Reckoning with a scarcity paradigm: a critical analysis of efforts to address sexual violence within the constraints of the global health and development system in Zambia

Breton, Nancy Nyutsem (2024) Reckoning with a scarcity paradigm: a critical analysis of efforts to address sexual violence within the constraints of the global health and development system in Zambia. PhD thesis, London School of Economics and Political Science.

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Abstract

In recent years, global health and development (GH&D) institutions have increasingly advocated for implementing a decolonial praxis. However, research shows that GH&D still draws from colonial legacies and perpetuates power dynamics and trauma, often through structural violence and the medicalisation of health, promoting individualised approaches that overlook systemic issues. Current institutional attempts to decolonise risk bypassing critical steps in addressing power dynamics and systemic barriers, including in the context of sexual and gender-based violence (SGBV), where these dynamics manifest through interpersonal and structural violence, often met with individualised responses while community-centred empowerment perspectives are side-lined. This institutional inertia demands engagement with manifestations of power dynamics and trauma, particularly in SGBV interventions, and emphasises the importance of embracing community-centred perspectives to effectively address these challenges. To unpack these dynamics, this PhD project employs a collaborative approach, incorporating a critical discourse analysis, an interview study, and a participatory action research (PAR) investigation. Instead of focusing solely on decolonial discourses, the research examines the potential for community empowerment to strengthen SGBV interventions in Zambia. Using various qualitative methods, the project seeks to illuminate the barriers hindering transformative change in GH&D efforts: (i) a critical discourse analysis of relevant international policies to examine how tensions from power dynamics shape interventions; (ii) interviews with institutional SGBV stakeholders to reveal opportunities and barriers for a shift in the GH&D system; (iii) focus group discussions (FGDs) with diverse community groups (sex workers, SGBV activists, and persons with disabilities) and a stakeholder workshop to understand how inequity perpetuates itself; and, (iv) the author’s reflexive process to assess her own complicity in these dynamics. The findings suggest that constraints perpetuated by a scarcity paradigm – a deeply entrenched societal structure that prioritises individualised approaches, reinforces a narrative of limited resources, and justifies unequal distribution based on factors like race, gender, and worthiness – hinder the transformative potential of GH&D efforts. Specifically, protectionist agendas in SGBV policies often infantilise women and other systemically marginalised groups, perpetuating their victimhood and failing to address systemic inequities. Additionally, resource constraints, poor institutional coordination, and entrenched social norms maintain power dynamics, exacerbating challenges in SGBV interventions. Lastly, the difficulties of implementing PAR within these constraints reveal that entrenched power dynamics limit genuine community empowerment and often commodify empowerment. This research offers theoretical insights into the scarcity paradigm, empirical findings on Zambia’s SGBV intervention challenges, and methodological advancements through PAR, enhancing our understanding of how to approach systemic change in GH&D. The findings highlight the need for this understanding to foster genuine community empowerment and guide decolonisation efforts beyond rhetoric to achieve substantive transformation. The research urges GH&D actors to acknowledge our complicity, stressing the importance of understanding these social and systemic dynamics alongside addressing structural inequities and fostering genuine empowerment within communities, thereby laying the groundwork for meaningful and enduring change.

Item Type:	Thesis (PhD)
Additional Information:	© 2024 Nancy Nyutsem Breton
Library of Congress subject classification:	H Social Sciences > HN Social history and conditions. Social problems. Social reform H Social Sciences > HV Social pathology. Social and public welfare. Criminology R Medicine > RA Public aspects of medicine
Sets:	Departments > Methodology
Supervisor:	Cornish, Flora and Tarr, Jen and Alejandro, Audrey
URI:	http://etheses.lse.ac.uk/id/eprint/4777

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