Project summary 
My doctoral research looks at the kinds of relations of care that form as migrant women find their feet in a new city.  Focusing primarily on forced migrant women, I explore the ways relations of care are affected by the spaces of the city, especially as they encourage, hinder or maintain ways of belonging to the city.

Research approach
Drawing on urbanistic principles, the project views health relationally with place. The physical characteristics of the neighbourhood, such as dwelling spaces, the open realm and networks of circulation, form a key parameter against which relations of care and forms of belonging are interrogated.

People involved

• Maayan Ashkenazi, Research Degree Student, LSHTM
• Simon Cohn, PhD project supervisor, Professor at LSHTM

Project summary 
We conduct research to understand the implications and effects of community involvement and dialogue in promoting health, planning health services, and quality improvement of existing services.

Our work spans seven key research themes:

• Voices and experiences in health
• Community participation and citizenship
• Dialogues about sexual and reproductive health
• Transitions to adulthood
• Digital life
• Conducting and communicating science in an ethical way
• Dialogue and the arts

Our research involves community involvement and participation, including:

• Young people; for example sociology of sickle cell disease and transitions to adulthood (‘This Sickle Cell Life’)
• Patient involvement, including ethnographic research of patient co-production of health, developing theory on citizenship and participation
• Sexual and reproductive health, especially for young people
• Relationships between sex, sexuality, and technology

Current projects

• ‘This Sickle Cell Life’ examines the experiences of young people with sickle cell as they transition to adulthood and move from using child to adult services
• NIHR CLAHRC for NWL patient involvement
• Theorising community and patient participation and involvement in health promotion and health research
• Forthcoming pending contract, a DFID-funded multi-country study of sexual and reproductive health and rights aiming to understand and improve sexual and reproductive health and rights among marginalised populations in complex and challenging environment

Publications

• Marston C, Renedo A, Nyaaba GN. Fertility regulation as identity maintenance: Understanding the social aspects of birth control. J Health Psychol. 2018;23(2):240-51
• Miles S. Sex in the digital city: location-based dating apps and queer urban life. Gender, Place & Culture 2017; 24(11):1595-1610
• Renedo A, Marston C. Spaces for Citizen Involvement in Healthcare: An Ethnographic Study. Sociology-the Journal of the British Sociological Association. 2015;49(3):488-504
• Renedo A, Komporozos-Athanasiou A, Marston C. Experience as Evidence: The Dialogic Construction of Health Professional Knowledge through Patient Involvement. Sociology-the Journal of the British Sociological Association. 2018;52(4):778-95

PhDs

• Kühlbrandt, C (2017) Containment - An examination of Roma health mediation in Romania. PhD thesis, London School of Hygiene & Tropical Medicine. DOI: https://doi.org/10.17037/PUBS.04645511 (supervised by AR)
• Grenfell, P. (2018). Structural violence and sex work in Lima, Peru (supervised CM)

Website: www.lshtm.ac.uk/DEPTH
Twitter: www.twitter.com/DEPTH_LSHTM and www.twitter.com/ThisSClif
Blog: www.blogs.lshtm.ac.uk/depth

People involved

• Cicely Marston
• Alicia Renedo
• Catherine McGowan
• Sam Miles

Project summary

‘Fluid Bodies’ refers to a set of projects that take a material-semiotic approach to bodily boundaries and construction of the body, interactions between bodies and environments, and wider moral orders, focusing particularly on fluids.

1. Bodies, persons, and blood donation (COMPLETED)
2. Leaky bodies - examining female urinary incontinence (COMPLETING APRIL 2019)

People involved

• Simon Cohn, Professor of Medical Anthropology at LSHTM
• Rebecca Lynch, Assistant Professor (Medical Anthropology) at LSHTM

Research approach

Projects have involved ethnographic observation and interviews with patients, blood donors, and clinical staff in two different biomedical settings in different UK hospitals: blood donation clinics and urogynaecology clinics.

Critiquing and seeking to advance approaches to conceptualisations of the body, we have sought to produce outputs that speak to clinical as well as anthropology/sociological audiences.

Aim/direction/findings

Blood donation work examined how posthuman and materialist approaches might enable a reconsideration of anthropological concern with personhood and ownership of donated materials.

Work on urinary incontinence has involved considering the distributed nature of decision-making, self-control, bodily boundaries, embodiment, and the contribution of an anthropological approach to surgery.

Projects and collaborations in development extend debates on the body through considering the body: environment interaction, and indeed, where such a line might be drawn.

Publications/outputs

• Lynch, R. (2019) ‘Of flesh and mesh: Time, materiality, and health in surgical recovery’ in Parkhurst, A. & Carroll, T. (eds) Medical Materialities, Routledge
• Lynch, R; Cohn, S; (2018) Donor understandings of blood and the body in relation to more frequent donation. Vox sanguinis, 113 (4). pp. 350-356
• Lynch, R; Cohn, S; (2017) Beyond the person: the construction and transformation of blood as a resource. Critical public health, 27 (3). pp. 362-372
• Cohn, S; Lynch, R; (2017) Posthuman perspectives: relevance for a global public health. Critical public health, 27 (3). pp. 285-292
• Cohn, S; Lynch, R; (2017) Diverse bodies: the challenge of new theoretical approaches to medical anthropology. Anthropology & medicine, 24 (2). pp. 131-141

Project summary

Forms of Care is an ethnographic study of palliative care practices. We seek to explore how routine practices of ‘not doing’ – whether they are conscious and deliberate or the result of more distributed social interactions – are an active and valuable form of care.

We aim to contribute to current debates about what appropriate clinical practice and good care are, and can be.

Research approach

The project involves an ethnography of palliative and end of life care in a large NHS hospital and its neighbouring community services.

The methods are:

• observations of multidisciplinary staff meetings of the palliative care team
• shadowing and interviewing palliative care staff members
• carrying out detailed case studies of patients and their close family members

Aim of the project

We aim to develop theoretical and methodological approaches that are able to take acts of not doing seriously.

As part of the project, we will organise innovative workshop sessions to reflect upon the ethnographic findings and help these to be useful to palliative care, and wider clinical practice.

People involved

• Simon Cohn, Professor of medical anthropology, LSHTM
• Dr Erica Borgstrom, Lecturer, Open University (OU)
• Annelieke Driessen, Research Fellow, LSHTM
  
  Project website

Project summary

My PhD uses the case study of hip replacements to understand the current debates around the crisis of the NHS.

I have now decided it will be entitled “How I fell out of love with the NHS” as I found that many of the inequalities I found in care are to do with 1) subtle sorting practices based on principles of liberal democracy 2) the obsession with quantitative data and 3) the gendered and classed inequalities embedded in the NHS structure.

I therefore propose that rather than looking to the past the “save the NHS” we should be proposing an alternative political reformation of the healthcare service in the UK.

• Hannah Cowan– PhD researcher
• Simon Cohn – primary supervisor
• Nicolas Mays – Secondary Supervisor
• Megan Clinch – Advisory member

Research approach

I have taken a broad ethnographic approach where I spent time in many places to do with hips and the NHS. This included recovery wards, operation theatres, clinics, and equipment sterilisation units as well as orthopaedic and hip conferences and events, informal conversations with past patients and orthopaedic staff, NHS campaigning events and meetings, as well as the local authorities and national bodies trying to implement change.

I have also taken a historical angle to try and understand the NHS from its beginnings. I therefore followed the parallel history of hips through reading historic literature, visiting museums and websites, as well as going to visit the hospital where hips were “invented” to gather oral histories.

Finally I spent a lot of time looking at online resources and carrying out discourse analysis on key documents.

Project summary

My current work focuses on understandings of child health, exploring the perspectives of families and healthcare providers, and the role of food and feeding practices in creating and sustaining a ‘healthy child’.

Secondary interest in the use of ethnographic approaches in process evaluation of health interventions - focus on understanding the roles of key individual actors in implementation in a specific context, and implications for scale-up/transferability.

People involved

• Ruth Willis, Research Fellow, GHD, PHP

Mentors:

• Audrey Prost, Professor of Global Health, GHD, PHP
• Marko Kerac, Assistant Professor of Public Health Nutrition, PH, EPH

Research approach
The project took an ethnographic approach to child health practices and health care provision, in community and health system settings in the Peruvian Amazon.

Critical anthropological approach to construction and use of routine public health data.

Aim
Aiming ultimately to generate a body of comparative analysis and develop theory about how food and feeding practices relate to community and health care provider understandings of child health across low, middle and high income settings.

Funded by Department of Health and Social Care NHS in England.

• Health system governance – organisational structures, accountability, funding flows, regulation etc.
• Use of competition and cooperation mechanisms in commissioning health care services
• Functioning of the internal market in the NHS
• Understanding of the rules on competition by NHS managers
• Regulatory frameworks and actions of the regulators
• Commissioning policy and practice
• Institutional and policy change in the NHS

See for more information http://prucomm.ac.uk/.

People Involved

• Professor Pauline Allen, Professor of Health Services Organisation, HSRP
• Dr Marie Sanderson, Research Fellow, HSRP
• Dr Dorota Osipovic, Research Fellow, HSRP

Publications

• Osipovic D., Allen, P., Shepherd, E., Coleman, A., Perkins, N., Williams, L., Checkland, K. 2016. Interrogating institutional change: actors’ attitudes to competition and cooperation in commissioning health services in England. Public Administration. Volume 94, Issue 3, pp. 823–838
• Osipovic D., 2015. Conceptualisations of welfare deservingness by Polish migrants in the UK, Journal of Social Policy, 44 (4). pp. 729-746
• Osipovic D., 2013. ‘If I Get Ill, It’s onto the Plane, and off to Poland.’ Use of Health Care Services by Polish Migrants in London. Central and Eastern European Migration Review 2(2): 98-114

Project summary

• How do people judge other people’s deservingness to publicly funded benefits and services, in particular health care and social care?
• How do people think public services and benefits ought to be funded and provided?
• How do such normative social attitudes feed into the public policy making?

People Involved

• Dr Dorota Osipovic, Research Fellow (part-time), HSRP

Project summary

My thesis, entitled "Place, Need and Precarity in UK mental health care: An ethnography of access" looks ethnographically at the work it takes to include people who are seen to be excluded from mental health care; specifically, from psychotherapy services in the UK. I seek to understand how this work plays out in three voluntary sector clinics and how, in these places, needs and eligibility criteria are “done differently.”

People involved

• Natassia Brenman, Research Degree Student, LSHTM
• Simon Cohn, PhD project supervisor, Professor at LSHTM
• Nicki Thorogood, Secondary Supervisor, Professor at LSHTM

Research approach

I orient my analysis towards moments of access, as they are enacted by those who encounter and deliver mental health services in this inner city area of London in the UK. I use ethnography and specific creative methods to engage with spatial and material aspects of accessing care, feeding into overarching ideas in my thesis on the dynamic relationship between "place" and "need’

Aim/direction/findings

My research aims to understand practices of inclusion, exclusion and articulations of need in particular places, in order to produce a situated and critically engaged notion of “access.” My thesis shows the ways in which the work of inclusion, in these voluntary spaces, reproduces precarity (of service providers as well as users) in the health and social care system.

Selected conference papers and publications in preparation

• “The political and its afterlives: accounting and being accountable in ethnographies of healthcare in motion” Ethnographies & Health Network workshop: Re-politicising public health, King’s Collage London, October 2018
• “‘No dumping!’ Space and value in voluntary mental health care in London” Valuing Health: Edinburgh Centre for Medical Anthropology Conference, September 2018
• When Categories Collide: Attending to the aggregation and enactment of “BME” categories in UK mental health care. Roundtable discussion paper, European Association for Social Anthropology Conference, August 2018
• “Placing precarity: mapping im/migrant experiences of accessing psychotherapy in the UK” German Anthropological Association Conference, Berlin, October 2017
• “The diffusion of diagnostic practices beyond clinical settings; the case of mental health care in the UK” Configurations of diagnostic processes, practices, and evidence: MAAH Conference Tromsø, June 2016

Project summary

The RECAP (Research capacity strengthening and knowledge generation to support preparedness and response to humanitarian crises and epidemics) project is a 4y (2018-2021) collaboration focusing on the health and protection sectors in humanitarian response. We do research and strengthen research capacity to help improve decision-making and accountability in response to conflict, forced displacement and epidemics.

https://www.lshtm.ac.uk/research/centres-projects-groups/recap#welcome 

People involved (anthropologists and sociologists)

Melissa Parker, Professor of medical anthropology, LSHTM
Tim Allen, Professor in development anthropology, LSE
Jennifer Palmer, Assistant professor, LSHTM
Diane Duclos, Research fellow, LSHTM
Fred Martineau, Research fellow, LSHTM
Patricia Kingori, Associate professor, University of Oxford
Isabelle Lange, Research Fellow, LSHTM

RECAP Principal Investigator: Bayard Roberts, Professor at LSHTM

Aim of the project

Working in a network of key humanitarian NGOs and universities situated in regional humanitarian ‘hubs’ we aim to:

• Document tensions and areas of good practice in democratic, evidence-informed decision-making
• Identify solutions to ethical issues devised by frontline humanitarian staff
• Facilitate joint knowledge production, explore how the capabilities of beneficiaries to hold humanitarian actors to account can be enhanced
• Contribute to humanitarian guidelines, programmes and policies

Research approach

Across the 6 multi-disciplinary work packages, anthropologists are involved in exploring:

• evidence use in humanitarian decision-making;
• accountability frameworks and enforcement mechanisms in humanitarian settings;
• ethical preparedness and provisioning in crises

We are conducting a series of ethnographic case studies during and after humanitarian crises in:

1. Northern Uganda: Protection of children of ex LRA soldiers; public authority in PH for refugees; displaced healthcare workers in health system building
2. Lebanon: Displaced healthcare workers in health system building; issue legitimisation surrounding war and births
3. Sierra Leone: Ethical challenges at the frontlines; community health ecosystems, accountability legacies of Ebola response
4. Bangladesh: Decision-making for preventive vaccination
5. Afghanistan: Priority setting, approaches and evidence use in health system restructuring

Recent publications (selection):

• Allen, T; MacDonald, A; Radice, H, (eds.) Humanitarianism A Dictionary of Concepts. Routledge, Abingdon, Oxon; New York, NY, pp. 81-95. DOI: https://doi.org/10.1108/IJHRH-04-2018-0033
• Allen, Tim (2015) Life beyond the bubbles: Cognitive Dissonance and Humanitarian Impunity in Northern Uganda. In: Abramowitz, Sharon and Panter-Brick, Catherine, (eds.) Medical Humanitarianism: Ethnographies of Practice. University of Pennsylvania Press, Pennsylvania, USA, pp. 96-118. ISBN 9780812291698
• Allen, Tim and Reid, Kyla (2015) Justice at the margins: witches, poisoners, and social accountability in Northern Uganda. Medical Anthropology, 34 (2). pp. 106-123. ISSN 0145-9740
• Chandler, C; Fairhead, J; Kelly, A; Leach, M; Martineau, F; Mokuwa, E; Parker, M; Richards, P; Wilkinson, A; Ebola Response Anthropology Platform; (2014) Ebola: limitations of correcting misinformation. Lancet, 385 (9975). pp. 1275-7. ISSN 0140-6736 DOI: https://doi.org/10.1016/S0140-6736(14)62382-5
• Duclos, D; (2016) Revisiting Iraqi Cultural Heritage from “Outside” in Times of Looting and Destruction: Al-Mutanabi Street in Motion. Autrepart, 78-79 (2). ISSN 1278-3986 DOI: https://doi.org/10.3917/autr.078.0219
• Duclos, D; (2017) When ethnography does not rhyme with anonymity: Reflections on name disclosure, self-censorship and storytelling. Ethnography. ISSN 1466-1381 DOI: https://doi.org/10.1177/1466138117725337
• Kingori, P. (2013). Experiencing everyday ethics in context: Frontline data collectors perspectives and practices of bioethics. Social science & medicine, 98, 361-370
• Macdonald, Anna and Allen, Tim (2015) Social accountability in war zones – confronting local realities of law and justice. International Journal on Minority and Group Rights, 22 (3). pp. 279-308. ISSN 1385-4879
• Martineau, F, Wilkinson A, Parker M. “Epistemologies of Ebola: Reflections on the Experience of the Ebola Response Anthropology Platform.” Anthropological Quarterly 90, no. 2 (2017): 475–94
• Palmer, JJ; Kelly, AH; Surur, EI; Checchi, F; Jones, C; (2014) Changing landscapes, changing practice: Negotiating access to sleeping sickness services in a post-conflict society. Social science & medicine (1982). ISSN 0277-9536 DOI: https://doi.org/10.1016/j.socscimed.2014.03.012
• Palmer, JJ; Robert, O; Kansiime, F; (2017) Including refugees in disease elimination: challenges observed from a sleeping sickness programme in Uganda. Conflict and health, 11. p. 22. ISSN 1752-1505 DOI: https://doi.org/10.1186/s13031-017-0125-x
• Parker, M., & Kingori, P. (2016). Good and bad research collaborations: researchers’ views on science and ethics in global health research. PloS one, 11(10), e0163579
• Parker, M; Allen, T; (2013) Questioning Ethics in Global Health. In: MacClancy, Jeremy; Fuentes, Agustin, (eds.) Ethics in the Field. Berghahn Books, pp. 24-41. ISBN 9780857459626 http://researchonline.lshtm.ac.uk/id/eprint/2853537
• Storeng, KT; Palmer, J; Daire, J; Kloster, MO; (2018) Behind the scenes: International NGOs' influence on reproductive health policy in Malawi and South Sudan. Global public health. pp. 1-15. ISSN 1744-1692 DOI: https://doi.org/10.1080/17441692.2018.1446545
• Wilkinson, A; Parker, M; Martineau, F; Leach, M; (2016) Engaging 'communities': anthropological insights from the West African Ebola epidemic. Philosophical transactions of the Royal Society of London Series B, Biological sciences, 372 (1721). ISSN 0962-8436 DOI: https://doi.org/10.1098/rstb.2016.0305

Project summary

Systematic racism and infant mortality in zip codes 76010 and 76011: A photovoice approach seeks to engage community members in the research process through the application of photovoice and asset mapping.

The aim is to promote conversations around race and infant mortality by engaging black women in zip codes with high infant mortality rates to photograph their daily life, answering the question, “How do you view or experience racism in your community?”

Research approach

Photovoice is a form of community-based participatory research that involves providing community members with cameras and asking them to photograph their everyday experiences and realities on a particular topic; these photos are then used to prompt policymakers and stakeholders to mobilize around desired change.

Asset mapping engages community members as they “map” local resources that can be used for community growth and change.

Objectives

The project goals are to identify institutionalized discriminatory practices and policies in the city of Arlington, Texas, and to focus city funding and policy on monitoring, addressing, and eliminating social determinants of health, particularly as they relate to race and infant mortality.

People involved

• Catherine McMains, DrPH Candidate at LSHTM
• Neil Spicer, Primary Supervisor, Assistant professor of global health policy at LSHTM
• Dorota Osipovic, Secondary Supervisor, Research Fellow at LSHTM

Project summary

My research follows the translation of a multi-million pound global elimination policy for trachoma; one of the neglected tropical diseases, and the commonest infectious cause of global blindness; at national, regional and local levels in Malawi. I critically reflect on the ideas and assumptions embedded in the global and national policies, and identify how strategic ignorance is fostered in the interest of achieving the elimination goals.

People involved

• Maddy Gupta-Wright, Research degree student, LSHTM
• Dr Melissa Parker, PhD project supervisor, Professor at LSHTM
• Dr Simon Cohn, PhD project supervisor, Professor at LSHTM
• Prof Robin Bailey, Member of the Advisory Committee
• Dr Nicola Desmond, Member of the Advisory Committee

Research Approach

Critical engagement with public health and anthropological literature laid the foundations for my fieldwork. I conducted ethnographic fieldwork amongst a rural population in South East Malawi, defined as a ‘hotspot’ of disease. I followed local, district and ministry of health officials working on trachoma interventions and policy. As well as participant observation, I conducted open ended interviews.

Aim

My research traces how insufficient acknowledgment of trachoma’s complexity and local specificity, creates challenges for the public health response to trachoma. I examine the political nature of various epidemiological constructs, labels, and metaphors including ‘hotspot’, ‘refusals’, and racing, showing consequences for the local realities of those experiencing the disease.

Publications

• Gupta-Wright, M. (2019). Multipositionality and ‘Inbetweenness’: Reflections on Ethnographic Fieldwork in Malawi; Ch 4 In Johnstone, L. Editor The Politics of Conducting Research in Africa: Ethical and Emotional Challenges in the Field, Palgrave Macmillan