SESSION 4: 4:00 PM - 5:30 PM

Panel C: Back to the Drawing Board: Rethinking Development Strategy

C100 Hesburgh Center Auditorium

Moderator: Rachel Tomas Morgan

Connecting Grassroots Development Evaluation to Achieving the UN Sustainable Development Goals

Maya Sterling, Vassar College

2020 marks the year when according to the United Nations Sustainable Development Goals, the global community has 10 years left to end poverty in all its manifestations. While thousands of organizations work every day to achieve this goal and the 16 others, the international capacity to track progress towards these goals does not adequately exist. This paper offers a critique of the methods used to conduct development evaluation and argues that the data gathered and synthesized by supranational organizations like the World Bank and the OECD does not appropriately capture and elevate the development progress that occurs at the grassroots level. This paper calls for increased global attention on the successes of grassroots development and proposes a new global framework for how to use data, monitoring, evaluation, and learning to measure global progress more honorably and effectively. Research for this paper draws on the work of the Inter-American Foundation, USAID, academics, and researchers who over time have become stronger advocates, not only for community-driven development, but for building the capacity of grassroots partners to evaluate their own progress towards achieving sustainable development. In conclusion, this paper suggests best practices for transitioning away from the purpose of evaluation to be for improving a single organization’s program delivery to adopting a more global knowledge-sharing network. Only then can there be an industry-wide systemic shift that will make funders, international NGOs, and supranational organizations more accountable to grassroots actors.


Human Development in Kerala and an Interpretation of its Replicable Resilience

Mira Carroll, University of Richmond

India, a nation of 1.2 billion, continues to have high levels of poverty and low literacy rates in comparison to other countries. However, a few states within India have shown high levels of social development in the past few decades. The most consistent among them is Kerala, unique for its historic social and political circumstances, whose subnational strength has enabled great regional levels of social and human development. This paper will first discuss the existing literature explaining its high levels of social development from the perspectives of good governance, constructivism, and institutionalism. Building on the current scholarship, this essay asks what features of Kerala contribute to its high levels of social development and how do they interact with each other in a local context? Through the presence of Marxism, matrilineal communities, and Malayalam, this essay will show how the confluence of these elements created an environment that is conducive to social development and the hypotheses are supported by firsthand perspectives of native Keralites. 


Integration, Negotiation, and Provision of Care at the Intersection of Traditional Chinese Medicine and Biomedicine

Jessica Ding, Harvard University

The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. At the most recent 2016 World Health Organization Global Conference on Health Promotion, participants confirmed their commitment to “consider the growing importance and value of traditional medicine, which could contribute to improved health outcomes” and potentially, the achievement of universal health care (WHO 2016). Healthcare policies are rapidly changing in response—in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles—practices, products, and practitioners—with regards to traditional medicines. My research primarily draws on 10 weeks of ethnographic fieldwork conducted in Shanghai during the summer of 2019 but is based on previous experiences in China's Yunnan Province as well. It expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before formal ideas of integration. I specifically look at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how “good quality” caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of TCM in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global development strategies regarding the future use and integration of traditional medicines.


Investigating Community-Based Mental Health Solutions in Nepal

Marissa Vender Missen, University of Notre Dame

Nepal ranks 147th on the UN Human Development Index (HDI), qualifying as one of the most impoverished countries worldwide. Mental health disorders disproportionately affect populations living in poverty (WHO 2014). Less than 1% of Nepal’s annual healthcare budget is allocated for mental health (Luitel 2015). KOSHISH is a “mental health self-help organization” providing rehabilitation services (Devkota 2011). The study evaluated what mental health solutions succeed in countries with reduced resources, focusing on KOSHISH’s self help groups. These groups provide community-led solutions to mental health problems where clinical psychiatric care is less accessible. At self help group meetings in villages near Kathmandu, 34 anonymous participants were surveyed. Psychology instruments– Cognitive Style Questionnaire (CSQ) and Mood/Anxiety Symptom Questionnaire (MASQ)– collected data on mindset and mental illness symptoms, and informal discussions about group experiences were conducted. The Nepali CSQ was compared to a Honduran sample to evaluate the groups’ effectiveness relative to a country with a comparable HDI rank.

The Nepali CSQ average, 4.52, was higher than Honduras, 3.4, indicating increased vulnerability to mental illness and negative mindset. This disparity could be attributed to different cultural paradigms on mental illness. In conversations, members described how the groups positively impacted their lives. Numerically, the evaluation of KOSHISH self help groups is inconclusive, but anecdotally, their impact on communities was tangibly beneficial. Additional cross-cultural techniques should be developed to research the groups’ impact, in order to uphold them as a model intervention for areas with limited access to psychiatric services globally.