health workers in Punjab, India
The Accredited Social Health Activist (ASHA) program is the world’s largest all-female community health worker (CHW) initiative. While most CHW programs have been extensively studied in rural contexts, little is known about how ASHAs and CHWs operate in urban settings. Research on urban programs globally remains limited with a primary focus on single-disease interventions. A more holistic understanding of urban ASHAs’ roles is needed to more comp…
Moving away from volunteerism in community health? Motivations and wellbeing among urban and rural Ethiopian volunteers
Hierarchy, class, race and PPE in an American hospital in the early days of Covid-19
From legacy to integration in the Global Polio Eradication Initiative
INTRODUCTION: The Global Polio Eradication Initiative (GPEI) is a global single-disease programme with an extensive infrastructure in some of the world's most underserved areas. It provides a key example of the opportunities and challenges of transition efforts-the process of shifting from donor-funded, single-disease programmes to programmes with more integrated and sustainable programmatic and funding streams. Our goal is to closely analyse the…
An anthropological history of Nepal’s Female Community Health Volunteer program
Across public health, an awareness of history is useful in understanding the present and avoiding past mistakes. These histories are often not well-archived, and risk getting lost. Lessons from the history of Nepal's FCHV program have much to offer present-day debates around CHW policies, particularly around gender, workload and payment
Breaking the silence on gendered harassment and assault of community health workers
INTRODUCTION: Across a variety of settings, women in tenuous financial circumstances are drawn to community health work as a way to advance themselves in the context of limited employment options. Female Community Health Workers (CHWs) are often preferred because they can more easily access mothers and children; at the same time, gender norms are at the heart of many of the challenges and inequities that these workers encounter. Here, we explore …
How to eradicate polio in Pakistan
Pakistan, along with Afghanistan, is one of two countries where wild poliovirus is still endemic. Frontline workers (FLWs) are the staff most intimately familiar with both implementation challenges and community context. Harnessing their expertise may be a way to improve the community-polio program interface, which has been a persistent and shifting challenge in polio-endemic areas of both countries. From 2020–2022, we engaged frontline workers i…
A scoping review on integrated health campaigns for immunization in low- and middle-income countries
Health campaign integration is a key implementation strategy outlined by the World Health Organization to achieve universal health coverage. This scoping review synthesizes the evidence on Integrated Health Campaigns (IHC) in the field of immunization in low- and middle-income countries (LMICs) regarding the most common strategies, facilitators and barriers. Four reviewers followed a systematic approach to identify, screen and analyse relevant ar…
Everyday capabilities were a path to resilience during Covid-19
COVID-19 demanded urgent responses by all countries, with wide variations in the scope and sustainability of those responses. Scholarship on resilience has increasingly emphasized relational considerations such as norms and power and how they influence health systems’ responses to evolving challenges. In this study, we explored what influenced countries’ national pandemic responses over time considering a country’s capacity to test for COVID-19. …
Global Health
Global health can be understood as part of a larger history of global cooperation that reflects and enacts uneven politics, power, and privilege on an unequal earth. Global health emerged in the early 21st century when the groundswell of money for HIV/AIDS transformed the field, and a global orientation, as opposed to one of international relations or modularity, took hold. It is rooted in a long history of wealthier countries intervening in poor…
Vaccine acceptance in rural India
Introduction: Religious faith is a key marker of identity and shapes community perspectives and trust. Faith leader involvement in vaccine campaigns in India have been beneficial to counter misinformation regarding infectious diseases such as polio. Faith leaders are influential stakeholders who bear potential to enhance public confidence in vaccine campaigns. Context: While vaccine coverage has been increasing in India, inequities abound, especi…
A light touch intervention with a heavy lift – gender, space and risk in a global vaccination programme
Frontline workers (FLWs) in the Global Polio Eradication Initiative go door-to-door delivering polio vaccine to children. They have played a pivotal role in eliminating wild polio from most countries on earth; at the same time, they face significant bodily risk. STRIPE, an international consortium, conducted a mixed-methods study exploring the knowledge and experiences of polio staff in seven countries (Afghanistan, Bangladesh, Democratic Republi…
The anthropology of health systems
Ethnographies of health systems are a theoretically rich and rapidly growing area within medical anthropology. Critical ethnographic work dating back to the 1950s has taken policymakers and health staff as points of entry into the power structures that run through the global health enterprise. In the last decade, there has been a surge of ethnographic work on health systems. We conceptualize the anthropology of health systems as a field; review t…
Years of polio campaigns in Ethiopia, India and Nigeria
Introduction The debate over the impact of vertical programmes, including mass vaccination, on health systems is long-standing and often polarised. Studies have assessed the effects of a given vertical health programme on a health system separately from the goals of the vertical programme itself. Further, these health system effects are often categorised as either positive or negative. Yet health systems are in fact complex, dynamic and tightly l…
Impact and effect mechanisms of mass campaigns in resource-constrained health systems
BACKGROUND: Mass campaigns are a key strategy for delivering life-saving interventions under Global Health Initiatives, especially in weak health system contexts. They are frequently designed parallel to the health system to rapidly achieve programme targets such as vaccination coverage, but we lack quantitative evidence demonstrating their impact and effect mechanisms on health system performance at sub-/national level. This longitudinal study r…
The family context of Asha and Anganwadi work in rural Rajasthan
Across the literature on CHWs globally, the role of CHWs' families remains largely unexplored. This article focuses on ASHAs and Anganwadi Workers in a town in rural Rajasthan, India. We interviewed all twenty ASHAs and Anganwadi Workers in this town, and ten of their families; we also conducted participant observation in Anganwadi Centers, health centres, and family settings. ASHA and Anganwadi work was in high demand, despite being low paying, …
Community perceptions of vaccination among influential stakeholders
Communication of broader benefits of vaccines and vaccination services by community health workers could be impactful in increasing vaccine acceptance. Vaccine uptake could potentially be improved by facilitating community health workers' ownership over vaccine acceptance and uptake by involving them in the design and implementation of interventions to target mothers and mothers-in-law. A 'bottom-up' approach, leveraging community health workers'…
Political connections and psychosocial wellbeing among Women's Development Army leaders in rural amhara, Ethiopia
The Corruption Game
Drawing on ethnographic material collected in Pakistan, India, and Nepal, this article analyzes patterns of corruption in vaccination programs in South Asia. Corrupt practices-which required substantial work-were deeply shaped by both the money and systems of accountability of the global health system. Bilateral and multilateral donors provided substantial funding for immunization programs across South Asia. International agencies and governments…
Polio
Reviewed by: Polio: The Odyssey of Eradication by Thomas Abraham Svea Closser Thomas Abraham. Polio: The Odyssey of Eradication. London: Hurst & Co., 2018. xxviii + 252 pp. £25.00 (978-1-84904-956-6). Polio: The Odyssey of Eradication is a comprehensive history of the effort to eradicate polio, spanning from Roosevelt's founding of the National Foundation for Infantile Paralysis to the modern program's struggles to eliminate polio from Pakistan. …
Does volunteer community health work empower women? Evidence from Ethiopia’s Women’s Development Army
Of the millions of Community Health Workers (CHWs) serving their communities across the world, there are approximately twice as many female CHWs as there are male. Hiring women has in many cases become an ethical expectation, in part because working as a CHW is often seen as empowering the CHW herself to enact positive change in her community. This article draws on interviews, participant observation, document review and a survey carried out in r…
Promoting the Anthropological Perspective in Global Health Systems Scholarship
Psychosocial distress among unpaid community health workers in rural Ethiopia
The Vital Drop
A Women’s Development Army
Using community health workers
In this article, we use semistructured interviews and documents produced by Ethiopian government officials and international health donors to examine two key features of the nation's community health worker (CHW) program: (1) the process and criteria of selecting community health workers; and (2) policies, rhetoric, and experiences of payment and empowerment. We examine these from the varied perspectives of district health officials, Health Exten…
The Global Context of Vaccine Refusal
Many of medical anthropology's most pressing research questions require an understanding how infections, money, and ideas move around the globe. The Global Polio Eradication Initiative (GPEI) is a $9 billion project that has delivered 20 billion doses of oral polio vaccine in campaigns across the world. With its array of global activities, it cannot be comprehensively explored by the traditional anthropological method of research at one field sit…
Listening to Community Health Workers
Many actors in global health are concerned with improving community health worker (CHW) policy and practice to achieve universal health care. Ethnographic research can play an important role in providing information critical to the formation of effective CHW programs, by elucidating the life histories that shape CHWs’ desires for alleviation of their own and others’ economic and health challenges, and by addressing the working relationships that …
Does volunteer community health work empower women? Evidence from Ethiopia’s Women’s Development Army
Of the millions of Community Health Workers (CHWs) serving their communities across the world, there are approximately twice as many female CHWs as there are male. Hiring women has in many cases become an ethical expectation, in part because working as a CHW is often seen as empowering the CHW herself to enact positive change in her community. This article draws on interviews, participant observation, document review and a survey carried out in r…
Psychosocial distress among unpaid community health workers in rural Ethiopia
A New Reflexivity
Per Diems in Polio Eradication
Nearly all global health initiatives give per diems to community health workers (CHWs) in poor countries for short-term work on disease-specific programs. We interviewed CHWs, supervisors, and high-level officials (n = 95) in 6 study sites across sub-Saharan Africa and South Asia in early 2012 about the per diems given to them by the Global Polio Eradication Initiative. These per diems for CHWs ranged from $1.50 to $2.40 per day. International of…
Pakistan's lady health worker labor movement and the moral economy of heroism
In December 2012, militants began targeted attacks on workers going door to door in Pakistan delivering polio vaccine, including members of a community health worker cadre called Lady Health Workers (LHWs). Over the next several years, more than 50 workers, most of them women, were murdered as they worked. Media accounts frequently refer to these workers as "aid workers" or "heroes." This paper complicates and theorizes this conception. Two confl…
The Corruption Game
Drawing on ethnographic material collected in Pakistan, India, and Nepal, this article analyzes patterns of corruption in vaccination programs in South Asia. Corrupt practices-which required substantial work-were deeply shaped by both the money and systems of accountability of the global health system. Bilateral and multilateral donors provided substantial funding for immunization programs across South Asia. International agencies and governments…
Political connections and psychosocial wellbeing among Women's Development Army leaders in rural amhara, Ethiopia
We Can't Give Up Now
The Polio Eradication Initiative, the largest coordinated public health project in history, is currently facing serious difficulties. For years, it has tried and failed to eliminate polio from its last strongholds in Afghanistan, Pakistan, and Nigeria. Drawing on document analysis as well as participant observation and interviews in Pakistan, Atlanta, Geneva, and Montreal, I explore how officials in the Polio Eradication Initiative systematically…
Culture, status and context in community health worker pay
Sense and Sustainability
sustainability, teaching strategies, global health, organic garden, anthropology education, Middlebury College
Methods for evaluating the impact of vertical programs on health systems
The study design has four major benefits: (1) the careful selection of a range of qualitative case studies allowed for systematic comparison; (2) the use of participant observation yielded important insights on how policy is put into practice; (3) results from our quantitative analysis could be explained by results from qualitative work; and (4) this research protocol can inform the creation of actionable recommendations. Here, recommendations fo…
We Can't Give Up Now
The Polio Eradication Initiative, the largest coordinated public health project in history, is currently facing serious difficulties. For years, it has tried and failed to eliminate polio from its last strongholds in Afghanistan, Pakistan, and Nigeria. Drawing on document analysis as well as participant observation and interviews in Pakistan, Atlanta, Geneva, and Montreal, I explore how officials in the Polio Eradication Initiative systematically…
Measuring the health systems impact of disease control programmes
As with frameworks in general, the WHO Building Blocks framework is valuable because it creates a common language and shared understanding. However, for applied research, it falls short of what is needed to holistically evaluate the impact of specific interventions on health systems. We propose that if researchers use the framework, it should be adapted and made context-specific
Listening to Community Health Workers
Many actors in global health are concerned with improving community health worker (CHW) policy and practice to achieve universal health care. Ethnographic research can play an important role in providing information critical to the formation of effective CHW programs, by elucidating the life histories that shape CHWs’ desires for alleviation of their own and others’ economic and health challenges, and by addressing the working relationships that …
Quacks, Healers and Rationalists
The Global Dreams and Local Complexities of Malaria Eradication
Additional informationNotes on contributorsSvea ClosserSvea Closser is assistant professor of anthropology at Middlebury College. Her book, Chasing Polio in Pakistan, is an ethnography of the Global Polio Eradication Initiative
A Women’s Development Army
Using community health workers
In this article, we use semistructured interviews and documents produced by Ethiopian government officials and international health donors to examine two key features of the nation's community health worker (CHW) program: (1) the process and criteria of selecting community health workers; and (2) policies, rhetoric, and experiences of payment and empowerment. We examine these from the varied perspectives of district health officials, Health Exten…
Pakistan's lady health worker labor movement and the moral economy of heroism
In December 2012, militants began targeted attacks on workers going door to door in Pakistan delivering polio vaccine, including members of a community health worker cadre called Lady Health Workers (LHWs). Over the next several years, more than 50 workers, most of them women, were murdered as they worked. Media accounts frequently refer to these workers as "aid workers" or "heroes." This paper complicates and theorizes this conception. Two confl…
The Global Context of Vaccine Refusal
Many of medical anthropology's most pressing research questions require an understanding how infections, money, and ideas move around the globe. The Global Polio Eradication Initiative (GPEI) is a $9 billion project that has delivered 20 billion doses of oral polio vaccine in campaigns across the world. With its array of global activities, it cannot be comprehensively explored by the traditional anthropological method of research at one field sit…
A New Reflexivity
Per Diems in Polio Eradication
Nearly all global health initiatives give per diems to community health workers (CHWs) in poor countries for short-term work on disease-specific programs. We interviewed CHWs, supervisors, and high-level officials (n = 95) in 6 study sites across sub-Saharan Africa and South Asia in early 2012 about the per diems given to them by the Global Polio Eradication Initiative. These per diems for CHWs ranged from $1.50 to $2.40 per day. International of…
Volunteers in Ethiopia’s women’s development army are more deprived and distressed than their neighbors
In rural Amhara, women who seek out and/or are sought and recruited for leader roles in the WDA are a population living in precarity. In several domains, they experience even more hardship than their neighbors. These findings highlight a need for careful attention and further research into processes of volunteer CHW selection, and to determine whether or not volunteering for CHW programs increases socioeconomic and health risks among volunteers. …
Polio
Reviewed by: Polio: The Odyssey of Eradication by Thomas Abraham Svea Closser Thomas Abraham. Polio: The Odyssey of Eradication. London: Hurst & Co., 2018. xxviii + 252 pp. £25.00 (978-1-84904-956-6). Polio: The Odyssey of Eradication is a comprehensive history of the effort to eradicate polio, spanning from Roosevelt's founding of the National Foundation for Infantile Paralysis to the modern program's struggles to eliminate polio from Pakistan. …
Does volunteer community health work empower women? Evidence from Ethiopia’s Women’s Development Army
Of the millions of Community Health Workers (CHWs) serving their communities across the world, there are approximately twice as many female CHWs as there are male. Hiring women has in many cases become an ethical expectation, in part because working as a CHW is often seen as empowering the CHW herself to enact positive change in her community. This article draws on interviews, participant observation, document review and a survey carried out in r…
Promoting the Anthropological Perspective in Global Health Systems Scholarship
Psychosocial distress among unpaid community health workers in rural Ethiopia
Political connections and psychosocial wellbeing among Women's Development Army leaders in rural amhara, Ethiopia
The Corruption Game
Drawing on ethnographic material collected in Pakistan, India, and Nepal, this article analyzes patterns of corruption in vaccination programs in South Asia. Corrupt practices-which required substantial work-were deeply shaped by both the money and systems of accountability of the global health system. Bilateral and multilateral donors provided substantial funding for immunization programs across South Asia. International agencies and governments…
Years of polio campaigns in Ethiopia, India and Nigeria
Introduction The debate over the impact of vertical programmes, including mass vaccination, on health systems is long-standing and often polarised. Studies have assessed the effects of a given vertical health programme on a health system separately from the goals of the vertical programme itself. Further, these health system effects are often categorised as either positive or negative. Yet health systems are in fact complex, dynamic and tightly l…
Impact and effect mechanisms of mass campaigns in resource-constrained health systems
BACKGROUND: Mass campaigns are a key strategy for delivering life-saving interventions under Global Health Initiatives, especially in weak health system contexts. They are frequently designed parallel to the health system to rapidly achieve programme targets such as vaccination coverage, but we lack quantitative evidence demonstrating their impact and effect mechanisms on health system performance at sub-/national level. This longitudinal study r…
The family context of Asha and Anganwadi work in rural Rajasthan
Across the literature on CHWs globally, the role of CHWs' families remains largely unexplored. This article focuses on ASHAs and Anganwadi Workers in a town in rural Rajasthan, India. We interviewed all twenty ASHAs and Anganwadi Workers in this town, and ten of their families; we also conducted participant observation in Anganwadi Centers, health centres, and family settings. ASHA and Anganwadi work was in high demand, despite being low paying, …
Community perceptions of vaccination among influential stakeholders
Communication of broader benefits of vaccines and vaccination services by community health workers could be impactful in increasing vaccine acceptance. Vaccine uptake could potentially be improved by facilitating community health workers' ownership over vaccine acceptance and uptake by involving them in the design and implementation of interventions to target mothers and mothers-in-law. A 'bottom-up' approach, leveraging community health workers'…
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