Conceptualising global health: theoretical issues and their relevance for teaching

Globalization and Health - Tập 8 - Trang 1-8 - 2012
Mike Rowson1, Chris Willott1, Rob Hughes2, Arti Maini3, Sophie Martin4, J Jaime Miranda5, Vicki Pollit6, Abi Smith7, Rae Wake8,9, John S Yudkin10
1UCL Institute for Global Health, London, UK
2UK Department for International Development, London, UK
3General Practitioner and Medical Educationalist, NHS Ealing, London, UK
4Independent consultantg, London, UK
5CRONICAS Centro de Excelencia en Enfermedades Crónicas and Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
6National Clinical Guideline Centre, Royal College of Physicians, London, UK
7Academic Clinical Fellow in Obstetrics and Gynaecology, Women's Health, Southmead Hosptial, Westbury on Trym, Bristol, UK
8Division of Global Health and Human Rights, Massachusetts General Hospital, Boston, USA
9Juba Teaching Hospital, Juba, Sudan
10University College London, London, UK

Tóm tắt

There has long been debate around the definition of the field of education, research and practice known as global health. In this article we step back from attempts at definition and instead ask what current definitions tell us about the evolution of the field, identifying gaps and points of debate and using these to inform discussions of how global health might be taught. What we now know as global health has its roots in the late 19th century, in the largely colonial, biomedical pursuit of ‘international health’. The twentieth century saw a change in emphasis of the field towards a much broader conceptualisation of global health, encompassing broader social determinants of health and a truly global focus. The disciplinary focus has broadened greatly to include economics, anthropology and political science, among others. There have been a number of attempts to define the new field of global health. We suggest there are three central areas of contention: what the object of knowledge of global health is, the types of knowledge to be used and around the purpose of knowledge in the field of global health. We draw a number of conclusions from this discussion. First, that definitions should pay attention to differences as well as commonalities in different parts of the world, and that the definitions of global health themselves depend to some extent on the position of the definer. Second, global health’s core strength lies in its interdisciplinary character, in particular the incorporation of approaches from outside biomedicine. This approach recognises that political, social and economic factors are central causes of ill health. Last, we argue that definition should avoid inclusion of values. In particular we argue that equity, a key element of many definitions of global health, is a value-laden concept and carries with it significant ideological baggage. As such, its widespread inclusion in the definitions of global health is inappropriate as it suggests that only people sharing these values may be seen as ‘doing’ global health. Nevertheless, discussion of values should be a key part of global health education. Our discussions lead us to emphasise the importance of an approach to teaching global health that is flexible, interdisciplinary and acknowledges the different interpretations and values of those practising and teaching the field.

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Globalization and Health

Tập 8

1-8

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