Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews

Recent calls for global health decolonization suggest that addressing the problems of global health may require more than ‘elevating country voice’. We employed a frame analysis of the diagnostic, prognostic, and motivational framings of both discourses and analyzed the implications of convergence o...

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Main Authors: Michael Kunnuji, Yusra Ribhi Shawar, Rachel Neill, Malvikha Manoj, Jeremy Shiffman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022394/?tool=EBI
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author Michael Kunnuji
Yusra Ribhi Shawar
Rachel Neill
Malvikha Manoj
Jeremy Shiffman
author_facet Michael Kunnuji
Yusra Ribhi Shawar
Rachel Neill
Malvikha Manoj
Jeremy Shiffman
author_sort Michael Kunnuji
collection DOAJ
description Recent calls for global health decolonization suggest that addressing the problems of global health may require more than ‘elevating country voice’. We employed a frame analysis of the diagnostic, prognostic, and motivational framings of both discourses and analyzed the implications of convergence or divergence of these frames for global health practice and scholarship. We used two major sources of data–a review of literature and in-depth interviews with actors in global health practice and shapers of discourse around elevating country voice and decolonizing global health. Using NVivo 12, a deductive analysis approach was applied to the literature and interview transcripts using diagnostic, prognostic and motivational framings as themes. We found that calls for elevating country voice consider suppressed low- and middle-income country (LMIC) voice in global health agenda-setting and lack of country ownership of health initiatives as major problems; advancing better LMIC representation in decision making positions, and local ownership of development initiatives as solutions. The rationale for action is greater aid impact. In contrast, calls for decolonizing global health characterize colonialityas the problem. Its prognostic framing, though still in a formative stage, includes greater acceptance of diversity in approaches to knowledge creation and health systems, and a structural transformation of global health governance. Its motivational framing is justice. Conceptually and in terms of possible outcomes, the frames underlying these discourses differ. Actors’ origin and nature of involvement with global health work are markers of the frames they align with. In response to calls for country voice elevation, global health institutions working in LMICs may prioritize country representation in rooms near or where power resides, but this falls short of expectations of decolonizing global health advocates. Whether governments, organizations, and communities will sufficiently invest in public health to achieve decolonization remains unknown and will determine the future of the call for decolonization and global health practice at large.
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spelling doaj.art-98511434bd4445518109d260ccc49e8d2023-09-03T10:08:21ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0132Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviewsMichael KunnujiYusra Ribhi ShawarRachel NeillMalvikha ManojJeremy ShiffmanRecent calls for global health decolonization suggest that addressing the problems of global health may require more than ‘elevating country voice’. We employed a frame analysis of the diagnostic, prognostic, and motivational framings of both discourses and analyzed the implications of convergence or divergence of these frames for global health practice and scholarship. We used two major sources of data–a review of literature and in-depth interviews with actors in global health practice and shapers of discourse around elevating country voice and decolonizing global health. Using NVivo 12, a deductive analysis approach was applied to the literature and interview transcripts using diagnostic, prognostic and motivational framings as themes. We found that calls for elevating country voice consider suppressed low- and middle-income country (LMIC) voice in global health agenda-setting and lack of country ownership of health initiatives as major problems; advancing better LMIC representation in decision making positions, and local ownership of development initiatives as solutions. The rationale for action is greater aid impact. In contrast, calls for decolonizing global health characterize colonialityas the problem. Its prognostic framing, though still in a formative stage, includes greater acceptance of diversity in approaches to knowledge creation and health systems, and a structural transformation of global health governance. Its motivational framing is justice. Conceptually and in terms of possible outcomes, the frames underlying these discourses differ. Actors’ origin and nature of involvement with global health work are markers of the frames they align with. In response to calls for country voice elevation, global health institutions working in LMICs may prioritize country representation in rooms near or where power resides, but this falls short of expectations of decolonizing global health advocates. Whether governments, organizations, and communities will sufficiently invest in public health to achieve decolonization remains unknown and will determine the future of the call for decolonization and global health practice at large.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022394/?tool=EBI
spellingShingle Michael Kunnuji
Yusra Ribhi Shawar
Rachel Neill
Malvikha Manoj
Jeremy Shiffman
Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews
PLOS Global Public Health
title Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews
title_full Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews
title_fullStr Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews
title_full_unstemmed Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews
title_short Why ‘elevating country voice’ is not decolonizing global health: A frame analysis of in-depth interviews
title_sort why elevating country voice is not decolonizing global health a frame analysis of in depth interviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022394/?tool=EBI
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