Travelling models and the challenge of pragmatic contexts and practical norms

The case of maternal health

Dados Bibliográficos

ID23341900
AutoresJean-Pierre Olivier De Sardan (0000-0001-7273-3498, United Nations Children's Fund Niger, autor correspondente), Aïssa Diarra (0000-0001-7685-2128), Mahaman Moha
Ano2017
Volume15
FascículoS1
Páginas60-60
Data de publicação2017-07-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Research Policy and Systems (JOURNAL)
Identificadores do periódicoISSN: 1478-4505 • E-ISSN: 1478-4505
EditoraSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1186/s12961-017-0213-9
PMID28722553
OpenAlexW2736206036
IdiomaEN
Citações recebidas69
Referências citadas91

As in other areas of international development, we are witnessing the proliferation of 'traveling models' developed by international experts and introduced in an almost identical format across numerous countries to improve some aspect of maternal health systems in low- and middle-income countries. These policies and protocols are based on 'miracle mechanisms' that have been taken out of their original context but are believed to be intrinsically effective in light of their operational devices.In reality, standardised interventions are, in Africa and elsewhere, confronted with pragmatic implementation contexts that are always varied and specific, and which lead to drifts, distortions, dismemberments and bypasses. The partogram, focused antenatal care, the prevention of mother-to-child transmission of HIV or performance-based payment all illustrate these implementation gaps, often caused by the routine behaviour of health personnel who follow practical norms (and a professional culture) that are often distinct from official norms - as is the case with midwives.Experiences in maternal and child health in Africa suggest that an alternative approach would be to start with the daily reality of social and practical norms instead of relying on models, and to promote innovations that emerge from within local health systems.

Health administration · Health services research · Political science · Public health · Social policy · Sociology · Global Maternal and Child Health · Health Informatics · Health Policy Implementation Science · Law · Medicine · Nursing · Primary Care and Health Outcomes · Health Policy