gender and ethics in practice: experiences of researchers conducting qualitative health policy and...
TRANSCRIPT
Sassy Molyneux, University of Oxford, KEMRI-Wellcome Trust Research Programme
Gender and ethics in practice: experiences of researchers
conducting qualitative health policy and systems research
(HPSR) studies
KEMRI-Wellcome Trust colleagues
Lucy Gilson & Catherine Goodman
Benjamin Tsofa Edwine Barasa Mary Nyikuri Evelyn Waweru
Colleagues from RinGsa partnership bringing together 3 consortia to galvanise gender and ethics thinking in HPSR
Many ways to think about ethics in practice…• How do existing guidelines apply in practice for my
kind of study/project/work… • Issues/realities in relation to those concepts/requirements
on the ground? • How should I do my study, or respond to a situation?
• What are the ethical issues I/we face on the ground?• What situations in ‘the field’ / in our work that make us
question whether we are doing the ‘right thing’?• What do stakeholders and literature, including guidelines,
suggest we should do
Journal of International DevelopmentJ. Int. Dev. 21, 309–326 (2009)
Developing World Bioethics, 2016ISSN 1471-8731 (print); 1471-8847 (online)
Voices from the research team… three ‘talking heads’
http://resyst.lshtm.ac.uk/resources/video-learning-more-about-ethics-health-systems-research-kenya
Challenges emerged, often about relationships• Being informed about or observing apparently
unethical behaviour - really unethical? if and how to intervene? Research team responsibilities?
• Being requested to assist - If and how? Sustainability? and implications for more sustainable interventions?
• Researchers not objective observers but part of – embedded in - complex social relationships - potential to influence relationships in intended and unintended/ unexpected ways (‘an intervention’)
Importance of positionality and reflexivity
Cautionary approach vs transformative agenda? Where intervene ‘for good’, track for unintended perverse effects
So where does gender come in?Gender and ethics are inter-twined
• Deal with power relations and equity and how these are transformed over time and space• Pay attention to fairness,
vulnerability and agency in diverse contexts• Consider how gender interacts
with other social stratifiers
Two inter-related concerns regarding HPSR
Research often fails to sufficiently consider
gender as a social relation
Governance of the field remains underdeveloped
and contested, with limited attention to the role of power and how
this is experienced within different contexts.
Gender and power in conducting HPSR: reflections from RinGs funded researchers
• In March 2016, RinGs brought together 9 grantees conducting health systems research on gender and ethics in Kilifi, Kenya
• During meeting discussed key challenges they faced related to gender and power in HPSR
Ways in which gender and power shapes interactions during research process
Resistance to gender
perspective in research
Misunderstanding gender analysis
Questioning relevance of gender
analysis
Power relations in methods
Power relations between
researchers and respondents
Gender &
Power
Questioning relevance of gender analysis …Power and gender abstract and difficult to engage with, even for those with an interest in equity.
Beyond maternal and child health, research from a gender perspective questioned:• What you need are health services for all. • Do diseases differentiate between males and
females?• Do mosquitoes disaggregate by gender?• If we are to study malaria, let us study malaria,
not gender because malaria catches all equally
Resistance to gender perspective in research…By those who feel criticised or challenged, or who do not believe that gender discrimination is a reality.… by women who don’t want men encroaching in their ‘space’
Specific concerns:• ‘Is focusing on women a punishment of men? And
are all men guilty of women’s suffering?’• ‘But some women oppress men!’ …. The focus on
women ignores men’s suffering! Ie are we talking about gender or women?
Misunderstanding of what gender analysis is…• Continued focus of women and girls within
gender analysis.
• While important, it does not necessarily address determinants of gender inequality that can also undermine such a focus, and underestimates ingrained power relations and men’s roles.
• Heteronormative nature of much international development also means that people who define their gender as neither man nor women are often excluded.
What worked well – reflections from our workshop…• Build our capacity for quality ethical research:
• reflect on positionality and implications• co-learn with others• Use methods that flatten power relations as much as
possible – participatory, narrative, visual
• Ask about gender & power without using the words; draw on frameworks to probe
• Develop/agree/debate strategies and appropriate approaches to respect local norms and requirements, and challenge them • Specific to study and socio-cultural and policy context• At least do no harm
Photo credit: Robyne Hayze
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