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Therapeutic citizens and clients

Diverging healthcare practices in Malawi's prenatal clinics

Bibliographic Data

ID2249493
AuthorsAmy Zhou (0000-0001-8727-8678, Institute for Practical Ethics University of California San Diego USA, corresponding author)
Year2019
Volume41
Issue4
Pages625-642
Publication date2019-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12841
PMID30671979
OpenAlexW2914069341
LanguageEN
Citations received5
References cited61

This article examines how HIV policies and the funding priorities of global institutions affect practices in prenatal clinics and the quality of healthcare women receive. Data consist of observations at health centres in Lilongwe, Malawi and interviews with providers (N = 37). I argue that neoliberal ideology, which structures the global health field, produces a fragmented healthcare system on the ground. Findings show two kinds of healthcare practices within the same clinic: donor-funded NGOs took on HIV services while government providers focused on prenatal care. NGO practices were defined by surveillance, where providers targeted pregnant HIV-positive women and intensively monitored their adherence to drug treatment. In contrast, state-led practices were defined by rationing. Government providers worked with all pregnant women, but with staff and resource shortages, they limited time and services for each patient in order to serve everyone. This paper builds on concepts of therapeutic citizenship and clientship by exploring how global health priorities produce different conditions, practices and outcomes of NGO and state-led care

Business · Economic growth · Economics · Environmental health · Government (linguistics · Health care · Political science · Population · Prenatal care · Public relations · Rationing · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Medicine · Nursing · Poverty, Education, and Child Welfare

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Unique citing works5
Citations per year0,71
Citation span2019 - 2024 (6)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 4

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