June 14, 2024

Global Health InitiativesGlobal Health organizations play a crucial role in alleviating the suffering caused by poverty worldwide. However, as a paradigm rooted in colonialism with a history of racial bias, many receiving communities complain of the ineffectual nature of improperly conducted health care aid. Hence, professionals contributing to modern-day initiatives have to work hard to make sure that their global health interventions consider ethics at every step of implementation.

Leading the Charge for Ethics in Global Health

The Abdul Latif Jameel Poverty Action Lab (J-PAL) brought eth0s to the forefront of global health. This was achieved through its proven success in supporting other organizations in measuring the impact of interventions to avoid funneling money into unsuccessful or unethical initiatives. J-PAL focuses on tracking and analyzing program outcomes by training specialists in surveying for community feedback through “randomized evaluations and scoping studies.”

The initiative conducts impact evaluations in partnership with actors on the global health stage to highlight the most cost-efficient and largest-impact interventions and report on local community review and feedback. This article will delve into current programs run by the World Health Organization (WHO) and the Bill and Melinda Gates Foundation to demonstrate the critical role of impact evaluation in assessing the success and ethos of global health initiatives, improving services and informing policy for a more impactful future.

Taking Responsibility

In 2024, the WHO announced it is pushing forward its 2022 One Health initiative, emphasizing its goal to incorporate a holistic approach to intervention that focuses on collaborative efforts between environmental and public health entities in targeted regions. The spearheads of the initiative express goals that echo tones from J-Pal-supported programs, understanding the importance of regional participation and feedback in sustainable and ethical health development.

Under this new program, WHO believes it will “[empower] countries, [strengthen] health systems and [foster] cross-sectoral collaboration to drive transformative change from the ground up to achieve improved health and well-being globally.” This emphasis on collaboration at a local level, across all agencies involved in health development programs, is a crucial aspect of modern success in ethical development within the global health sector. Moving forward, prominent actors on the scene, such as the WHO, are stepping up to set an example of cultural relativism, distancing themselves from global health’s foundations in ethnocentrism.

Holistic Approach

An example of this holistic approach is the WHO’s recent initiative in Côte d’Ivoire to “reduce avoidable maternal deaths by 75% between 2022 and 2024.” By analyzing historical evidence pointing to the most common causes of maternal deaths in the region, including postpartum hemorrhage, high blood pressure and infections, the WHO staff in Côte d’Ivoire realized that the simplest solution is training hospital staff and local midwives. This training focuses on a structured birth plan and “key life-saving clinical skills.”

The initiative will implement sustainable change by working with regional birthing professionals in the formal and informal sectors and considering environmental and cultural factors. This change aims to be passed down through generations, facilitating obstetric and midwife practices in the region and decreasing maternal mortality rates.

On the other hand, nongovernmental organizations (NG0) like the Bill and Melinda Gates Foundation are demonstrating this same implementation plan by funding J-PAL’s research into previously unregulated direct cash transfers for child health programs in India. In this context, J-PAL research is conducted by residents of India, which is a crucial part of ethical global intervention.

By avoiding sending foreigners to do the jobs that can be provided to locals, organizations like J-PAL positively contribute to regional economies and generate a more sustainable and community-accepted impact due to a deeper connection to and understanding of the people they are serving. Moreover, by analyzing evidence of cash transfer impact over the years, J-PAL will offer the Indian government a blueprint to upscale the most successful cash transfer programs efficiently and effectively.

Looking Ahead

While many unregulated organizations continue to ignore the ethical implications of their work, increased awareness surrounding best practices in the field makes it easy to identify bad ethos. By fostering positive examples of sustainable and culturally relevant initiatives, global health professionals can contribute to the phasing out of organizations that do more harm than good.

– Kiera Gorman
Photo: Flickr


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