PhD Upgrade | Managing everyday fever: an ethnographic study of antibiotic use in Harare, Zimbabwe
Salome, LSHTM is a Zimbabwean PhD student funded by the Febrile Illness Evaluation in a Broad Range of Endemicities research project. She has been carrying out social research in Zimbabwe for more than ten years and is based with the Biomedical Research and Training Institute (BRTI) in Harare.
Amidst rising concerns of antimicrobial resistance (AMR), heightened attention is being paid to the management of common illnesses such as ‘fever’, a symptom that often leads to antimicrobial use (AMU). While discourses around AMU typically centre on delineations of ‘rational’ and ‘irrational’ behaviour, this PhD study proposes to unsettle this behavioural focus by exploring the relationship between everyday fever and AMU in a context of expanding medical pluralism in Harare, Zimbabwe. This study takes place at a time in which routine healthcare is increasingly the domain of a plurality of providers both within and beyond the formal sector – where retail pharmacies, drug vendors, faith healers and traditional healers are prominent sources of care – yet at the same time global efforts to curb AMR are seeking to reassert control over antimicrobials. By focusing on how fever case management and AMU are entwined within the social, economic and political life of Zimbabwe at the time, this study will help to better understand connections between fever and AMU in the material realities in which they occur and to aid in the development of contextually-appropriate solutions to fever management.
In this study, I propose to use of anthropologically-informed ethnographic research methods including participant observation, in depth interviews and key informant interviews, which will be conducted across a variety of formal and informal settings in clinics, hospitals, pharmacies, markets, traditional and faith healers’ shrines and homes. The study also engages residents in a medicines survey to gain insights on antimicrobial use in homes. Critical discourse analysis is utilized to situate the management of fever in Harare within global health around febrile illness and AMR. This research supports efforts to address rising AMR by helping to improve guidelines for fever management. The findings will directly inform action in Zimbabwe as well as being informative across other settings of care.
Speaker: Salome Manyau
Supervisors: Clare Chandler, Justin Dixon
Date: Tuesday 4th September
Venue: Room LG7, Keppel Street