Poor Working Conditions, HIV/AIDS and Burnout: A Study in Cameroon

Tantchou, Josiane

doi:10.3167/aia.2014.210305

Cited by 6 publications

(6 citation statements)

References 22 publications

(30 reference statements)

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“…Corruption is almost systemic in health facilities, as it is in all public services (Médard 1977, 1998, 2001). Tensions related to accusations and suspicions of corruption taint professional relations and collaboration between services (Tantchou 2007, forthcoming). Patients and family members are encouraged to pay the fee for surgeries directly to the surgeon, who is supposed to share the amount with the entire staff.…”

Section: Physical Space: the Operating Theater In The Hospitalmentioning

confidence: 99%

Blurring Boundaries

Tantchou

2013

Science, Technology, & Human Values

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This study looks at the interactions between health workers, physical space, surgical tools, and the “patient-body” in an operating theater. My aim is to explore the approaches of Katz, Rawlings, and Collins and to show that when rituals, restrictive entrance procedures, and clothing requirements are not in place, when rules are not observed for reasons that this article addresses, the boundary between the operating theater and its surroundings blurs. It becomes a trivialized space. Data were collected in the regional hospital of one major town of the Extrême Nord of Cameroon. I describe a context of crisis and a lack of equipment and personnel that narrow the boundaries of the operating room (the limits of which are supposed to be kept sterile and isolated) but do not erase them. Restrictive entrance procedures, clothing requirements, rituals, and rules that are supposed to separate the operating theater from its surroundings, as Katz has shown, are not observed. Instead, the theater is connected to its surroundings through an “intriguing combination of practices” consistent with the analyses of Rawling and Collins. Thus, the operating theater is not a closed and limited area inside the hospital that can be completely isolated from its surroundings. There is continuity between the interior and the exterior.

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Section: Physical Space: the Operating Theater In The Hospitalmentioning

confidence: 99%

Blurring Boundaries

Tantchou

2013

Science, Technology, & Human Values

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“…Les résultats de nos investigations dans cinq pays contribuent à documenter la complexité des changements en matière de soins aux nouveau-nés, et l'ampleur de la tâche confiée aux agents de santé chargés de promouvoir les pratiques recommandées. Ce travail nous invite à plaider en faveur d'une meilleure prise en compte des contraintes matérielles et sociales s'exerçant sur ceux qui dispensent des soins néonataux, mais aussi d'une posture compréhensive vis-à-vis de leurs rationalités [50]. Cette posture est condition d'une approche éthique de l'éducation pour la santé, le principe de « bienfaisance » d'un programme ne pouvant être simplement lié à la légitimité d'un objectif tel que l'amélioration de la survie [51].…”

Section: Discussionunclassified

Soins aux nouveau-nés : les recommandations internationales face aux enjeux sociaux de la naissance

Kane¹

2020

Santé Publique

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Sous l'impulsion de larges programmes internationaux ciblant spécifiquement la survie néonatale, un ensemble de pratiques de soins recommandées sont promues en Afrique de l'Ouest. À partir des données d'une étude anthropologique multicentrique, nous proposons d'interroger comment les pratiques locales intègrent les recommandations diffusées par ces programmes. Méthode : Les enquêtes ont été réalisées dans des localités rurales de cinq pays : Bénin, Burkina Faso, Mali, Mauritanie, Togo. Sur chaque site, les investigations ont combiné une ethnographie des soins aux nouveau-nés et des entretiens approfondis dans les maternités et aux domiciles. Résultats : Les soins aux nouveau-nés s'accordent à un ensemble de représentations et de logiques sociales locales, les recommandations médicales étant intégrées de manière hétérogène. Dans les maternités, les professionnels de santé rencontrent des difficultés à mettre en oeuvre les pratiques recommandées, et opèrent diverses conciliations face aux contraintes matérielles et sociales locales. Du côté des familles, les « messages » promouvant les soins favorables à la survie des nouveau-nés ponctuent les propos, mais donnent lieu à diverses interprétations et à de variables modifications des soins. Discussion : L'irrégulière intégration des recommandations médicales dans les soins aux nouveau-nés est analysée autour de trois axes : les divergences d'intentionnalités autour de la naissance et de l'accueil du nouveau-né, les dissonances entre les soins préconisés et les conceptions locales du nouveau-né, l'influence des relations de pouvoir intrafamiliales. Considérant la complexité des changements en matière de soins néonataux, nous plaidons en faveur d'une mise en oeuvre des programmes respectueuse à la fois des cultures d'accueil du nouveau-né, et des compétences des professionnels de santé à concilier des contraintes contradictoires.

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“…Some nurses receive US$400 in their share, and this does not include activities in private clinics. Do you think it’s for nothing that people do not want to come here?” The cities also host international nongovernmental organizations and international development agencies’ health programs (Tantchou 2013, 2014). When involved in those programs, one gains in experience, incomes, and symbolic recognition.…”

Section: Out Of Medicoscapes: “Dry” Positions and Frustrationmentioning

confidence: 99%

“…Maternity wards have been highlighted as representative of these behaviors (Olivier de Sardan 2001). Workload, low incomes, and limited human resources for health crises have been put forward to explain health providers’ attitude (e.g., Raviola et al 2002; Walker and Gilson 2004; Tantchou 2014). But the materiality of care has not been considered, although clinical practice is mediated through tools, technological devices, and a pragmatic organization of space (architectural structures and spatial organization), which should be suitable for the activities carried out.…”

Section: Introductionmentioning

confidence: 99%

“…Data for this article were collected over a period of seven years, during which I conducted fieldwork in Maroua, the main city in Cameroon's Far North region, on access to tuberculosis and HIV treatment, the burnout syndrome, the quality of emergency obstetric care, and a communitybased reproductive health program (Tantchou 2007(Tantchou , 2009(Tantchou , 2014. These research projects gave me access to all the city's health facilities, both public and private, and allowed me to organize semistructured interviews and focus group discussions with health providers and users of health facilities.…”

Section: Introductionmentioning

confidence: 99%

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The Materiality of Care and Nurses’ “Attitude Problem”

Tantchou

2017

Science, Technology, & Human Values

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Health systems in Africa have been widely studied in the social sciences. Several aspects have been addressed in particular: the provision of and access to care, working conditions, the human resources crisis, and patient–provider relations, for example. In this respect, the idea of an “attitude problem,” with health-care providers offering different services for different patients, has been suggested. Recently, researchers have studied the impact of global health initiatives on local health systems, mainly in the fight against HIV/AIDS. Others have explored why some health issues have attracted more attention than others. Despite this wealth of studies, one point remains insufficiently addressed: the materiality of care and its impact on interactions (human and nonhuman) within hospital settings. In this article, I consider the heuristic value of the uses of a maternity ward in a resource-limited country (Cameroon) to understand health workers’ so-called attitude problem, specifically, the tension characteristic of patient–provider interactions. I suggest that this tension is related to a continuous process of translation and anticipation to adapt the maternity ward’s space to everyday activities. Drawing on Akrich’s description of technical objects, and Lussault’s pragmatics of space, I attempt to show that in this context, care is also an art of tinkering with unpredictable bodies in unstable hospitals’ spaces.

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Poor Working Conditions, HIV/AIDS and Burnout: A Study in Cameroon

Cited by 6 publications

References 22 publications

Blurring Boundaries

Blurring Boundaries

Soins aux nouveau-nés : les recommandations internationales face aux enjeux sociaux de la naissance

The Materiality of Care and Nurses’ “Attitude Problem”

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