03182nas a2200301   4500000000100000008004100001260003400042653001100076653001200087653001800099653002400117653002400141653003400165653002400199653001900223100001500242700001800257700001300275700001300288700002500301700002000326700001400346245006900360856010400429300000900533520232400542022001402866       2024                            d  bOxford University Press (OUP)10aequity10ajustice10aglobal health10aepistemic injustice10acredibility deficit10ahermeneutical marginalisation10aknowledge practices10adecolonisation1 aAbimbola S1 avan de Kamp J1 aLariat J1 aRathod L1 aKlipstein-Grobusch K1 avan der Graaf R1 aBhakuni H00aUnfair knowledge practices in global health: a realist synthesis  uhttps://academic.oup.com/heapol/advance-article-pdf/doi/10.1093/heapol/czae030/57293869/czae030.pdf  a1-323 a<p>Unfair knowledge practices easily beset our efforts to achieve health equity within and between countries. Enacted by people from a distance and from a position of power (‘the centre’) on behalf of and alongside people with less power (‘the periphery’), these unfair practices have generated a complex literature of complaints across various axes of inequity. We identified a sample of this literature from 12 journals, and systematised it using the realist approach to explanation. We framed the outcome to be explained as ‘manifestations of unfair knowledge practices’; their generative mechanisms as ‘the reasoning of individuals or rationale of institutions’; and context that enable them as ‘conditions that give knowledge practices their structure’. We identified four categories of unfair knowledge practices, each triggered by three mechanisms: 1. credibility deficit related to pose (mechanisms: ‘the periphery’s cultural knowledge, technical knowledge, and ‘articulation’ of knowledge do not matter); 2. credibility deficit related to gaze (mechanisms: ‘the centre’s learning needs, knowledge platforms, and scholarly standards must drive collective knowledge-making’); 3.interpretive marginalisation related to pose (mechanisms: ‘the periphery’s sensemaking of partnerships, problems, and social reality do not matter’); and 4. interpretive marginalisation related to gaze (mechanisms: ‘the centre’s learning needs, social sensitivities and status-preservation must drive collective sensemaking’). Together, six mutually overlapping, reinforcing and dependent categories of context influence all 12 mechanisms: mislabelling (the periphery as inferior); miseducation (on structural origins of disadvantage); under-representation (of the periphery on knowledge platforms); compounded spoils (enjoyed by the centre); under-governance (in making, changing, monitoring, enforcing, and applying rules for fair engagement); and colonial mentality (of/at the periphery). These context-mechanism-outcome links can inform efforts to redress unfair knowledge practices; investigations of unfair knowledge practices across disciplines and axes of inequity; and ethics guidelines for health system research and practice when working at a social or physical distance.</p>
  a1460-2237