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Chronicity of disruptive project rhythms: The projectification of the ‘post-Ebola' health system rebuilding in Sierra Leone
Time & Society ( IF 2.2 ) Pub Date : 2021-04-27 , DOI: 10.1177/0961463x211005207
Michaela Hubmann 1
Affiliation  

Global health development projects are inherently governed by bounded, temporal and linear time frames: the initiation, implementation and ending of time-limited interventions. This projectification of global health programmes has wide-reaching consequences as global health projects, often unsustainable and produces both new life possibilities and uncertain futures. This article highlights the temporal effects of the global health agenda on the primary health system rebuilding efforts in Sierra Leone. Attention is paid to how the projectification of public health programmes affected the primary healthcare management in a district in the southern region of Sierra Leone. Throughout this article, I develop the theoretical concept of chronicity of disruptive project rhythms where local public healthcare actors encounter project disruptions on a continuum of chronic lack. I base this concept on Manderson and Smith-Morris’s definition of chronicity of illness experience, which is marked by punctuated episodes of acute sickness, where chronic patients are temporally transmuted into acute patients, while at the same time continuing to suffer from their ongoing chronic ailments. Drawing on 14 months of ethnographic research, I show how a district health management team (DHMT) contested the bounded time frames of public health funding; how waiting time for funding impacted the operation of the DHMT and, by extension, the district health system as a whole and how DHMT employees and other actors within the health system employed time-tricking strategies to resist this project time.



中文翻译:

破坏性项目节奏的长期性:塞拉利昂“埃博拉后”卫生系统重建的项目化

全球卫生发展项目固有地受有界,时间和线性时间表的约束:有时间限制的干预措施的启动,实施和结束。全球卫生计划的这种设想会产生广泛的后果,因为全球卫生计划往往是不可持续的,并带来新的生活可能性和不确定的未来。本文重点介绍了全球卫生议程对塞拉利昂初级卫生系统重建工作的时间影响。应注意公共卫生计划的规划如何影响塞拉利昂南部地区的一个地区的初级卫生保健管理。在整篇文章中,我提出了破坏性项目节奏的慢性性的理论概念,在这种概念中,地方公共卫生保健参与者在长期缺乏连续性的情况下遇到了项目破坏。我以曼德森(Manderson)和史密斯·莫里斯(Smith-Morris)对疾病经历的慢性性的定义为基础,其特征是出现了急性疾病的标点符号,其中慢性患者暂时转变为急性患者,而与此同时继续遭受持续的慢性疾病。借助14个月的人种志研究,我将展示一个地区卫生管理团队(DHMT)如何应对公共卫生资金的有限时限。等待资金的时间如何影响DHMT的运行,以及由此扩展的内容,

更新日期:2021-04-27
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