Global Social Welfare Academic Research Partnerships: Lessons Learned from Two Studies in Mongolia

Global Social Welfare - Tập 6 - Trang 145-154 - 2019
Susan S. Witte1, Denise Burnette2, Toivgoo Aira3, Sugarmaa Myagmarjav4
1Columbia University School of Social Work, New York, USA
2Virginia Commonwealth University School of Social Work, Richmond, USA
3Wellspring NGO, Zorig Foundation Building, Ulaanbaatar, Mongolia
4Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia

Tóm tắt

Literature on scientific and ethical issues concerning research in low- and middle-income countries has expanded greatly with globalization, highlighting the need to prioritize health and human rights over sociopolitical agendas in NGO-academic research partnerships. The purposes of this paper are to examine the development of a long-term partnership of social work and public health researchers in the U.S. and Mongolia and to describe two illustrative studies of mental health issues in Mongolia. The National Institutes of Health funded the first study, which tested the efficacy of an HIV prevention and microfinance intervention in Ulaanbaatar. In the second, the World Bank supported a needs assessment of social welfare programming across Mongolia. We then draw on principles of the Tropical Health and Education Trust (THET) model to highlight three themes that were central in both cases: (1) intentional, strategic negotiation of power, resources, and knowledge, balancing contributions from global North and South; (2) flexibility to permit adaptation to changing political, economic, and social contexts in the host setting; and (3) early and proactive building of local government and NGO/global donor support to implement and sustain programming. We conclude with suggestions and recommendations for global North-South partnerships based on our experience and lesson learned, reflecting on our successes and achievements and unresolved challenges.

Tài liệu tham khảo

Aira, T., Witte, S. S., Tsai, L. C., Riedel, M., & Ssewamala, F. (2014). A savings-led HIV prevention intervention for women engaging in sex work in Mongolia. In M. Sherraden, L. Zou, B. H. Ku, S. Deng, & S. Wang (Eds.), Asset-building policies and innovations in Asia (pp. 256–261). London: Routledge. Bartlett, N., Garriott, W., & Raikhel, E. (2014). What’s in the “treatment gap”? Ethnographic perspectives on addiction and global mental health from China, Russia, and the United States. Medical Anthropology, 33(6), 457–477. https://doi.org/10.1080/01459740.2013.877900. Best, J. (2013). Redefining poverty as risk and vulnerability: Shifting strategies of liberal economic governance. Third World Quarterly, 34(1), 109–129. https://doi.org/10.1080/01436597.2013.755356. Citrin, D., Mehanni, S., Acharya, B., Wong, L., Nirola, I., Sherchan, R., et al. (2017). Power, potential, and pitfalls in global health academic partnerships: Review and reflections on an approach in Nepal. Global Health Action, 10(1), 1367161. https://doi.org/10.1080/16549716.2017.1367161. Comstock, D. L., Hammer, T. R., Strentzsch, J., Cannon, K., Parsons, J., & Salazar, G., II. (2008). Relational-cultural theory: A framework for bridging relational, multicultural, and social justice competencies. Journal of Counseling & Development, 86(3), 279–287. De Maeyer, J., Vandenbussche, H., Claes, C., & Reynaert, D. (2017). Human rights, the capability approach and quality of life: An integrated paradigm of support in the quest for social justice. Therapeutic Communities: The International Journal of Therapeutic Communities, 38(3), 156–162. https://doi.org/10.1108/TC-03-2017-0011. Farmer, P. (1999). Infections and inequalities: The modern plagues. Berkeley: University of California Press. Geleg, T., & Dalkhjav, B. (2016). Income inequality changes in growing economies: The case of Mongolia. Retrieved from http://www.akes.or.kr/eng/papers(2016)/F41.pdf. Gelfand, M. J., Lyons, S. L., & Lun, J. (2011). Toward a psychological science of globalization. Journal of Social Issues, 67(4), 841–853. https://doi.org/10.1111/j.1540-4560.2011.01731.x. Gupta, G. R., Parkhurst, J. O., Ogden, J. A., Aggleton, P., & Mahal, A. (2008). Structural approaches to HIV prevention. Lancet (London, England), 372(9640), 764–775. https://doi.org/10.1016/S0140-6736(08)60887-9. Hansen, H., Braslow, J., & Rohrbaugh, R. M. (2018). From cultural to structural competency—Training psychiatry residents to act on social determinants of health and institutional racism. JAMA Psychiatry, 75(2), 117–118. https://doi.org/10.1001/jamapsychiatry.2017.3894. Jansen, S., White, R., Hogwood, J., Jansen, A., Gishoma, D., Mukamana, D., & Richters, A. (2015). The “treatment gap” in global mental health reconsidered: Sociotherapy for collective trauma in Rwanda. European Journal of Psychotraumatology, 6. https://doi.org/10.3402/ejpt.v6.28706. Kaplinsky, R. (2005). Globalization, poverty and inequality: Between a rock and a hard place. Cambridge: Polity Press. Kilbourne, A. M., Neumann, M. S., Waxmonsky, J., Bauer, M. S., Kim, H. M., Pincus, H. A., & Thomas, M. (2012). Evidence-based implementation: The role of sustained community-based practice and research partnerships. Psychiatric Services, 63(3), 205–207. https://doi.org/10.1176/appi.ps.201200032. Miller, J. B. (2012). Toward a new psychology of women. New York: Beacon Press. Oakley, J. G. (2000). Gender-based barriers to senior management positions: Understanding the scarcity of female CEOs. Journal of Business Ethics, 27(4), 321–334. Offringa, R., Tsai, L. C., Aira, T., Riedel, M., & Witte, S. S. (2017). Personal and financial risk typologies among women who engage in sex work in Mongolia: A latent class analysis. Archives of Sexual Behavior, 46(6), 1857–1866. https://doi.org/10.1007/s10508-016-0824-1. Organisation for Economic Co-operation and Development (Ed.). (2007). Promoting pro-poor growth: Policy guidance for donors. Paris: Organisation for Economic Co-operation and Development. Pinto, R. M., Da Silva, S. B., Penido, C., & Spector, A. Y. (2011). International participatory research framework: Triangulating procedures to build health research capacity in Brazil. Health Promotion International, 27(4), 435–444. Pinto, R. M., Spector, A. Y., Witte, S. S., & Gilbert, L. (2014). Systematizing planning and formative phases of HIV prevention research: Case studies from Brazil, Mongolia, and Kazakhstan. Global Social Welfare, 1(3), 137–144. Rosenmann, A., Reese, G., & Cameron, J. E. (2016). Social identities in a globalized world: Challenges and opportunities for collective action. Perspectives on Psychological Science, 11(2), 202–221. https://doi.org/10.1177/1745691615621272. Sabates-Wheeler, R., & Haddad, L. (2005). Reconciling different concepts of risk and vulnerability: A review of donor documents. Sussex: Institute of Development Studies. Schuerkens, U. (2010). Globalization and transformations of social inequality (1st ed.). New York: Routledge. Sen, A. (2014) Development as freedom. In J. T. Roberts, A. B. Hite, & N. Chorev (Eds.), The globalization and development reader: Perspectives on development and global change (2nd ed.). Chichester: Wiley-Blackwell. Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., & McKee, M. (2011). Effects of the 2008 recession on health: A first look at European data. The Lancet, 378(9786), 124–125. https://doi.org/10.1016/S0140-6736(11)61079-9. Tannen, D. (1994). Talking from 9 to 5: How women’s and men’s conversational styles affect who gets heard, who gets credit, and what gets done. New York: William Morrow & Co.. Tol, W. A., Komproe, I. H., Jordans, M. J., Ndayisaba, A., Ntamutumba, P., Sipsma, H., Smallegange, E. S., Macy, R. D., & de Jong, J. T. (2014). School-based mental health intervention for children in war-affected Burundi: A cluster randomized trial. BMC Medicine, 12(1), 56. https://doi.org/10.1186/1741-7015-12-56. Tsai, L. C., Witte, S. S., Aira, T., Altantsetseg, B., & Riedel, M. (2011). Piloting a savings-led microfinance intervention with women engaging in sex work in Mongolia: Further innovation for HIV risk reduction. The Open Women’s Health Journal, 5, 26–32. https://doi.org/10.2174/1874291201105010026. Tsai, L. C., Witte, S. S., Aira, T., Riedel, M., Hwang, H. G., & Ssewamala, F. (2013). “There is no other option: We have to feed our families…who else would do it?”: The financial lives of women engaging in sex work in Ulaanbaatar, Mongolia. Global Journal of Health Science, 5(5), 41–50. https://doi.org/10.5539/gjhs.v5n5p41. Tsai, L. C., Carlson, C. E., Aira, T., Norcini Pala, A., Riedel, M., & Witte, S. S. (2016). The impact of a microsavings intervention on reducing violence against women engaged in sex work: A randomized controlled study. BMC International Health and Human Rights, 16. https://doi.org/10.1186/s12914-016-0101-3. Tsai, L. C., Witte, S. S., Aira, T., Riedel, M., Offringa, R., & Chang, M. (2018). Efficacy of a microsavings intervention in increasing income and reducing economic dependence upon sex work among women in Mongolia. International Social Work, 61(1), 6–22. https://doi.org/10.1177/0020872815594866. United Nations (2015). United Nations 2030 agenda for sustainable development. https://www.un.org/sustainabledevelopment/development-agenda/. Varmus, H., & Satcher, D. (1997). Ethical complexities of conducting research in developing countries. The New England Journal of Medicine, 337(14), 1003–1005. https://doi.org/10.1056/NEJM199710023371411. Ventevogel, P. (2014). Integration of mental health into primary healthcare in low-income countries: Avoiding medicalization. International Review of Psychiatry, 26(6), 669–679. https://doi.org/10.3109/09540261.2014.966067. Walsh, A., Brugha, R., & Byrne, E. (2016). “The way the country has been carved up by researchers”: Ethics and power in north–south public health research. International Journal for Equity in Health, 15(1), 204. Whitley, R. (2015). Global mental health: Concepts, conflicts and controversies. Epidemiology and Psychiatric Sciences, 24(4), 285–291. https://doi.org/10.1017/S2045796015000451. Witte, S. S., Batsukh, A., & Chang, M. (2010). Sexual risk behaviors, alcohol abuse, and intimate partner violence among sex workers in Mongolia: Implications for HIV prevention intervention development. Journal of Prevention & Intervention in the Community, 38(2), 89–103. https://doi.org/10.1080/10852351003640625. Witte, S. S., Altantsetseg, B., Aira, T., Riedel, M., Chen, J., Potocnik, K., el-Bassel, N., Wu, E., Gilbert, L., Carlson, C., & Yao, H. (2011). Reducing sexual HIV/STI risk and harmful alcohol use among female sex workers in Mongolia: A randomized clinical trial. AIDS and Behavior, 15(8), 1785–1794. https://doi.org/10.1007/s10461-011-9984-0. Witte, S. S., Aira, T., Tsai, L. C., Riedel, M., Offringa, R., Chang, M., el-Bassel, N., & Ssewamala, F. (2015). Efficacy of a savings-led microfinance intervention to reduce sexual risk for HIV among women engaged in sex work: A randomized clinical trial. American Journal of Public Health, 105(3), e95–e102. https://doi.org/10.2105/AJPH.2014.302291. Witte, S. S., Aira, T., & Tsai, L. C. (2018). Addressing women’s health through economic opportunity: Lessons from women engaged in sex work in Mongolia. In M. Najafizadeh & L. Lindsey (Eds.), Women of Asia: Globalization, development, and gender equity. New York: Routledge. World Bank. (2001). Social protection sector strategy: From safety net to springboard (No. 21643) (p. 1). The World Bank. Retrieved from http://documents.worldbank.org/curated/en/299921468765558913/Social-protection-sector-strategy-from-safety-net-to-springboard. World Bank (2013). Mongolia: Improving public investments to meet the challenge of scaling up infrastructure. Poverty Reduction and Economic Management Sector Unit East Asia and Pacific Region. World Bank. (2016). New country classifications by income level: 2016-2017. Retrieved October 10, 2018, from https://blogs.worldbank.org/opendata/new-country-classifications-2016. World Health Organization. (2016a). Global strategy on human resources for health: Workforce 2030. Retrieved from http://www.who.int/hrh/resources/pub_globstrathrh-2030/en/. World Health Organization. (2016b). mhGAP intervention guide—Version 2.0. Retrieved from http://www.who.int/mental_health/mhgap/mhGAP_intervention_guide_02/en/. World Health Organization. (2017). WHO country cooperation strategy 2017-2021: Mongolia (Technical Report). World Health Organization. Regional Office for the Western Pacific. Retrieved from http://iris.wpro.who.int/handle/10665.1/13684. World Health Organization. (2018). Mental disorders. Retrieved October 10, 2018, from http://www.who.int/news-room/fact-sheets/detail/mental-disorders. World Population Review. (2018). Mongolia population 2018 (Demographics, Maps, Graphs). Retrieved June 18, 2018, from http://worldpopulationreview.com/countries/mongolia-population/.