{"title":"“我认为认为每个人的目标都是”:赞比亚性暴力利益攸关方的观点如何使通往“非殖民化”的全球卫生路线图复杂化。","authors":"Nancy Nyutsem Breton, Nancy Lwimba Mukupa, Mazuba Mushota-Mafwenko","doi":"10.1186/s12913-025-13188-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The global health and development field is embracing calls to decolonize, producing 'roadmaps' to decolonial practices. These calls are echoed in the field of sexual and gender-based violence (SGBV), where entrenched global structural power relations undermine the potential for the community-centered, liberatory change to which decolonial roadmaps aspire. Despite the ubiquity of such calls, empirical research on the prospects for their implementation remains limited. This paper investigates the readiness among SGBV-related institutions in Zambia to address coloniality. We ask: can a decolonial praxis be realized amidst entrenched barriers, and is the global health and development industry ready to implement roadmaps for decolonization?</p><p><strong>Methods: </strong>We conducted 19 interviews with Zambia-based donor, implementing agency, and grassroots stakeholders involved in SGBV policy and programs. We performed a critical thematic analysis to explore the complexities within the country's SGBV interventions.</p><p><strong>Results: </strong>While the Zambian Anti-Gender-Based Violence Act and subsequent policies aimed to transform the SGBV landscape by establishing a systemized approach, we find considerable discrepancies between intervention expectations and the local implementation realities. Norms contributing to SGBV, a perception of a \"bad\" Zambian culture, and conflicting social values impede the impact of legal instruments. These challenges not only hinder sustainable implementation of transformative policies, but also reflect deeper structural and epistemic inequities that undermine efforts to pursue a decolonial praxis. As such, they illuminate how colonial legacies continue to shape policy and intervention outcomes and constrain the feasibility of decolonization in practice.</p><p><strong>Conclusion: </strong>This paper argues that addressing power dynamics and profit-driven motives is crucial for genuine transformation and will require a recalibration of current systems. The disparity between these factors raises critical questions about decolonization and the potential for alternative, community-focused interventions which give people agency over their liberation. The current study speaks to broader global health and development discussions by spotlighting the challenges to transformative interventions in Global Majority contexts. Confronting these challenges is essential for reshaping narratives around the implementation of decolonial roadmaps and the aspiration to community empowerment.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1364"},"PeriodicalIF":3.0000,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523078/pdf/","citationCount":"0","resultStr":"{\"title\":\"\\\"I think it is quite naive to think everybody's goal is that\\\": how Zambian sexual violence stakeholder perspectives complicate global health roadmaps to 'decolonization'.\",\"authors\":\"Nancy Nyutsem Breton, Nancy Lwimba Mukupa, Mazuba Mushota-Mafwenko\",\"doi\":\"10.1186/s12913-025-13188-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The global health and development field is embracing calls to decolonize, producing 'roadmaps' to decolonial practices. These calls are echoed in the field of sexual and gender-based violence (SGBV), where entrenched global structural power relations undermine the potential for the community-centered, liberatory change to which decolonial roadmaps aspire. Despite the ubiquity of such calls, empirical research on the prospects for their implementation remains limited. This paper investigates the readiness among SGBV-related institutions in Zambia to address coloniality. We ask: can a decolonial praxis be realized amidst entrenched barriers, and is the global health and development industry ready to implement roadmaps for decolonization?</p><p><strong>Methods: </strong>We conducted 19 interviews with Zambia-based donor, implementing agency, and grassroots stakeholders involved in SGBV policy and programs. We performed a critical thematic analysis to explore the complexities within the country's SGBV interventions.</p><p><strong>Results: </strong>While the Zambian Anti-Gender-Based Violence Act and subsequent policies aimed to transform the SGBV landscape by establishing a systemized approach, we find considerable discrepancies between intervention expectations and the local implementation realities. Norms contributing to SGBV, a perception of a \\\"bad\\\" Zambian culture, and conflicting social values impede the impact of legal instruments. These challenges not only hinder sustainable implementation of transformative policies, but also reflect deeper structural and epistemic inequities that undermine efforts to pursue a decolonial praxis. As such, they illuminate how colonial legacies continue to shape policy and intervention outcomes and constrain the feasibility of decolonization in practice.</p><p><strong>Conclusion: </strong>This paper argues that addressing power dynamics and profit-driven motives is crucial for genuine transformation and will require a recalibration of current systems. The disparity between these factors raises critical questions about decolonization and the potential for alternative, community-focused interventions which give people agency over their liberation. The current study speaks to broader global health and development discussions by spotlighting the challenges to transformative interventions in Global Majority contexts. Confronting these challenges is essential for reshaping narratives around the implementation of decolonial roadmaps and the aspiration to community empowerment.</p>\",\"PeriodicalId\":9012,\"journal\":{\"name\":\"BMC Health Services Research\",\"volume\":\"25 1\",\"pages\":\"1364\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12523078/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Health Services Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12913-025-13188-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Health Services Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12913-025-13188-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
"I think it is quite naive to think everybody's goal is that": how Zambian sexual violence stakeholder perspectives complicate global health roadmaps to 'decolonization'.
Background: The global health and development field is embracing calls to decolonize, producing 'roadmaps' to decolonial practices. These calls are echoed in the field of sexual and gender-based violence (SGBV), where entrenched global structural power relations undermine the potential for the community-centered, liberatory change to which decolonial roadmaps aspire. Despite the ubiquity of such calls, empirical research on the prospects for their implementation remains limited. This paper investigates the readiness among SGBV-related institutions in Zambia to address coloniality. We ask: can a decolonial praxis be realized amidst entrenched barriers, and is the global health and development industry ready to implement roadmaps for decolonization?
Methods: We conducted 19 interviews with Zambia-based donor, implementing agency, and grassroots stakeholders involved in SGBV policy and programs. We performed a critical thematic analysis to explore the complexities within the country's SGBV interventions.
Results: While the Zambian Anti-Gender-Based Violence Act and subsequent policies aimed to transform the SGBV landscape by establishing a systemized approach, we find considerable discrepancies between intervention expectations and the local implementation realities. Norms contributing to SGBV, a perception of a "bad" Zambian culture, and conflicting social values impede the impact of legal instruments. These challenges not only hinder sustainable implementation of transformative policies, but also reflect deeper structural and epistemic inequities that undermine efforts to pursue a decolonial praxis. As such, they illuminate how colonial legacies continue to shape policy and intervention outcomes and constrain the feasibility of decolonization in practice.
Conclusion: This paper argues that addressing power dynamics and profit-driven motives is crucial for genuine transformation and will require a recalibration of current systems. The disparity between these factors raises critical questions about decolonization and the potential for alternative, community-focused interventions which give people agency over their liberation. The current study speaks to broader global health and development discussions by spotlighting the challenges to transformative interventions in Global Majority contexts. Confronting these challenges is essential for reshaping narratives around the implementation of decolonial roadmaps and the aspiration to community empowerment.
期刊介绍:
BMC Health Services Research is an open access, peer-reviewed journal that considers articles on all aspects of health services research, including delivery of care, management of health services, assessment of healthcare needs, measurement of outcomes, allocation of healthcare resources, evaluation of different health markets and health services organizations, international comparative analysis of health systems, health economics and the impact of health policies and regulations.