Global Health and the Village

Contents List of Acronyms and Abbreviations Glossary of Acholi (Luo) Words Acknowledgements Chapter One: Introduction to A Crisis in Maternal Health Introduction Contexts of Care Background on the Millennium Development Goals (MDGs) Skilled birth attendants (SBAs) and traditional birth attendants (TBAs) Policy and social contexts for maternity care and childbirth The post-conflict setting Methodology and Methods Key Institutional Ethnography definitions: Institutions, participants, and work Data collection Positioning myself as researcher Theorizing methods Outline Chapter Two: Ongoing Social Distress: Care-seeking in a Remote Post-Conflict Context Introduction Overview of the Conflict in Northern Uganda Ongoing Social and Economic Impacts of the War Abduction, health and community membership The internally displaced persons (IDP) camps Ongoing Social Distress: Land Conflicts and Disease Epidemics The outbreak of disease Agriculture Land disputes Poverty and lack of infrastructure Impacts on study participants Conclusion Map of Uganda Chapter Three: Pregnancy and Daily Life: Health System and Home Factors Shaping Care Introduction Focused (Goal-Oriented) Antenatal Care (ANC) The Message to Attend ANC The Provision of Mama Kits Formal Health Care Providers The setting for formal health care provision Clinical officers Midwives Enrolled comprehensive nurses, registered nurses, nursing assistants, and nurse aides Informal Health Care Providers Traditional birth attendants (TBAs) The village health team (VHT) Transportation, Nutrition, and Work Transportation Lack of capacity to provide care at sub-county health centres Nutrition and work Chapter Four: Charity and Control: When Help Requires Compliance Introduction A Reward for Care or a Gift to the Vulnerable? Divergent Ideas the Mama Kit’s Role The mama kit as creating and rewarding compliance with ANC The mama kits as an incentive or reward for health centre delivery The mama kits as supporting and signaling ‘vulnerable’ women The mama kits as a gift or charity Registration and Distribution of Mama Kits Health Centre Staff and Administrators on the Mama Kits’ Role: Helping the Vulnerable, or Motivating Care-seeking? “In our setting, who is the most poor?” Perceptions of vulnerability as a distribution criteria Health centre staff on the mama kit: ‘Motivating’ women to deliver at a health facility The Goals of the Uganda Red Cross NGO - Health Centre Partnerships: Problems with Withdrawal and Shortages Unpredictable Distribution Affects how Women Perceive Formal Care and Health Workers Conclusion Chapter Five: Vertical Health: Failures of Compulsory Couples HIV Testing Introduction Background: Prevalence, Policies, and Practice Women’s experiences of male reluctance Health Worker Perspectives on Couples HIV Testing During ANC Health Worker Strategies for Couples Testing in the Face of Male Reluctance “Without a Man We are Not Going to Give you a Card”: Male Refusal as a Barrier to Women’s Care Gender, Couples Testing, and Vertical Health Gender and Intersectional Power Relationships Conclusion Chapter Six: Conclusions: Reconceiving the Maternal Health Crisis Introduction Global goals, Local lives Discourses governing care: Choice, tradition and culture Limitations Conclusion References