Positionality
The physical and socio-political positions of researchers have implications for health systems research in terms of the development of research questions, the way research is conducted, and its eventual impact.
Positions can be informed by an individual’s personal characteristics such as age, ethnicity, sex, nationality, class and so on. But they can also be considered by how close they are to a system and those who make decisions. Some writers have talked of ‘insider’ and ‘outsider’ perspectives on research.
Some researchers do not state their position, assuming that their work is ‘apolitical’ or ‘objective’. This is a position that is not often afforded to minority scholars working on issues that they are personally affected by or those working on gender or women’s rights. These researchers are regularly asked to account for their positions and to justify their potential biases or accused of ‘identity politics’.
The resources by Foreman (2016) and Ooms (2015) explore unspoken or hidden normative presences in global health through which agendas are set and power relations reinforced. Walt (2006) explores how researchers’ positions shape research agendas and explicitly engages with how North/South dynamics effect health systems research processes. Simon and Mosavel (2011) apply an ethical lens to the issue of positionality, drawing on research in South Africa, and suggest conceptual tools for organising work in this area. Erika Nelson (2019) and Constance Mackworth-Young et al. (2018) explore the navigation of complex relationships of power in Latin America and Zambia respectively.
Muhammad et al. (2014) explore how participatory research might provide a mechanism for better acknowledging and dealing with researcher positionality. MacGregor and Bloom (2016) suggest several ways deal with researcher positionality, for example, self-reflection, stakeholder consultations, community engagement and setting time aside in the research process to reflect on positionality.
Useful resources
‘Labouring’ on the frontlines of global health research: mapping challenges experienced by frontline workers in Africa and Asia
ABSTRACT Drawing on the reflections and discussions from a special session at the 2021 Global Health Bioethics Network summer school, this paper has summarised the key challenges faced by Frontline Workers (FWs) across research sites in Africa and Asia in performing the everyday ‘body work’ entailed in operationalising global health research. Using a ‘body work’ […]
Whose voices should shape global health education? Curriculum codesign and codelivery by people with direct expertise and lived experience
There are contrasting opinions of what global health (GH) curricula should contain and limited discussion on whose voices should shape it. In GH education, those with first-hand expertise of living and working in the contexts discussed in GH classrooms are often absent when designing curricula. To address this, we developed a new model of curriculum […]
‘I’m Not that Kind of Doctor’ On Being In-Between in a Global Health Intervention
Within multi-disciplinary global health interventions, anthropologists find themselves navigating complex relationships of power. In this article, I off er a critical reflection on this negotiated terrain, drawing on my experience as an embedded ethnographer in a four-year adolescent sexual and reproductive health research intervention in Latin America. I critique the notion that the transformative potential […]
Navigating ‘ethics in practice’: An ethnographic case study with young women living with HIV in Zambia
While ‘procedural ethics’ provides essential frameworks for governing global health research, reflecting on ‘ethics in practice’ offers important insights into addressing ethically important moments that arise in everyday research. Particularly for ethnographic research, renowned for it’s fluid and spontaneous nature, engaging with ‘ethics in practice’ has the potential to enhance research practice within global health. […]
The Ghost Is the Machine: How Can We Visibilize the Unseen Norms and Power of Global Health?
In his recent commentary, Gorik Ooms argues that “denying that researchers, like all humans, have personal opinions … drives researchers’ personal opinion underground, turning global health science into unconscious dogmatism or stealth advocacy, avoiding the crucial debate about the politics and underlying normative premises of global health.” These ‘unconscious’ dimensions of global health are as […]
Navigating Between Stealth Advocacy and Unconscious Dogmatism: The Challenge of Researching the Norms, Politics and Power of Global Health
Global health research is essentially a normative undertaking: we use it to propose policies that ought to be implemented. To arrive at a normative conclusion in a logical way requires at least one normative premise, one that cannot be derived from empirical evidence alone. But there is no widely accepted normative premise for global health, […]
‘Doing’ health policy analysis: methodological and conceptual reflections and challenges
The case for undertaking policy analysis has been made by a number of scholars and practitioners. However, there has been much less attention given to how to do policy analysis, what research designs, theories or methods best inform policy analysis. This paper begins by looking at the health policy environment, and some of the challenges to researching […]
Getting personal: Ethics and identity in global health research
‘Researcher identity’ affects global health research in profound and complex ways. Anthropologists in particular have led the way in portraying the multiple, and sometimes tension-generating, identities that researchers ascribe to themselves, or have ascribed to them, in their places of research. However, the central importance of researcher identity in the ethical conduct of global health […]
Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes
The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It […]
Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale
This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can […]
