IF 2.3 4区医学

Health Pub Date : 2026-03-23 DOI: 10.1177/13634593261433138

Snigdha Sahai

{"title":"SIECHI: A systems model of elite capture and structural inertia in health inequity.","authors":"Snigdha Sahai","doi":"10.1177/13634593261433138","DOIUrl":"https://doi.org/10.1177/13634593261433138","url":null,"abstract":"Persistent health inequities continue to shape population health outcomes across diverse political and economic contexts, despite sustained policy attention to the social determinants of health. Across countries with varying income levels and health system designs, disparities in housing stability, food security, access to care, and preventable morbidity remain resistant to reform. These enduring patterns suggest that barriers to health equity are not merely technical or programmatic, but are embedded within broader systems of governance, power, and institutional design. This editorial focuses primarily on the United States, not as an assertion of exceptionalism, but as a theoretically informative case for examining how elite capture and structural inertia operate within highly unequal, market-oriented democracies. The United States combines pronounced income inequality, fragmented governance, and extensive private sector involvement in social provision, creating conditions under which power concentration and institutional delay are particularly visible. Similar dynamics have been documented in other contexts with high inequality or constrained state capacity, including Brazil and the United Kingdom, where reform efforts have likewise been shaped by political contestation, administrative bottlenecks, and fiscal constraint. The mechanisms articulated here are therefore analytically transferable beyond the United States, even as their specific expressions vary across settings. This editorial introduces the SIECHI model, or Structural Inertia and Elite Capture in Health Inequity, as a conceptual framework for understanding how political economic forces and institutional resistance jointly suppress progress on the social determinants of health. Rather than treating stalled reform as evidence of policy failure alone, the model conceptualizes inequity as an emergent outcome of reinforcing structural dynamics that persist even when formal policy change occurs.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261433138"},"PeriodicalIF":2.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adolescent girls as local active citizens: Developing a sense of belonging to local parks through 'walk and talk' and navigating local gender politics. 作为当地积极公民的青春期女孩：通过“边走边聊”和引导当地的性别政治，培养对当地公园的归属感。

IF 2.3 4区医学

Health Pub Date : 2026-03-20 DOI: 10.1177/13634593261425702

Satrio Nindyo Istiko, Amanda Seims, Mariam Fargin, Sally Barber, Jamie Crowther, Abida Rafiq, Laura Sheard

{"title":"Adolescent girls as local active citizens: Developing a sense of belonging to local parks through 'walk and talk' and navigating local gender politics.","authors":"Satrio Nindyo Istiko, Amanda Seims, Mariam Fargin, Sally Barber, Jamie Crowther, Abida Rafiq, Laura Sheard","doi":"10.1177/13634593261425702","DOIUrl":"https://doi.org/10.1177/13634593261425702","url":null,"abstract":"Parks offer opportunities for adolescent girls to be physically active, yet many are excluded from these spaces, particularly those who are affected by intersecting inequalities. This paper draws from six focus groups with 33 adolescent girls in Bradford, United Kingdom, to explore the relationship between their sense of belonging in their local parks and their engagement with physical activity (PA) in these spaces. Drawing on Yuval-Davis' sociological understanding of citizenship, we highlight local parks as a symbol of belonging to their local communities, and 'walk and talk' as a form of local park-based PA practice that also enhances their sense of belonging (citizenship) to their local communities while also reducing stress. Male domination of local parks is perceived as a barrier to use these spaces for PA, which is also influenced by high level deprivation. As a response, many develop experiential knowledge and strategies that demonstrate their local active citizenship. Moving forward, we call for a combined strategy to leverage local parks for adolescent girls affected by intersecting inequalities to do PA: first, a better park and city design that is attuned to their walking experiences and safety, and; second, re-investment in youth organisations to support their development of citizenship competencies through local park-based PA interventions.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261425702"},"PeriodicalIF":2.3,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding the spatiality in neglected tropical diseases: An ethnographic study of scrub typhus in Puducherry, India. 了解被忽视的热带病的空间性：印度普度切里丛林斑疹伤寒的人种志研究。

IF 2.3 4区医学

Health Pub Date : 2026-03-17 DOI: 10.1177/13634593261428065

Anoop C Choolayil, Panneer Devaraju, Srikanth Srirama, Waseema Arif, Muhammed Jabir, Aravindasamy Chakkravarthy, Rajkumar Srinivasan, Srividya Vissvesaran, Murali Ramachandiran

{"title":"Understanding the spatiality in neglected tropical diseases: An ethnographic study of scrub typhus in Puducherry, India.","authors":"Anoop C Choolayil, Panneer Devaraju, Srikanth Srirama, Waseema Arif, Muhammed Jabir, Aravindasamy Chakkravarthy, Rajkumar Srinivasan, Srividya Vissvesaran, Murali Ramachandiran","doi":"10.1177/13634593261428065","DOIUrl":"https://doi.org/10.1177/13634593261428065","url":null,"abstract":"Individuals from marginalised backgrounds are often \"placed\" in spatial planes marked by disadvantages and poor resource availability, impacting their health outcomes. This study explored the role of spatiality in shaping health outcomes, with scrub typhus-a neglected tropical disease (NTD) of zoonotic origin-as an illustrative case. Employing a spatial justice framework, the study investigated the intersection of geospatial and socio-spatial factors influencing health and illness experience in Puducherry, India. An interdisciplinary mixed-methods approach was employed, involving geospatial hotspot mapping of 256 individuals who were diagnosed with scrub typhus over a period of 12 months, vector studies in the hotspots and a go-along ethnography with participants selected from the hotspots. Quantitative findings revealed a higher incidence during cooler months and post-rainfall among households proximate to vegetation and agricultural land, and the vector studies confirmed the presence of mite vectors in these areas, reinforcing the geospatial links to vulnerability. Qualitative findings highlighted how socio-spatial factors like housing conditions, decaying infrastructure, systemic neglect, poor patient education, and mobility create disproportionate vulnerability to the marginalised. The study underscores the importance of addressing the spatiality of health in its geo-spatial and socio-spatial dimensions to reduce the disease burden and the need for spatially informed public health interventions to address NTDs.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261428065"},"PeriodicalIF":2.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Antibiotic misuse and vaccine hesitancy: A hidden relation? 抗生素滥用与疫苗犹豫：隐藏的关系？

IF 2.3 4区医学

Health Pub Date : 2026-03-12 DOI: 10.1177/13634593261425701

Ana Patrícia Hilário, Fábio Rafael Augusto

{"title":"Antibiotic misuse and vaccine hesitancy: A hidden relation?","authors":"Ana Patrícia Hilário, Fábio Rafael Augusto","doi":"10.1177/13634593261425701","DOIUrl":"10.1177/13634593261425701","url":null,"abstract":"The relationship between vaccine hesitancy and antibiotic misuse remains complex and insufficiently understood, raising questions about whether these phenomena are directly connected or shaped by shared underlying factors. As vaccine hesitancy and antimicrobial resistance constitute intertwined public health challenges with serious implications for population well-being, it is crucial to explore how attitudes toward vaccination correspond with patterns of antibiotic use. This study examines antibiotic hesitancy and misuse among vaccine-hesitant parents in Portugal-a group often inclined toward alternative health practices in managing family health. Based on in-depth interviews with 31 parents, the findings reveal that participants critically reflect on medical interventions, frequently questioning the necessity and appropriateness of antibiotics. The study highlights consumption practices that diverge from biomedical guidelines, potentially increasing children's vulnerability, and draws attention to the limited focus on antibiotic misuse in existing literature. Results confirm an interconnection between vaccine uptake and parental knowledge of antibiotics, suggesting that limited understanding of antibiotic roles is associated with delayed or refused childhood vaccination. Echoing patterns of vaccine refusal, parents who reject or selectively use antibiotics often adopt a 'natural' approach to health, reinforcing a broader social identity in which parents position themselves as experts in safeguarding their children's well-being. These findings point to wider perceptions of risk surrounding conventional medicine and science in general, underscoring the need for more effective health communication.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261425701"},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Queering the diagnostic trajectory of borderline personality disorder. 边缘型人格障碍的诊断轨迹。

IF 2.3 4区医学

Health Pub Date : 2026-03-11 DOI: 10.1177/13634593261421653

Emma-Louise Seal, Renata Kokanović, Tamara Borovica, Lisa Blackman

{"title":"Queering the diagnostic trajectory of borderline personality disorder.","authors":"Emma-Louise Seal, Renata Kokanović, Tamara Borovica, Lisa Blackman","doi":"10.1177/13634593261421653","DOIUrl":"https://doi.org/10.1177/13634593261421653","url":null,"abstract":"There is increasing evidence that LGBTQIA+ people are diagnosed with borderline personality disorder (BPD) at higher rates than cisgender and heterosexual populations. Despite this, limited qualitative research has critically examined the social, cultural, institutional, and diagnostic processes that shape these disparities. BPD is a highly stigmatised and contested psychiatric diagnosis, with a long history of debate across disciplines, including psychiatry. Critically unpacking these diagnostic trajectories is essential for understanding how gender and sexual diversity, and LGBTQIA+ people more broadly, are responded to within mental health and social care systems. Drawing on in-depth interviews with 13 LGBTQIA+ individuals who had received a BPD diagnosis, this study is informed by the sociology of diagnosis and queer theory. This framework enables a critical interrogation of how gender and sexual diversity intersect with dominant psychiatric discourses that continue to pathologise non-normative identities, emotional expression and relational practices. Findings are organised around three interrelated themes. First, participants described how limited understanding, validation, and access to LGBTQIA+ -affirming care contributed to experiences of distress that were subsequently interpreted through a diagnostic lens. Second, participants highlighted how BPD diagnostic criteria risk pathologising identity exploration and self-expression that diverge from cisnormative and heteronormative expectations. Third, clinical judgements were frequently shaped by superficial assumptions about appearance, gender expression and sexuality, compounded by limited queer-specific training among practitioners. Collectively, our findings suggest everyday clinical interactions, diagnostic practices and healthcare cultures contribute to the disproportionate application of BPD diagnoses among LGBTQIA+ people. The study underscores the need for further critical research, practitioner education and the resourcing of LGBTQIA+ -affirming mental health services.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261421653"},"PeriodicalIF":2.3,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dual dependency: Conceptualisations of depression in Polish psychiatry between east and west. 双重依赖：波兰精神病学中东西方之间的抑郁症概念。

IF 2.3 4区医学

Health Pub Date : 2026-03-06 DOI: 10.1177/13634593251409223

Beata Radomska

{"title":"Dual dependency: Conceptualisations of depression in Polish psychiatry between east and west.","authors":"Beata Radomska","doi":"10.1177/13634593251409223","DOIUrl":"https://doi.org/10.1177/13634593251409223","url":null,"abstract":"Contrary to the argument that biological conceptualisations of mental distress serve as a smokescreen for the ills of capitalism in Western neoliberal societies, the findings show that the biological and individualised definitions of depression were present in the socialist Eastern Bloc. Taking the history of Polish psychiatry as a vantage point, this study introduces its historical development throughout late socialism and into the capitalist regime, revealing the continuity of biological conceptualisations of depression over time. It draws from archival research of the Polish Psychiatry journal, supplemented by interviews with psychiatrists from different generations. The study complicates the history of the European psychiatry during the Cold War period, by tracking knowledge transfers between East and West. It proves that the understanding of depression in late socialist Poland as an endogenous disease, an organic disorder independent of the social environment, was partly shaped by the Pavlovian paradigm and partly by Western neurobiological discoveries. Since the 1990s, with the dominance of American science, conceptualisations of depression as an endogenous disease have prevailed, albeit under a new wording of biological vulnerability. The study argues that the simultaneous impact of the Soviet and Western psychiatry in late socialist Poland was an instance of dual dependency resulting from the country's geopolitical positioning. With the systemic transformation in the 1990s, a shift in the dependency pattern occurred, as Polish psychiatry clearly oriented towards the U.S. science.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251409223"},"PeriodicalIF":2.3,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ill by mouth? Patients' experiences of the oral and dental manifestations of scleroderma. 口不舒服？硬皮病患者口腔及口腔表现的体会。

IF 2.3 4区医学

Health Pub Date : 2026-03-04 DOI: 10.1177/13634593261419410

Elizabeth Price, Liz Walker, Tyler James Mills, Vishal Aggarwal, Francesco Del Galdo

{"title":"Ill by mouth? Patients' experiences of the oral and dental manifestations of scleroderma.","authors":"Elizabeth Price, Liz Walker, Tyler James Mills, Vishal Aggarwal, Francesco Del Galdo","doi":"10.1177/13634593261419410","DOIUrl":"https://doi.org/10.1177/13634593261419410","url":null,"abstract":"Scleroderma is a rare chronic multi-system disease characterised by fibrotic changes in the skin, connective tissues and internal organs. The high mortality rate associated with the condition means that clinical attention is often focussed exclusively in these contexts. This paper reports on a mixed methods study which explored patients' and practitioners' experiences of the oral and dental manifestations of scleroderma - other aspects of the condition that, patients state, also have life-changing, and limiting, effects. The overarching research questions underpinning the study were, what are patients' and practitioners' experiences of scleroderma-related dental problems and what strategies can be developed to improve patients' quality of life? Here we focus exclusively on patients, who reported a significant disjuncture between their own experiences and professionals' understanding and intervention, such that their scleroderma related oral and dental problems were perceived to be clinically ignored and/or trivialised. This evident mismatch generates a range of keenly felt absences wherein the patient, the mouth, and the oral cavity more broadly, can be seen to both literally, and metaphorically, dis/dysappear. We draw on a range of theoretical and empirical perspectives to recognise the complex interplay of priorities and expectations that play out between patient and practitioner, concluding that far greater clinical attention should be afforded to the patient's own account of their condition whether or not this fully aligns with practitioners' perspectives. Scleroderma affects in excess of 2.5 million people globally, but the issues we explore here have a resonance far beyond this one rare condition. A range of other auto-immune and chronic conditions, such as type 1 diabetes and rheumatoid arthritis, also prominently feature oral and dental problems and, as such, this work has the potential to help shape the treatment and understanding of the illness experiences of significant numbers of people.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261419410"},"PeriodicalIF":2.3,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

'One time my gut and psyche talked to each other': The flexible use of mind-body dualism to articulate socially situated selves. “有一次，我的内心和心灵互相交谈”：灵活地使用身心二元论来表达处于社会地位的自我。

IF 2.3 4区医学

Health Pub Date : 2026-03-01 Epub Date: 2025-07-28 DOI: 10.1177/13634593251358046

Tine Friis, Monica Greco, Louise Whiteley

{"title":"'One time my gut and psyche talked to each other': The flexible use of mind-body dualism to articulate socially situated selves.","authors":"Tine Friis, Monica Greco, Louise Whiteley","doi":"10.1177/13634593251358046","DOIUrl":"10.1177/13634593251358046","url":null,"abstract":"Instead of pursuing the dissolution of mind-body dualism, this article argues for examining when and to what purposes it is mobilised. The article explores notions of the 'gut', 'psyche' and 'self' as mobilised in descriptions of personal experiences, which were examined through collective memory-work with three groups of women. Rather than responding to direct questions about mind-body dualism, participants wrote memories from the prompt One time my gut and psyche talked to each other. . . Our analysis shows that the memories use 'gut' and 'psyche' to articulate 'selves', and these articulations illuminate and help participants navigate the social situations that structure the experiences they describe. More generally, our memory-work shows that meanings of 'gut' and 'psyche' - and thus implicit ideas about mind-body dualism - are flexible and unsettled. They find their meaning(s) in the ways their relations are articulated, but also via attributions of agency and responsibility. We argue that this is not as such problematic. Rather, our analysis calls for an orientation towards appreciating, rather than fixing or controlling, this mutability. Our memory-work offers and exemplifies such an orientation, and develops the use of memory prompts that provocatively contain the very categories that are in question, rather than trying to avoid their premature articulation or dissolution.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"143-167"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rethinking posthumanism in rehabilitation science: Lessons from Indigenous, Black, and decolonial thought. 重新思考康复科学中的后人文主义：来自土著、黑人和非殖民思想的教训。

IF 2 4区医学

Health Pub Date : 2026-03-01 Epub Date: 2025-06-13 DOI: 10.1177/13634593251345082

Eduan Breedt, Erin Tichenor, Kim McLeod, Tim Barlott

{"title":"Rethinking posthumanism in rehabilitation science: Lessons from Indigenous, Black, and decolonial thought.","authors":"Eduan Breedt, Erin Tichenor, Kim McLeod, Tim Barlott","doi":"10.1177/13634593251345082","DOIUrl":"10.1177/13634593251345082","url":null,"abstract":"Posthumanism is a theoretical paradigm in Western continental philosophy with emerging significance and popularity in the health disciplines. Rehabilitation science scholars in fields like occupational therapy and physical therapy have taken up posthumanism, valuing its interventions into the harms of European humanist conceptualizations of the \"(hu)man\" which perpetuate individualism, ableism, and anthropocentrism. This paper responds to the pervasive use of posthumanism in the rehabilitation science literature-particularly among white scholars in the \"Global North\"-and its omission of sustained engagements with forms of dehumanization (specifically racism, colonialism, and anti-Blackness). For posthuman healthcare and rehabilitation scholarship to have utility beyond white, globally elite populations, we invite fellow rehabilitation science scholars to engage with the important critiques of posthumanism made by Black, Indigenous, and Latin American decolonial scholars. We synthesize these critiques and warnings about the forms of epistemic colonial violence embedded within popular approaches to posthumanism, and query rehabilitation scholars' responsibilities to pause and center theories of the human and posthuman that have long been developed and lived by racialized and Indigenous scholars, activists, and knowledge holders.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"168-192"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The unravelling of person-centred care: The value and necessity of analysing power relations in contraceptive services. 以人为本的护理的解体：分析避孕服务中的权力关系的价值和必要性。

IF 2 4区医学

Health Pub Date : 2026-03-01 Epub Date: 2025-04-30 DOI: 10.1177/13634593251336175

Tracy Morison, Catriona Ida Macleod, Yanela Ndabula

{"title":"The unravelling of person-centred care: The value and necessity of analysing power relations in contraceptive services.","authors":"Tracy Morison, Catriona Ida Macleod, Yanela Ndabula","doi":"10.1177/13634593251336175","DOIUrl":"10.1177/13634593251336175","url":null,"abstract":"Global research indicates ongoing challenges in delivering person-centred contraceptive care. Much of the contraceptive research investigates this issue using systems-focussed approaches to map institutional constraints (e.g. institutional or health system barriers to accessing contraception). The assumption underlying this research approach is that simply removing structural barriers can address issues and enhance contraceptive autonomy, but this is not the case. Our research shows how discursively constructed power relations undermine bodily integrity and contraceptive agency even as contraceptive providers endorse the principles of patient-centred care. Using a synthetic narrative/discourse approach to analyse provider interviews in South Africa and New Zealand, we draw on Foucauldian analytics of biopower to show how an idealised person-centred care narrative collapses under the weight of discourses of medicalised risk, protectionism, and biomedical expertise, signalling practices of power through confession, responsibilisation and surveillance. Our findings highlight an essential perspective frequently missing in systems-focussed research on contraceptive care: the crucial dimension of power and reproductive politics. Thus, we argue for the necessity of investigating this dimension, in addition to systemic challenges. Our work demonstrates the value of frameworks that illuminate power dynamics, such as the Foucauldian analytics of biopower we undertook. Expanding the range of research perspectives in contraceptive research can deepen understandings of how systems constraints and power relations together undermine relational person-centred contraceptive care.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"214-234"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12923625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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