Proofs and Politics: Re-assembling evidence-informed health policy in global health as a matter of and for care

Jensen, Nele. 2019. Proofs and Politics: Re-assembling evidence-informed health policy in global health as a matter of and for care. Doctoral thesis, Goldsmiths, University of London [Thesis]

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Abstract or Description

Demands to ground policies and practices in objective scientific proofs have become ubiquitous in global health. This thesis problematizes such demands as they are articulated in efforts to foster evidence-informed health policymaking (EIHP) in the Global South. With an empirical focus on the World Health Organization (WHO)-backed Evidence-Informed Policy Network EVIPNet and its ‘country node’ in Uganda, I show that Ugandan health professionals strive for EIHP yet face conflicting requirements for evidence that is both globally excellent and locally relevant. Rather than critiquing EIHP as a hegemonic ‘evidentiary regime’ or debunking the desire for trustworthy scientific evidence, this thesis carefully engages with concerns for EIHP while examining the problematic questions articulated by demands to link proofs presumed by evidence-making processes and politics in practice.

Based on archival research, document analysis and ethnographic methods, this thesis seeks to re-assemble EIHP as a matter of and for care. I show that current EIHP frameworks focus on circulating global scientific evidence on ‘what works’ and its adaption to local contexts. By purporting to integrate objective evidence with subjective local values, however, these frameworks must insist on the separatedness of facts and values, of proofs and politics. I argue that in assigning to science the role as rational solution provider, EIHP frameworks pay insufficient attention to the many concerns and questions that emerge with the situated dimensions of a policy problem – and thus risk failing to link proofs and politics.

Drawing on the work of Isabelle Stengers, Maria Puig de la Bellacasa, and Helen Verran, among others, I propose that what may be called for is the conceptualisation of evidence-making as a situated and contingent achievement; that is, for a careful and generative critique not against evidence, but for possible re-formulations of what ‘good’ evidence may be and how it may come (in-)to matter.

Item Type:

Thesis (Doctoral)

Identification Number (DOI):

https://doi.org/10.25602/GOLD.00026849

Keywords:

evidence, evidence-informed policy, global health, Stengers

Departments, Centres and Research Units:

Sociology

Date:

31 July 2019

Item ID:

26849

Date Deposited:

09 Sep 2019 10:42

Last Modified:

25 Jun 2021 08:25

URI:

https://research.gold.ac.uk/id/eprint/26849

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