Opposing Observations and the Political-Economy of Malaria Vulnerability: A Community-Based Study in Bududa, Uganda
Keywords:Malaria, Political-Economy, Climate Change, Privatization, Uganda
Malaria is a parasitic infection that remains a leading threat to health and development in many communities, especially in Sub-Saharan Africa. In Bududa, Uganda, malaria represents a key threat to health and well-being. However, whether or not malaria rates are improving in the district over time represents a conundrum. By using principles of structural fieldwork and drawing on multiple data sources that include the more- and less- powerful, opposing observations emerge, where community members perceive marked increases in malaria rates over time, while official district-level data depict the opposite. World-systems analysis illuminates the reasons behind this discrepancy, along with the factors that community members use to explain the rise in malaria suffering, including environmental changes and decreased healthcare access. Overall, this research demonstrates how global economic policies and structures create unequal health impacts, placing those in Bududa at disproportionate and elevated vulnerability to malaria.
Afrane,Y.A., Githeko, A.K., Yan, G. (2012). The ecology of Anopheles mosquitoes under climate change: case studies from the effects of deforestation in East African highlands. Annuals of the New York Academy of Sciences 1249: 204-210.
Austin, K.F. (2013). Export agriculture is feeding malaria: A cross-national examination of the environmental and social causes of malaria prevalence. Population and Environment 35(2): 133-158.
Austin, K.F. (2017). Brewing Unequal Exchanges in Coffee: A qualitative investigation into the consequences of the java trade in rural Uganda. Journal of World-Systems Research 23(2): 326-352.
Austin, K.F., DeScisciolo, C.L. and Samuelsen, L.V. (2016). The failures of privatization: A cross-national investigation of the tuberculosis and the structure of healthcare in less-developed nations. World Development 78: 450-460.
Barros, F.S.M. and Honório, N.A. (2015). Deforestation and malaria on the Amazon frontier: Larval clustering of Anopheles darlingi determines focal distribution of malaria. American Journal of Tropical Medicine 93(5): 939-953.
Basu, S., Andrews, J., Kishire, S., Panjabi, R., and Stuckler, D. (2012). Comparative performance of private and public healthcare in low and middle income countries: A systematic review. PLoS Medicine 9(6): 1–13.
Basurko, C., Demattei, C., Han-Sze, R., Grenier, C., Joubert, M., Nacher, M., and Carme, B. (2013). Deforestation, agriculture and farm jobs: A good recipe for Plasmodium vivax in French Guiana. Malaria Journal 12(90): 1-6.
Bates I., Fenton C., Gruber J., et al., (2004). Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease. Part II: determinants operating at environmental and institutional level. Lancet Infect Diseases 4: 368-375.
Brady D., Kaya Y. and Beckfield J. (2007). Reassessing the effect of economic growth on well-being in less-developed countries, 1980-2003. Studies in Comparative International Development 42: 1–35.
Bunker, S. (1985). Underdeveloping the Amazon: Extraction, unequal exchange, and the failure of the modern state. Chicago: University of Chicago Press.
Center for Disease Control (CDC). (2019). About Malaria, Available at: https://www.cdc.gov/malaria/about/disease.html
Chandler, C.I.R., Hall-Clifford, R., Asaph, T., Pascal, M., Clarke, S., and Mbonye, A.K. (2011). Introducing malaria rapid diagnostic tests at registered drug shops in Uganda: Limitations of diagnostic testing in the reality of diagnosis. Social Science & Medicine. 72: 937-944.
Deressa, W., Ali, A. and Hailemariam, D. (2008). Malaria-related health-Seeking behaviour and challenges for care providers in rural Ethiopia: Implications for Control. Journal of Biosocial Science 40: 115-135.
Frey, Frey, R. and Wanjun Cui. (2016). Infant Mortality in the World-System. Journal of Globalization Studies 7(1): 47-55.
Gellert, P. K. and Shefner, J. (2009). People, place and time: How structural fieldwork helps world-systems analysis. Journal of World-Systems Research 15(2):193- 218.
Hahn, M.B., Gangnon, R.E., Barcellos, C., Asner, G.P., and Patz, J.A. (2014). Influence of deforestation, logging, and fire on malaria in the Brazilian Amazon. PLOS ONE 9(1): 85725.
Herrera, V. (2014). Does commercialization undermine the benefits of decentralization for local services provision? Evidence from Mexico’s urban water and sanitation sector. World Development 56(1): 16–31.
Kingston, C., Irikana, G., Dienye, V. and Kingston, K.G. (2011). The impacts of the World Bank and IMF structural adjustment programmes on Africa: The case Study of ote D'Ivoire, Senegal, Uganda, and Zimbabwe. Journal of Policy and Strategic Studies 1(2): 110-130.
Kweka, E.J., Kimaro, E.E., Munga, S. (2016). Effect of deforestation and land use changes on mosquito productivity and development in Western Kenya highlands: implication for malaria risk. Frontiers in Public Health 4(1): 1-9.
Maclean, L.M. (2011). The paradox of state retrenchment in Sub-Saharan Africa: The micro-level experience of public social service provision. World Development 39(7): 1155–1165.
Maheu-Giroux, M., Casapía, M. and Gyorkos, T.W. (2011). On the validity of self-reports and indirect reports to ascertain malaria prevalence in settings of hypoendemicity. Social Science & Medicine 72: 635-640.
Mbonye, A. K., Bygbjerg, I.C. and Mangussen, P. (2007). Prevention and Treatment Practices and Implications for Malaria Control in Mukono District Uganda. Journal of Biosocial Science 40: 283-296.
Maynard, G., Shircliff, E., and Restivo, M. (2012). IMF structural adjustment, public health spending, and tuberculosis: A longitudinal analysis of prevalence rates in poor countries. International Journal of Sociology 42(2): 5–27.
McMichael, P. (2017). Development and social change: A global perspective, 6th Edition. Thousand Oaks, CA: Pine Forge Press.
Navarro, V., Muntaner, C., Borrell, C., Benach, J., Quiroga, A., Rodriguez-Sanz, M., et al. (2006). Politics and health outcomes. Lancet 368: 1033–1037.
Norris, D.E. (2004). Mosquito-borne diseases as a consequence of land use change. EcoHealth 1: 19-24.
Patz, J.A. and Olson, S.H. (2006). Malaria risk and temperature: Influences from global climate change and local land use practices. Proceedings of the National Academy of Sciences of the United States of America 103(15): 5635-5636.
Postigo, A. (2008). Vulnerability and adaptation to the health impacts of climate change. Development 51: 403-408.
Rice, J. (2007). Ecological unequal exchange: International trade and uneven utilization of environmental space in the world system. Social Forces 85: 1369-1392.
Roberts, J.T. and Parks, B.C. (2007). A Climate of injustice: Global inequality, north–south politics, and climate policy. Cambridge, MA: MIT Press.
Rostow, W.W. (1960). The stages of economic growth: A non-communist manifesto (3rd ed.). London, England: Cambridge University Press.
Sachs J. and Malaney P. (2002). The economic and social burden of malaria. Nature 415: 680–685.
Shandra C.L., Shandra J.M. and London B. (2011). World bank structural adjustment, water, and sanitation: A cross-national analysis of child mortality in Sub-Saharan Africa. Organization & Environment 24(1): 107–129.
Stiglitz, J. (2002). Globalization and its discontents. New York: Norton Press.
Vittor, A.Y., Gilman, R.H., Tielsch, J., Glass, G., Shields, T., Lozano, W.S., Pinedo-Cancino, V. and Patz, J.A. (2006). American Journal of Tropical Medicine and Hygiene 74(1): 3–11.
Wilder, M., and Lankao, P.R. (2006). Paradoxes of decentralization: Water reform and social implications in Mexico. World Development 34(11): 1977–1995.
Wiseman, V., Scott, A., Conteh, L., McElroy, B., and Stevens, W. (2008). Determinants of provider choice for malaria treatment: Experiences from The Gambia. Social Science & Medicine 67: 487-496.
World Health Organization (WHO). (2019). Malaria. Available at: https://www.who.int/news-room/fact-sheets/detail/malaria
World Health Organization (WHO). 2013. Climate Change and Infectious Diseases. Available at: https://www.who.int/globalchange/climate/en/chapter6.pdf
Yanoviak, S.P., Paredes, J.E.R., Lounibos, L.P., and Weaver, S.C. (2006). Deforestation alters Phytotelm habitat availability and mosquito production in the Peruvian Amazon. Ecological Applications 16(5): 1954-1864.
How to Cite
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.