Biomedical Techniques in Context: On the Appropriation of Biomedical Procedures and Artifacts

Hadolt, Bernhard; Hörbst, Viola; Müller-Rockstroh, Babette

doi:10.1080/01459740.2011.636410

Cited by 16 publications

(5 citation statements)

References 42 publications

(18 reference statements)

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“…Informed by co-production theory of the technical and the social (Oudshoorn and Pinch 2005;Hadolt, Hörbst, and Müller-Rockstroh 2012), we start from the assumption that when ARTs travel across countries and become embedded in new contexts, changes may occur in the perception, organization and practice of these techniques. When analyzing transnational connections and their interactions with specific practices of ARTs in Ghana and Uganda, we found medicoscapes as laid out by Wolf (2003, 2014) to be a helpful concept to explore interacting complexities on the macro-and micro-levels in health arenas.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Transnational connections of health professionals: medicoscapes and assisted reproduction in Ghana and Uganda

Hörbst

Gerrits

2016

Ethnicity & Health

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Objectives. Based on our comparative fieldwork in two private fertility clinics in Accra (Ghana) and Kampala (Uganda), we explore the transnational mobility of providers involved in assisted reproductive technologies (ARTs) and analyze how resulting transnational networks influence the realization and appropriation of these therapeutic treatments. By exploring these case studies from developing countries, this article intends to contribute to the field of studies that examine the diversification and complexity of migration and health care. Design. We first summarize the dynamics affecting the health-care systems in Ghana and Uganda over the last decades. Then, we describe the transnational mobility engaged in the two clinics. Through the case studies, we highlight how ARTs are realized and appropriated in the two receiving countries, and the role transnational contacts play within the negotiations of medical ethos and financial interests. By using the concept of medicoscapes, we analyze the worldwide connections between ART providers, the institutions they work in, their medical practices, artifacts, and their regimes of medical knowledge. Result. Transnational professional contacts have been essential to the setup of both clinics offering ARTs in Ghana and Uganda. These contacts developed along colonial and post-colonial links, integrating also south-south relationship. The clinics' directors act as entrepreneurs and creative decision-makers who capitalize on their transnational professional network. The case studies show the diverse transnational entanglements in both clinics and demonstrate the frictions between the doctors' entrepreneurial interests, medical concerns and cultural values. Conclusion. The transnational professional contacts expose both clinics to varying practices and debates, and make them into sites for negotiating distinct clinical practices. They provoke frictions between entrepreneurial interests and medical concerns including cultural values. In current medicoscapes, in a situation of full absence of any form of financial support and of any national ART regulation in Ghana and Uganda, clinic directors are in the position to apply those practices that fit their interests and local circumstances best.

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Section: Theoretical Backgroundmentioning

confidence: 99%

Transnational connections of health professionals: medicoscapes and assisted reproduction in Ghana and Uganda

Hörbst

Gerrits

2016

Ethnicity & Health

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“…The embryo transfer was just one of many steps of an IVF cycle to be conducted in a particular way in these two Ghanaian clinics. This particular ‘local appropriation’ of IVF reflects local values and circumstances, underlining the notion that local factors may ‘reshape and sometimes curtail’ the way in which assisted reproductive technologies are used in particular localities ( Inhorn, 2003 : 16) and confirming the fact that technologies undergo local transformations and appropriation – for socio-material reasons – when travelling from the places where they are initiated (in ‘the West’) to other contexts ( Hadolt et al, 2012 ). The local appropriation of assisted reproductive technologies is a topic that deserves more scholarly attention, as it can further our understanding of the societies and cultures in which assisted reproductive technologies are embedded and employed, as well as of the local meanings, experiences and impacts of the use of assisted reproductive technologies.…”

Section: The Origin and Development Of Ivf In Ghanamentioning

confidence: 75%

Assisted reproductive technologies in Ghana: transnational undertakings, local practices and ‘more affordable’ IVF

Gerrits¹

2016

Reproductive Biomedicine & Society Online

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The article sketches the origins and development of IVF in Ghana as a highly transnational undertaking. Movements are from and to Africa, involving human beings (providers and users), and also refer to other entities such as technologies, skills and knowledge. None of these movements are paid for using public money, neither are they subsidized by international health organizations. Currently, ‘more affordable’ IVF is being introduced into Ghana, on initiative of the first Association of Childless Couples of Ghana (ACCOG), in collaboration with the Belgium based non-profit organization the Walking Egg (tWE), representing another form of transnational networking. The article underlines the scarcity of well-trained embryologists in Ghana, which turns the embryologists’ expertise and skills into a scarce and precious commodity and guarantees this expertise becomes a major challenge for the directors of the private clinics. Next to local Ghanaian couples, the clinics also attend to transnational reproductive travellers, including women and men from neighbouring countries and Ghanaians in the diaspora returning to their country of origin. Their manifold motivations to cross borders and visit the IVF clinics in Ghana provide insight into the structural conditions impeding or facilitating the use of assisted reproductive technologies at different local sites. Transnational movements also include the flow of new procreation practices (such as surrogacy and the use of donor material), which (re-)shape existing cultural and societal notions regarding kinship and the importance of blood/genetic ties. Finally, the article lists a number of thematic and theoretical issues which require further exploration and studies.

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“…The social science literature has criticized simplified ideas of technology diffusion and transfer underlying much technology design for global health (Engel, 2012; Hadolt et al, 2011; Pfotenhauer and Jasanoff, 2017; Prasad, 2014). Many have argued – in different ways – that the local context of use and the additional work that is required to enact technologies should be taken into account more and earlier during technology design.…”

Section: Discussionmentioning

confidence: 99%

“…Sociologists and STS scholars studying translational medicine emphasize that translation is not limited to a one- or two-directional relationship between bedside and bench (Crabu, 2016; Lewis et al, 2014; Paul et al, 2008); it can be better conceptualized as movement of knowledge across different institutional, disciplinary, spatial, geographical or conceptual domains (Rajan and Leonelli, 2013). Mostly based on ethnographies of science and technology in the Global South, the STS literature on global health examines how science and technology travel or translate between the Global North and South (Crane, 2013; de Laet and Mol, 2000; Engel, 2012; Geissler and Molyneux, 2011; Hadolt et al, 2011; Montgomery, 2012; Mueller-Rockstroh, 2011; Pollock, 2014; Prasad, 2014). Through concepts such as fluidity (de Laet and Mol, 2000; Redfield, 2016), sticky technologies (Scott-Smith, 2018) and immutable mobiles (Latour, 1990), scholars have explored the characteristics of technologies that make them travel well.…”

Section: Alignment Work In Constructing Doable Global Health Technolomentioning

confidence: 99%

Aligning in the dark: Variable and shifting (user-) settings in developing point-of-care diagnostics for tuberculosis and HIV

Engel

2020

Soc Stud Sci

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To be effective, healthcare technologies should be attuned to particular contexts of use. This article examines how such attuning is articulated in global innovation practices for tuberculosis and HIV diagnostics, and to what effect. It examines the development of point-of-care (POC) diagnostics – promised to be designed for users outside laboratories or in resource constrained settings – to study what developers and implementers do to align diagnostic technologies to the POC. Fieldwork among global health actors involved in diagnostic development, including manufacturers, donors, industry consultants, international organizations, policymakers, regulators and researchers, is combined with fieldwork among users of diagnostics in India, including decision-makers, NGOs, program officers, laboratory technicians and nurses. The article adds to STS’s theory of alignment and user interaction, where the setting and user to which developers and implementers of global health diagnostics align are multiple, varied, emerging and keep shifting. The characteristics of a local user setting include multiple engaged and imagined user settings, but also the settings of developers, of global intermediaries, competitors and diseases. As such, alignment is happening across multiple dimensions and scales and has an important temporal dimension. The results reveal how alignment happens to some extent in the dark, characterized by uncertainty about the elements that should align. Standardizing elements, politics and scarce resources cause frictions in the temporalities of aligning and over what constitutes a well-aligned diagnostic.

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Biomedical Techniques in Context: On the Appropriation of Biomedical Procedures and Artifacts

Cited by 16 publications

References 42 publications

Transnational connections of health professionals: medicoscapes and assisted reproduction in Ghana and Uganda

Transnational connections of health professionals: medicoscapes and assisted reproduction in Ghana and Uganda

Assisted reproductive technologies in Ghana: transnational undertakings, local practices and ‘more affordable’ IVF

Aligning in the dark: Variable and shifting (user-) settings in developing point-of-care diagnostics for tuberculosis and HIV

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