Abstract
In this chapter, Esther L. Jones compares health care systems and inequities in sub-Saharan Africa and the United States. Applying Jonathan Metzl and Helena Hansen’s concept of “structural competency,” developed within a US context to describe the strategies that must be deployed to understand the systemic and institutionalized structures that produce inequity in health care delivery, Jones defines national systems of structural violence and structural frailty to explore health care education contexts, delivery challenges, and their relationship to poverty in generating structurally frail health systems. Utilizing empirically derived data from regional and global studies alongside a narrative literary analysis of Abraham Verghese’s Cutting for Stone, she highlights both challenges and opportunities for generating structural resilience in health systems.
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Notes
- 1.
I propose the term structural frailty to refer to the fragility of the systems and structures of the institution of medicine. This is distinct from James Quesada et al.’s (2011) notion of structural vulnerability, which focuses on the experiences of individuals in their interactions with structures that leads to diminished health behaviors and/or help-seeking behaviors.
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Jones, E.L. (2018). Structural Competency and African Contexts: A Mixed Methodological Approach to Interrogating Strategies for Greater Health Equity. In: Gertz, S., Huang, B., Cyr, L. (eds) Diversity and Inclusion in Higher Education and Societal Contexts. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-70175-2_9
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