Displaying publications 1 - 20 of 52 in total

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  1. The traditional healer in obstetric care: A persistent wasted opportunity in maternal health
    Aborigo RA, Allotey P, Reidpath DD
    Soc Sci Med, 2015 May;133:59-66.
    PMID: 25841096 DOI: 10.1016/j.socscimed.2015.03.046
    Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs.
  2. Salted fish and nasopharyngeal carcinoma in Malaysia
    Armstrong RW, Eng AC
    Soc Sci Med, 1983;17(20):1559-67.
    PMID: 6635717 DOI: 10.1016/0277-9536(83)90100-4
    The evidence for a hypothesis that eating salted fish is associated with nasopharyngeal carcinoma (NPC) is reviewed. The hypothesis was tested among Malaysian Chinese using a matched case-control design. The kinds of salted fish and patterns of use were also investigated in a control group comprising 100 Chinese, 50 Malay and 50 Indian households. During 1980, in Selangor, Malaysia, interviews with 100 Chinese cases of NPC and 100 non-disease controls indicated that salted fish consumption during childhood was a significant risk (relative risk = 3.0, P = 0.04), with an elevated risk for daily as opposed to less frequent consumption. Salted fish consumption during adolescence was a less significant risk, and current consumption not at all. There were 19 kinds of fishes reported as being eaten as salted fish by the 200 control households. There were marked differences between ethnic groups in preference for different kinds: Chinese preferred red snapper (74% of households), Malay jewfish (54%) and Indian red snapper (28%). Salted fish was hardly ever eaten daily by any household; weekly was a moderate frequency in all ethnic groups; less than weekly most common. There were no statistically significant differences between Chinese NPC case and non-disease control participants in kind of salted fish eaten. Results were the same when the data were analyzed by sex, subethnic group and income.
  3. A grim contradiction: the practice and consequences of corporate social responsibility by British American Tobacco in Malaysia
    Barraclough S, Morrow M
    Soc Sci Med, 2008 Apr;66(8):1784-96.
    PMID: 18304713 DOI: 10.1016/j.socscimed.2008.01.001
    In the wake of the World Health Organization Framework Convention on Tobacco Control, corporate social responsibility (CSR) is among the few remaining mechanisms for tobacco corporations publicly to promote their interests. Health advocates may be unaware of the scale, nature and implications of tobacco industry CSR. This investigation aimed to construct a typology of tobacco industry CSR through a case study of the evolution and impact of CSR activities of a particular tobacco corporation in one country - British American Tobacco, Malaysia (BATM), the Malaysian market leader. Methods included searching, compiling and critically appraising publicly available materials from British American Tobacco, BATM, published literature and other sources. The study examined BATM's CSR strategy, the issues which it raises, consequences for tobacco control and potential responses by health advocates. The investigation found that BATM's CSR activities included assistance to tobacco growers, charitable donations, scholarships, involvement in anti-smuggling measures, 'youth smoking prevention' programs and annual Social Reports. BATM has stated that its model is predominantly motivated by social and stakeholder obligations. Its CSR activities have, however, had the additional benefits of contributing to a favourable image, deflecting criticism and establishing a modus vivendi with regulators that assists BATM's continued operations and profitability. It is imperative that health advocates highlight the potential conflicts inherent in such arrangements and develop strategies to address the concerns raised.
  4. Hot and cold in transformation: is Iban medicine humoral?
    Barrett RJ, Lucas RH
    Soc Sci Med, 1994 Jan;38(2):383-93.
    PMID: 8140465
    Iban categories of hot and cold are examined in the context of humoral medical systems in southeast Asia. These categories are more than binary and oppositional: they are also contradictory and can only be understood in terms of their capacity for transformation in 'depth'. Analysis of the Iban epistemology of temperature sensation reveals the limitations of reductionist empirical approaches to hot and cold. Illness is apprehended, at one level, in terms of unusual conjunctions of opposite temperatures which signify a deeper disturbance in the relationship between body and soul, humans and spirits. Iban therapy redefines and relocates these categories in their proper place and at their appropriate level. It progresses from hot lay treatments to cool ritual treatments, yet cannot be accounted for within a limited framework of homeostatic balance. This paper develops an ethnographically grounded definition of humoralism which emphasizes non-reductive logic, cultural practice and transformation. The key element, transformation, is defined as a transition between categories and a shift in the level of interpretation which fundamentally alter the Iban experience of body and illness.
  5. A comparative review of mobile health and electronic health utilization in sub-Saharan African countries
    Bervell B, Al-Samarraie H
    Soc Sci Med, 2019 07;232:1-16.
    PMID: 31035241 DOI: 10.1016/j.socscimed.2019.04.024
    This study distinguished between the application of e-health and m-health technologies in sub-Saharan African (SSA) countries based on the dimensions of use, targeted diseases or health conditions, locations of use, and beneficiaries (types of patients or health workers) in a country specific context. It further characterized the main opportunities and challenges associated with these dimensions across the sub-region. A systematic review of the literature was conducted on 66 published peer reviewed articles. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis and interpretation of findings. The results of the study showed that m-health was prevalent in usage for promoting information for treatment and prevention of diseases as well as serving as an effective technology for reminders towards adherence. For e-health, the uniqueness lay in data acquisition and patients' records management; diagnosis; training and recruitment. While m-health was never used for monitoring or training and recruitment, e-health on the other hand could not serve the purpose of reminders or for reporting cases from the field. Both technologies were however useful for adherence, diagnosis, disease control mechanisms, information provision, and decision-making/referrals. HIV/AIDS, malaria, and maternal (postnatal and antenatal) healthcare were important in both m-health and e-health interventions mostly concentrated in the rural settings of South Africa and Kenya. ICT infrastructure, trained personnel, illiteracy, lack of multilingual text and voice messages were major challenges hindering the effective usage of both m-health and e-health technologies.
  6. Public health care provisions: access and equity
    Bin Juni MH
    Soc Sci Med, 1996 Sep;43(5):759-68.
    PMID: 8870140
    Within the current exercise of reforming the health care system, underlying all issues, is the reassessment of the role of government. It is a government's responsibility and concern that the health sector be accessible and equitable to the population, and more important that the health sector be more efficient and affordable. Many governments in the world attempt to provide universal health care services to their population through public health care provisions. This paper reviews and analyses the experience of the Malaysian health system, focusing on the performance of the system in relation to access and equity. The performance of the Malaysian health system has been impressive. At minimum cost it has achieved virtually accessible and equitable health care to the entire population. This is evident by analysing almost all the commonly used indicators. These clearly show that when matched to comparable countries, health outcome is even better than predicted value.
  7. Regional inequalities of child mortality in peninsular Malaysia with special reference to the differentials between Perlis and Kuala Terengganu
    Brehm U
    Soc Sci Med, 1993 May;36(10):1331-4.
    PMID: 8511619
    In Peninsular Malaysia child mortality rates (5q0) vary from 13 to 63 per thousand at district level. The spatial pattern is closely associated with the regional distribution of socio-economic factors. But due to multicollinearity it is difficult to isolate the influence of socio-economic variables from other variables by employing aggregated data. However, individual data collected in a case-control-study that was conducted in Perlis and Kuala Terengganu confirm the important role of socio-economic factors. So it should be possible to achieve a further reduction of child mortality by raising the income and educational level of the under-privileged groups. Apart from that, as the case of Perlis shows, the provision of family planning and preventive medical services may also contribute to lower child mortality independent from socio-economic changes. But, as the comparison with Kuala Terengganu shows, the utilization of family planning and preventive medical services is not only influenced by the accessibility to, but also by the socio-culturally determined acceptability of such services.
  8. Ownership, control, and contention: challenges for the future of healthcare in Malaysia
    Chee HL
    Soc Sci Med, 2008 May;66(10):2145-56.
    PMID: 18329149 DOI: 10.1016/j.socscimed.2008.01.036
    The recent history of healthcare privatisation and corporatisation in Malaysia, an upper middle-income developing country, highlights the complicit role of the state in the rise of corporate healthcare. Following upon the country's privatisation policy in the 1980s, private capital made significant inroads into the healthcare provider sector. This paper explores the various ownership interests in healthcare provision: statist capital, rentier capital, and transnational capital, as well as the contending social and political forces that lie behind state interests in the privatisation of healthcare, the growing prominence of transnational activities in healthcare, and the regional integration of capital in the healthcare provider industry. Civil society organizations provide a small but important countervailing force in the contention over the future of healthcare in the country. It is envisaged that the healthcare financing system will move towards a social insurance model, in which the state has an important regulating role. The important question, therefore, is whether the Malaysian government, with its vested interests, will have the capacity and the will to play this role in a social insurance system. The issues of ownership and control have important implications for governance more generally in a future healthcare system.
  9. Longhouse dwelling, social contact and the prevalence of leprosy and tuberculosis among native tribes of Sarawak
    Chen PCY
    Soc Sci Med, 1988;26(10):1073-7.
    PMID: 3393924 DOI: 10.1016/0277-9536(88)90225-0
    In Sarawak, some tribes stay in communal longhouses whilst others live in villages of single dwellings. The present study looks into the question of whether there is an association between the prevalence of leprosy and tuberculosis with the quantum of social contact that occurs in these two types of settlement patterns. It was found that the prevalence of leprosy and tuberculosis is significantly higher among longhouse dwellers compared with single house dwellers. It was also noted that social groups tended to be larger and to persist for much longer among longhouse dwellers than among those in single dwellings. This lends support to the evidence that social contact in longhouses is more extensive and contributes towards a higher prevalence of leprosy and tuberculosis.
  10. Assessing socioeconomic correlates of birthweight in peninsular Malaysia: ethnic differences and changes over time
    DaVanzo J, Habicht JP, Butz WP
    Soc Sci Med, 1984;18(5):387-404.
    PMID: 6729519
    This paper presents evidence from the Malaysian Family Life Survey that mothers' reports of their babies' birthweights, including reports of unweighed babies' approximate size at birth, can be used to examine many biological and socioeconomic correlates of birthweight. The study uses a sample of 5583 singleton births that occurred between 1945 and 1976. In these data, the frequency distribution of birthweights and their bivariate and multivariate relationships with the biological correlates of mother's age, baby's sex, first parity and infant mortality are consistent with those found in prospective studies. A new biological correlate, mother's age at menarche, is introduced as a proxy for the mother's nutrition during childhood. Late age at menarche is associated with lower birthweight. Other results show mothers younger than 20 years and older than 35 appear to be at greater risk of bearing small babies, but the former effect is no longer important when parity is controlled. Short interbirth intervals are associated with small babies. We attempt to distinguish whether this is due to prematurity or to maternal nutritional depletion; both effects appear to be operating. Higher income appears to mitigate the pernicious effect of short interbirth intervals. Indian babies weigh significantly less than those of other ethnic groups. Furthermore, birthweights have increased since the 1950s for Malays and Chinese, but not for Indians. The lower birthweights and lack of improvement over time for Indians appear to be due to close birthspacing, lack of access to medical care and falling incomes.
  11. Ambiguity, synecdoche and affect in Semai medicine
    Dentan RK
    Soc Sci Med, 1988;27(8):857-77.
    PMID: 3227382
    Semai descriptions of their beliefs about health and disease vary from person to person. Moreover, at different times the same person expresses mutually incongruent beliefs. This amorphousness and fluidity merit analysis rather than neatening. This paper details Semai beliefs, loose ends and all, and suggests that their formal peculiarities are due to the prevalence of synecdoche in conceptual organization. Their inconsistency and fluidity may stem from individualistic egalitarianism within Semai society and powerlessness in the face of nonSemai attack. Finally, it is suggested that construing indigenous medicine as a crude form of Western medicine leads to overtidiness and consequent error.
  12. Cervical cancer screening in Malaysia: Are targeted interventions necessary?
    Dunn RA, Tan AKG
    Soc Sci Med, 2010 Sep;71(6):1089-93.
    PMID: 20685019 DOI: 10.1016/j.socscimed.2010.06.016
    This study examines the determinants of Papanicolaou Smear Test (PST) screening for cervical cancer among women in Malaysia. Attention is focused on the reasons different population subgroups give for non-screening. We find that Indian women are the least likely to have had a PST and also the least likely to know the reasons why one is screened. Malay women are less likely than Chinese women to have received a PST and are more likely to report embarrassment as the reason for not being tested. Urban women are less likely than rural women to have been tested and more likely to state lack of time as the reason. These results suggest targeted interventions may be necessary to increase screening rates in Malaysia.
    Study name: Malaysia Non-Communicable Disease Surveillance-1 (MyNCDS-1) survey
  13. Associations of religiosity, attitudes towards suicide and religious coping with suicidal ideation and suicide attempts in 11 muslim countries
    Eskin M, Baydar N, El-Nayal M, Asad N, Noor IM, Rezaeian M, et al.
    Soc Sci Med, 2020 11;265:113390.
    PMID: 33007656 DOI: 10.1016/j.socscimed.2020.113390
    OBJECTIVE: The study investigated the associations of religiosity, religious coping and suicide acceptance to suicide ideation and attempts in 7427 young adults affiliating with Islam from 11 Muslim countries.

    METHOD: A self-administered questionnaire was used to collect the data. We used F and χ2 tests and correlation analyses to report descriptive statistics. Multi-group path models with (i) a zero-inflated Poisson distribution and, (ii) a Binomial distribution were used to model the number of occurrences of suicidal ideation, and occurrence of a suicide attempt, respectively.

    RESULTS: Religiosity was negatively associated with acceptability of suicide, but it was positively related to punishment after death across the 11 countries. Religiosity was negatively associated with ever experiencing suicidal ideation, both directly and indirectly through its association with attitudes towards suicide, especially the belief in acceptability of suicide. Neither positive nor negative religious coping were related to suicidal ideation. However, religiosity was negatively related to suicide attempts among those who experienced suicidal ideation at least once. This association was mediated through the belief in acceptability of suicide and religious coping. Negative religious coping was positively associated with suicide attempts probably because it weakened the protective effects of religiosity.

    CONCLUSIONS: Findings from this study suggest that the effects of religiosity in the suicidal process operate through attitudes towards suicide. We therefore conclude that clinical assessment as well as research in suicidology may benefit from paying due attention to attitudes towards suicide.

  14. Predicting intention to participate in self-management behaviors in patients with Familial Hypercholesterolemia: A cross-national study
    Hagger MS, Hamilton K, Hardcastle SJ, Hu M, Kwok S, Lin J, et al.
    Soc Sci Med, 2019 12;242:112591.
    PMID: 31630009 DOI: 10.1016/j.socscimed.2019.112591
    RATIONALE: Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. BEHAVIORS: physical activity, healthy eating, and taking cholesterol lowering medication.

    OBJECTIVE: The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries.

    METHOD: Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total N = 726) completed measures of social cognitive beliefs about illness from the common sense model of self-regulation, beliefs about behaviors from the theory of planned behavior, and past behavior for the three self-management behaviors.

    RESULTS: Structural equation models indicated that beliefs about behaviors from the theory of planned behavior, namely, attitudes, subjective norms, and perceived behavioral control, were consistent predictors of intention across samples and behaviors. By comparison, effects of beliefs about illness from the common sense model were smaller and trivial in size. Beliefs partially mediated past behavior effects on intention, although indirect effects of past behavior on intention were larger for physical activity relative to taking medication and healthy eating. Model constructs did not fully account for past behavior effects on intentions. Variability in the strength of the beliefs about behaviors was observed across samples and behaviors.

    CONCLUSION: Current findings outline the importance of beliefs about behaviors as predictors of FH self-management behaviors. Variability in the relative contribution of the beliefs across samples and behaviors highlights the imperative of identifying sample- and behavior-specific correlates of FH self-management behaviors.

  15. Fulltext Clinician resistance to broaching the topic of weight in primary care: Digging deeper into weight management using strong structuration theory
    Hajizadeh A, Heath L, Ahmad A, Kebbe M, Jebb SA, Aveyard P, et al.
    Soc Sci Med, 2023 Jul;329:115997.
    PMID: 37327596 DOI: 10.1016/j.socscimed.2023.115997
    Clinical trials have shown that providing advice and support for people with excess weight can lead to meaningful weight loss. Despite this evidence and guidelines endorsing this approach, provision in real-world clinical settings remains low. We used Strong Structuration Theory (SST) to understand why people are often not offered weight management advice in primary care in England. Data from policy, clinical practice and focus groups were analysed using SST to consider how the interplay between weight stigma and structures of professional responsibilities influenced clinicians to raise (or not) the issue of excess weight with patients. We found that general practitioners (GPs) often accounted for their actions by referring to obesity as a health problem, consistent with policy documents and clinical guidelines. However, they were also aware of weight stigma as a social process that can be internalised by their patients. GPs identified addressing obesity as a priority in their work, but described wanting to care for their patients by avoiding unnecessary suffering, which they were concerned could be caused by talking about weight. We observed tensions between knowledge of clinical guidelines and understanding of the lived experience of their patients. We interpreted that the practice of 'caring by not offering care' produced the outcome of an absence of weight management advice in consultations. There is a risk that this outcome reinforces the external structure of weight stigma as a delicate topic to be avoided, while at the same time denying patients the offer of support to manage their weight.
  16. The developmental niche: a theoretical framework for analyzing the household production of health
    Harkness S, Super CM
    Soc Sci Med, 1994 Jan;38(2):217-26.
    PMID: 8140448
    Recent efforts to promote child survival and development internationally have focused new attention on the importance of the household as a mediator of both environmental risks and programmatic interventions to promote better health. In this paper, we introduce a theoretical framework, the 'developmental niche,' derived from studies of children's behavior and development in different cultural contexts, as a tool for analyzing the household production of health. The developmental niche is conceptualized in terms of three basic components: (1) the physical and social settings of the child's everyday life; (2) culturally regulated customs of child care and child rearing; and (3) the psychology of the caretakers. The relevance of each of these components to the household production of health is illustrated through examples from research in several cultures, including Malaysia, Kenya, Bangladesh, India, and the U.S. Further discussion centers on three corollaries of the developmental niche framework that point to the interactive relationships among the three components, between the niche and the larger environment, and between the niche and the child (or any individual seen from a developmental perspective). It is suggested that this approach is useful for identifying and collecting relevant information on household-level factors that affect health outcomes, and thus for organizing more effective interventions. At a theoretical level, the developmental niche framework also facilitates understanding processes of mutual adaptation between the individual and the environment as they are filtered through the constraints of household settings, customs and caretaker psychologies.
  17. A model of the demand for medical and health services in Peninsular Malaysia
    Heller PS
    Soc Sci Med, 1982;16(3):267-84.
    PMID: 7100978 DOI: 10.1016/0277-9536(82)90337-9
    This paper provides an empirical analysis of the determinants of the demand for medical services in Peninsular Malaysia. After elaborating a theoretical model of household demand for medical care in Section II an econometric model is specified and estimated in Sections III, IV, and V. The results indicate that total medical demand, as measured by the absolute volume of outpatient and inpatient consumption, is highly inelastic to the cash price and to the cost in time of utilization. Total medical demand is also inelastic with respect to income. Yet consumers are clearly responsive to the relative prices of alternative sources of medical care. Consumers are also sensitive to the way in which the time of utilization is spent, with high travel and treatment time causing reduced demand for services.
  18. Malay midwives and witches
    Karim WJ
    Soc Sci Med, 1984;18(2):159-66.
    PMID: 6701560
    This paper attempts to analyse professional rivalry and dissonance amongst traditional Malay midwives (bidan kampung) in the Northwest areas of Peninsular Malaysia. It elucidates how techniques of symbolic and ritual communication are carefully monitored by these female specialists, to develop regular clientele and professional credibility over time. However, since an integral element of Malay midwifery is protection from and mastery over mystical forces in nature and evil spirits harboured by witches, a midwife is also an exorcist with skills rather similar to the Malay bomoh (traditional medical practitioner, usually male) except that her range of knowledge of witchcraft is limited to diagnostic and curative rituals of spirit-possession, in infants and children, young unmarried women and pregnant mothers. Within a restricted population area, professional rivalries and competition amongst midwives regularly surface in oblique attacks of witchcraft accusations where the accused strives to maintain her credibility while her accuser gradually wins over her clientele. Significantly, codes of professionalism in traditional Malay midwifery are not only determined by skill and experience, but also religiousness (faith in Islam), benevolence, virtue, diligence and a sense of equality and fair-play in the practice of the trade. These qualities are seemingly lacking in witches who are conceived to be anti-Islamic, uncompromising, manevolent and destructive. Thus, government midwives who threaten the popularity of traditional midwives by being particularly active in their work or supervising and controlling midwives in an authoritarian way, are also labelled as witches. Generally, while midwifery and witchcraft reflect two forms of knowledge that are structurally opposed, in ideology and morality, they exist within the same sphere of ritual and symbolic communication where the practitioners aided by their clients, shift from one state of dissonance to another in an attempt to regulate behaviour.
  19. Fulltext The gender responsiveness of social entrepreneurship in health - A review of initiatives by Ashoka fellows
    Khalid S, Dixon S, Vijayasingham L
    Soc Sci Med, 2022 Jan;293:114665.
    PMID: 34954676 DOI: 10.1016/j.socscimed.2021.114665
    There are vocal calls to act on the gender-related barriers and inequities in global health. Still, there are gaps in implementing programmes that address and counter the relevant dynamics. As an approach that focuses on social problems and public service delivery gaps, social entrepreneurship has the potential to be a closer health sector partner to tackle and transform the influence of gender in health to achieve health systems goals better. Nevertheless, social entrepreneurs' engagement and impact on gender and health remain understudied. Using the Ashoka Fellows database as a sampling frame in November 2020 (n = 3352, health n = 129), we identified and reviewed the work of 21 organizations that implemented gender-responsive health-related programmes between 2000 and 2020. We applied the UNU-IIGH 6-I Analytic Framework to review the gender issues, interventions, included populations, investments, implementation, and impact in each organization. We found that a low proportion of fellows engage in gender-responsive health programming (<1%). Many organizations operate in low-and middle-income countries (16/21). The gender-responsive programmes include established health sector practices, to address gendered-cultural dynamics and deliver people-centred resources and services. Interestingly, most organizations self-identify as NGOs and rely on traditional grant funding. Fewer organizations (6/21) adopt market-based and income-generating solutions - a missed opportunity to actualise the potential of social entrepreneurship as an innovative health financing approach. There were few publicly available impact evaluations-a gap in practice established in social entrepreneurship. All organizations implemented programmes at community levels, with some cross-sectoral, structural, and policy-level initiatives. Most focused on sexual and reproductive health and gender-based violence for predominantly populations of women and girls. Closer partnerships between social entrepreneurs and gender experts in the health sector can provide reciprocally beneficial solutions for cross-sectorally and community designed innovations, health financing, evidence generation and impact tracking that improve the gender-responsiveness of health programmes, policies, and systems.
  20. Re-interpreting the citizen consumer: alternative consumer activism and the rights to health and development
    Khoo SM
    Soc Sci Med, 2012 Jan;74(1):14-9.
    PMID: 21570757 DOI: 10.1016/j.socscimed.2011.02.048
    Alternative Southern consumer activism, undertaken for example by the Consumers' Association of Penang (CAP) in Malaysia, presents significant sites of nodal governance through which local and global health rights are claimed. This alternative consumer approach distinctively integrates health with development, social justice and environmental issues. It has not always explicitly employed rights language, but consumer activism fits with rights-based approaches, emphasising entitlements, accountability and participation. This case-study traces the development of networked consumer campaigns to contest and shape global health governance. It highlights the important, yet under-researched role of Southern nodes within global networks mobilizing health rights and public health. Alternative consumer activism re-interprets the consumer as a countervailing force, collectively mobilizing citizens to claim their health rights.
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