Opposing Observations and the Political-Economy of Malaria Vulnerability: A Community-Based Study in Bududa, Uganda

Authors

  • Kelly F. Austin Lehigh University

DOI:

https://doi.org/10.5195/jwsr.2020.967

Keywords:

Malaria, Political-Economy, Climate Change, Privatization, Uganda

Abstract

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.

Author Biography

Kelly F. Austin, Lehigh University

Kelly F. Austin is an Associate Professor at Lehigh University. Her work specializes in examining global inequalities in health, the environment, and gender. Her work has been published in a variety of outlets, including Social Forces, Social Problems, and World Development.

References

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.

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Published

2020-03-02

How to Cite

Austin, K. F. (2020). Opposing Observations and the Political-Economy of Malaria Vulnerability: A Community-Based Study in Bududa, Uganda. Journal of World-Systems Research, 26(1), 9–39. https://doi.org/10.5195/jwsr.2020.967

Issue

Vol. 26 No. 1 (2020): Winter/Spring 2020

Section

Research Articles

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