Adrienne Strong

Medical anthropology, maternal mortality, hospital ethnography, and dignity in women's health care

I am a medical anthropologist with a joint Ph.D. from Washington University in St. Louis, USA and the Universiteit van Amsterdam in the Netherlands. I study maternal mortality and women's health in Tanzania, currently in the Rukwa Region, and conducted my dissertation fieldwork from January 2014- August 2015. From September 2010 through July 2011, I conducted research on access to healthcare services during pregnancy, birth, and the postpartum period in the Singida Region of Tanzania. My doctoral dissertation project focused on the inner workings of a government regional referral hospital, examining how institutional structures related to hierarchy, bureaucracy, historical precedents, communication and other factors, may influence the capacity of the institution to provide effective maternal healthcare during times of obstetric crisis. My research focused on biomedical healthcare providers and administrators, groups that are often overlooked in the context of medical anthropology in sub-Saharan Africa. I contextualize the hospital ethnography with interviews, participant observation, and focus group discussions in communities throughout the region, as well as through the use of primary archival sources from the colonial and post-independence eras. 

This is my personal website, which includes updates on my research, collaborations, conference presentations and papers, publications, teaching, and critical responses to current events related to women's health and reproduction.  

Mentions and Public Anthropology

Paper Prize

Washington University Feature

Feature on Anthropology Department Website

Research Report on Global Health Hub

Photoessay on SAPIENS.org

Research Interests

My research interests coalesce around maternal death in healthcare facilities. This has come to include scholarly interests in respectful maternity care, gendered dynamics in the nursing profession and care provision in biomedical settings, health system financing in ethnographic perspective, stillbirth and accountability, as well as the contemporary role of bridewealth, and men’s sexual and reproductive health in rural East Africa. Theoretical orientations include critical medical anthropological and feminist approaches to the study of bureaucracy, institutions, hospital ethnography, and concepts of risk, uncertainty, and care. My research interests sit at the nexus of anthropology, gender studies, science and technology studies, and history. 

For more on my professional development please see Washington University's feature article on my work: https://source.wustl.edu/2016/08/washington-people-adrienne-strong/

Tanzania

Map of Tanzania (from: http://www.ezilon.com/maps/images/africa/political-map-of-Tanzania.gif) 

Map of Tanzania (from: http://www.ezilon.com/maps/images/africa/political-map-of-Tanzania.gif) 

Tanzania: The first thing people usually ask me about my research is why Tanzania?  Tanzania was the first country in Africa that I was able to visit back in 2007. I was struck by the people and the country, intrigued by the language, as well as the country's natural beauty. I initially traveled to Tanzania as part of a service-learning program. In 2008, I began studying Kiswahili and have returned to the country in various capacities every year since. I began reading voraciously about the country, its history, and its varied ethnic groups and have since come to see it as a theoretically interesting site for my research, not simply a place that has become dear to my heart.  In 2010 and 2011 I was able to return to the Singida region to conduct a year-long original research project on access to maternal health care funded by a Fulbright Student Research Grant through the U.S. Department of State and the Institute for International Education. I am invested in helping to improve health care in the country through the unique routes provided by an anthropological lens. I have chosen to remain in Tanzania for my second major research for the PhD, which I commenced in January 2014.

Maternal Mortality and the Biomedical Setting

I first came in contact with maternal death during my second visit to Tanzania in 2008. I was shadowing doctors and nurses at the Singida Regional Hospital with a couple of other American college students. One of the doctors who consistently allowed us to shadow him and learn from him worked in obstetrics and gynecology. One morning, he asked us if we would like to watch an autopsy.  It turned out to be the autopsy of a woman who had died during delivery. The baby was full term and had also died, still in her uterus. I was 19 years old at the time and watching that autopsy motivated me to begin asking questions about the global distribution of resources, particularly those that could have saved the life of the woman on the autopsy table in front of me.  Since then, I have continued to strive to gain further insight into how access to medical care (both biomedical and other forms) contributes to maternal health or lack thereof. I have explored the perspectives of women, community members, and healthcare providers and administrators. 

While it is undeniable that access to certain drugs and procedures can save a woman's life, my research seeks to problematize the events that occur in the biomedical setting and an underlying policy assumption that suggests if only women could reach a hospital, they would receive the life-saving care they need. However, my research proposes that institutional and social dynamics of the maternity ward, the hospital more generally, and the overall health care system sometimes work against a woman and contribute to the deterioration of her condition and her subsequent death. Though many countries worldwide have seen success in reducing maternal mortality over the course of the Millennium Development Goals initiative, Tanzania has made very little progress. This project has already resulted in a number of conference talks, as well as several manuscripts currently under review.  

 

 

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