Ethnographic Exploration of Maternal and Child Health Projects in Nepal: A Critical Analysis of the Data Collection Processes
Data collection in development projects, primarily to produce measureable results, achieve stated targets, and meet the specified goals within a particular time frame, has increased dramatically in global health and global development practices. Two key global events, the Millennium Summit (2000) and Paris Declaration on Aid Effectiveness (2005) have further emphasised the importance of achieving measurable goals and results. However, this trend is not entirely new in policy debates (or scenarios) and development practice. Based on ethnographic research conducted from April 2014 to August 2016, and focusing on four projects implemented in Nepal – in the sector of maternal, neonatal, and child health – this paper argues for a paradigm shift in development practices. The current development paradigm is focused on producing measureable results within a specific time frame, as they are principally guided by value for money and efficiency in data collection. In doing so, all the projects/programmes are designed/developed and implemented under a results- framework. This trend not only overlooks crucial and critical aspects [such as quality of healthcare services, and their sustainability and impact] of the projects themselves, but it also silences several dimensions of the broader contexts in the area where these projects and programmes are implemented. Finally, the paper concludes by suggesting that this increasing tendency has dovetailed development projects into more technocratic and goal based endeavours, which are exclusively interested in measuring results and achieving targets that disregard the unique socio-cultural contexts of the issue. This direction neither provides the actual scenario of available healthcare services on the ground, nor does it offer a specific and a broader understanding of service development and delivery. Therefore, this paper calls for a more interdisciplinary approach to data collection, which incorporates methodologies and research design that embraces local subjectivities. Otherwise, all these development projects and the goals may become mere rhetoric without delivering the substantial changes the projects initially intended.
Key Words: evidence collection, ethnography, global health, recording and reporting of information, Nepal