Reconciling organisational intent and local strategies an in-depth study of health workers in an urban leprosy project in India


Harris, Kristine; (2009) Reconciling organisational intent and local strategies an in-depth study of health workers in an urban leprosy project in India. PhD thesis, London School of Hygiene & Tropical Medicine. DOI: 10.17037/PUBS.00967524

[img]
Preview
Text - Published Version
License:

Download (51Mb) | Preview

Abstract

There is growing interest in health systems research and implementation studies within public health, yet there is little in-depth research being carried out on the front-line health workers who implement interventions in the field. This study aims to add to our understanding of implementation processes through an in-depth ethnographic study conducted over a 12 month period of participant observation with field-level health workers in an urban leprosy project. The study employs a multidisciplinary approach, combining anthropological and public health methods and perspectives, and was carried out within one of India's largest leprosy organisations. The research is, in essence, a 'project ethnography' of the work and social identity of health workers, within the context of a rapidly changing policy landscape. The study argues that health workers are embedded in the structures they work within at the same time as they actively exercise agency within these structures. By understanding how health workers utilise agency within, rather than in opposition to, structure, we can come to understand health workers' social identity, as well as how they reconcile organisational intent with local strategies in the implementation process. There is a growing realisation within public health that health systems are complex social microcosms in which health workers play a pivotal role. The study argues that the application of social theory, that examines the relationship between agency and structure, will be instrumental in developing research frameworks that truly engage with the process and complexity of health systems.

Item Type: Thesis
Thesis Type: Doctoral
Thesis Name: PhD
Contributors: Porter, JDH (Thesis advisor); Kielmann, K (Thesis advisor);
Additional Information: Health Policy Unit (2009) uk.bl.ethos.536905
Faculty and Department: Faculty of Public Health and Policy
URI: http://researchonline.lshtm.ac.uk/id/eprint/967524

Statistics


Download activity - last 12 months
Downloads since deposit
1,792Downloads
390Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item