Thinking aloud allowed – is there equity in evidence?
By Kaaren Mathias – HSG board member
Rattling in the train as I chugged home from the National Symposium on Evidence Synthesis (NSES2019), my thoughts were still a tangle. How is it that the largest number of malaria researchers in Europe are located in a city in the north of England (where mosquito’s fear to fly)? Why is it that even among people who research inequalities, there are glaring inequalities? There is disproportionate representation of people who are European and living in High Income Countries as authors in studies on inequalities, with researchers from the Global South on the periphery. We are so many years from colonialism, but there are still so many ways that colonial approaches are enmeshed in the practice of global health.
When will we really be through with the perplexities created by colonialism?
In my own work, both as a practitioner and researcher, I have found it easier to write about rather than with, to work for rather than beside. We blithely use terms like ‘community participation’ and talk about ‘nothing about us, without us’. Yet, community participation and PAR are also contested, with critiques and responses to these critiques. It is easy to act without thinking, but we can also be quick to problematise in academia while inequalities escalate. We need to be critically reflective, give attention and time to ensure genuine participation, but also keep working among and with people in communities.
NSES2019 was organised jointly by the George Institute for Global Health, India and The Campbell Collaboration. The pre-conference workshop I attended on the first day, run by the Campbell Collaboration, focused on skill building in the area of mapping of evidence and gaps, and was engaging and practical. The plenaries gave an incisive overview on evidence synthesis as an approach coming of age in India and internationally. The individual presentations represented a wide spread of specialised knowledge, but possibly because they presented a similar methodology (systematic reviews primarily), and were fairly narrow in focus, they were perhaps mixed in the interest they attracted.
The working group meeting on Equity and Evidence was the highlight of the NSES gathering for me. Members of the Evidence to Action, SHAPES and Emerging Voices TWGs of HSG organised this meeting as a space to reflect on the approaches used to generate evidence. The discussion ranged across public and patient engagement, issues in the production and epistemology of knowledge, decolonising evidence, challenges in integrating equity into evidence synthesis and much more. It left me with more questions than answers and, yet, these are issues that all of us need to work on. I am looking forward to more collective action and outputs on equity and evidence in months ahead, even if I lose a few more nights of sleep as a consequence.
