Doing Health Anthropology

302 Pages·2008·1.05 MB·English

by  Kiefer, Christie W.

Doing Health Anthropology:
Research Methods for Community
Assessment and Change
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Christie W. Kiefer is Professor Emeritus of Anthropology in the
DepartmentofAnthropology,History,andSocialMedicineintheSchool
of Medicine, University of California, San Francisco. Over the past
20 years, Kiefer has done action research in Honduras, Nicaragua,
Mexico, Ecuador, South Africa, Thailand, the Philippines, and Berkeley,
California,workingwithmedicallyunderservedcommunitiestoimprove
their access to basic health services. He also teaches anthropology to
medical and nursing students at UCSF, and serves on the board of
directors of Lifelong Medical Care, a community-owned non-profit
clinic in Berkeley, California. His writings include Health Work with
the Poor: A Practical Guide (2000), Refuge of the Honored: Social
Organization in a Japanese Retirement Community (1992), and
Changing Cultures, Changing Lives: An Ethnographic Study of Three
Generations of Japanese Americans (1974). Kiefer received his Ph.D. in
culturalanthropologyattheUniversityofCalifornia,Berkeley,in1968.
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Doing Health
Anthropology: Research
Methods for Community
Assessment and Change
Christie W. Kiefer, PhD
ProfessorofAnthropology,Emeritus
DepartmentofAnthropology,
History,andSocialMedicine
UniversityofCalifornia—SanFrancisco
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Kiefer,ChristieW.
Doinghealthanthropology:researchmethodsforcommunityassessmentand
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Includesbibliographicalreferencesandindex.
ISBN0-8261-1557-8(hardback:alk.paper)
1.Medicalanthropology—Research—Methodology.
2.Publichealth—Anthropologicalaspects—Research—Methodology.I.Title.
GN296.K542006
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Contents
Acknowledgments xiii
Preface xv
1. WhyAnthropology? 1
GuidetoThisChapter 3
WhatisCulturalAnthropology?TheConceptofCulture 3
HowDoCulturalAnthropologistsCollectData? 6
HowDoCulturalAnthropologistsAnalyzeData? 7
TheAdvantagesofAnthropologyfortheHealthSciences 8
TheMightyDiseaseModel 9
TheSocialPerspectiveonHealth 10
WhyIsn’ttheSocialPerspectiveMoreWidelyUsed? 11
TheAdvantagesoftheSocialPerspective 13
Summary 19
2. Positivism:TheLaboratoryTheoryofKnowledge 21
GuidetoThisChapter 23
TheMeaningsofKnowledge 23
Positivism:TheLaboratoryScienceTheoryofKnowledge 25
Validity 26
EleganceandParsimony 26
TheLimitsofPositivism 29
Summary 32
3. TheNaturalisticTheoryofKnowledge:Anthropology 33
GuidetoThisChapter 35
NaturalisticTheory 35
TheIdeaofUsefulness 36
vii
viii Contents
TheNaturalisticSearchforKnowledge 37
Intuition,orUsingWhatWeAlreadyKnow 37
HowScienceIsDifferentfromEverydayProblem
Solving:TheIssueofPersuasion 39
TheProcessofNaturalisticResearch 39
AdvantagesofNaturalisticKnowledge 40
TheIssueofMeaning 41
TheIssueofPatternCoherence 43
TheDisadvantagesofNaturalisticTheory 45
ConceptualProblemNo.1:Verification 45
ConceptualProblemNo.2:Objectivity 46
TheNaturalisticResponse 47
PracticalProblemNo.1:Time 48
PracticalProblemNo.2:Generalizability 49
WhatAboutTheory? 50
Summary 51
4. TheStudyofRealPeopleinNaturalSituations 53
GuidetoThisChapter 55
EthnographyandtheAnthropologicalAttitude 55
TheMoralRelationshipofResearcherandCommunity 56
SurveyResearchandthePositivistAttitude 60
TheImportanceofContextsinSocialResearch 62
Summary 67
5. DesigningaResearchProject 69
GuidetoThisChapter 71
TheProcessofDetailedUnderstanding 72
IdentifyingaResearchProblem 75
WhyHaveWeChosenThisProblem? 76
HowWillWeRecognizetheAnswer? 77
TheProblemStatement 78
TheIntuitionStatement 80
FormulatingSpecificResearchQuestions 82
CharacteristicsofGoodQuestions 85
ResearchDesignAsaContinuousProcess 86
Summary 86
6. TheResearcherinandBeyondtheCommunity 89
GuidetoThisChapter 91
ParticipantObservation 91
EthicsandValues 93
EthicsforOtherStylesofResearch 94
ObservingUnacceptableBehavior 95
Contents ix
TakingRoles,Fittingin 96
Clothing,Speech,Manners 97
ExamplesofRoles 98
TheRoleofStudentorScholar 98
TheRoleofFriend 100
TheRolesofLeader,Teacher,andExpert 101
CultureShock:Unavoidable,HighlyValuable 103
IfYourTimeintheCommunityisLimited 104
TheResearcherBeyondtheCommunity 106
Summary 108
7. CollectingData 109
GuidetoThisChapter 111
PlanningforResearch 112
TheResearchProblem 112
BackgroundResearch 113
ObservingandTakingNotes 115
GeneralPrinciplesofObservation 116
WhatSituationsandBehaviorstoObserve 117
MinimizingDistortion 119
RapportBuilding 120
KeepingRecords 120
AudioandVideoRecordings 120
TakingNotes 120
AddingAnalyticDetails 121
Interviewing 122
MinimizingDistortion 122
Closed-EndedVersusOpen-EndedInterviews 123
GettingTruthThroughInterviews 125
MaintainingRapport 127
KeepingInterviewRecords 128
UnobtrusiveMeasures 130
IndirectIndicators 131
Summary 132
8. AnalyzingData 133
GuidetoThisChapter 135
DataAnalysisUsesNaturalHumanSkills 136
Analysis:MakingOurImplicitUnderstandingsExplicit 137
DataManagement 138
KinshipDiagrams,orGenograms 139
ClassificationTrees,OrganizationCharts 140
NetworksandFlowCharts 141
FaceSheets 142