Congratulations to Dr. Rachel Arnold on the acceptance by Social Science & Medicine (published by Elsevier) of the second paper based on her PhD on maternity care in Afghanistan . This interesting ethnography explores the experiences, motivations and constraints of healthcare providers in a large public Afghan maternity hospital. Arnold and colleagues identify barriers and facilitators in the delivery of care. Under the surface of this maternity hospital, social norms were in conflict with the principles of biomedicine. Contested areas included the control of knowledge, equity and the primary goal of work. The institutional culture was further complicated by pressure from powerful elites. These unseen values and pressures explain much of the disconnection between policy and implementation, education and the everyday behaviours of healthcare providers.
Improving the quality of care and equity in Afghan public maternity hospitals will require political will from all stakeholders to acknowledge these issues and find culturally attuned ways to address them. The authors argue that this notion of parallel and competing world-views on healthcare has relevance beyond Afghanistan. The paper co-authored by (a) Prof. Kath Ryan, Professor of Social Pharmacy at the University of Reading and Visiting Professor in FHSS, and BU’s Professors Immy Holloway and Edwin van Teijlingen.
- Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: An ethnography of care in an Afghan maternity hospital, Social Science & Medicine [online first] doi: 10.1016/j.socscimed.2018.09.010.