Leanne Brady | University of Cape Town (original) (raw)

Videos by Leanne Brady

When a country gains independence from a colonial power, it does not mean that all the effects of... more When a country gains independence from a colonial power, it does not mean that all the effects of colonialism automatically disappear. Coloniality is the condition that survives beyond the period of colonialism. Where decolonisation describes the process through which direct colonial rule was withdrawn, decoloniality is a political, epistemological and economic liberation project aimed at dislodging coloniality and its manifestations including the coloniality of power, and the coloniality of knowledge.

Considering what a decolonial lens offers us as southern scholars seeking to disrupt patterns of global knowledge production, and reflecting on what it offers us for our own research praxis, Leanne Brady & Lance Louskieter, HPSR PHD candidates at UCT, draw on some critical perspectives to kick start the discussion.

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Papers by Leanne Brady

Social science & medicine, May 1, 2024

Routledge eBooks, Nov 28, 2022

Background The Ebola virus disease epidemic in West Africa has infected 28 457 people and claimed... more Background The Ebola virus disease epidemic in West Africa has infected 28 457 people and claimed more than 11 000 lives. Many more people may have died from the indirect eff ects of the epidemic and closure of normal healthcare facilities. Unlike other facilities in West Africa, the emergency department in Connaught Hospital, Freetown, Sierre Leone, protected by an onsite Ebola holding unit, continued to provide emergency care throughout the outbreak. We aimed to assess the eff ect of the outbreak on emergency department attendance and presentation. We also analysed emergency care capacity across Freetown. Methods Attendance data from the emergency department and Ebola holding unit at Connaught Hospital were collected from June 1, 2014, to June 1, 2015. Severity of presentation was derived from South African Triage Score (SATS) assigned at fi rst presentation to the emergency department. A mean severity score was calculated by dividing the number of presentations with a SATS of 1-2 by the total number of presentations. Local prevalence of the disease was counted as RT-PCR positive cases at the Ebola holding unit. Emergency care capacity was assessed at the seven principal hospitals in Freetown in May, 2013, and in April, 2015, with a standardised tool, the Emergency Care Capacity Score (ECCS), specifi cally designed for the low-income setting. All data were collected in Excel (2013). Stata (version 13) was used for statistical analysis.

Human Resources for Health, 2019

Violence is a public health issue. It is the consequence of a complex set of interacting politica... more Violence is a public health issue. It is the consequence of a complex set of interacting political, social, and economic factors firmly rooted in past and current injustice. South Africa remains one of the most unequal countries in the world, and in some areas, the rates of violence are comparable to a country that is at war. Increasingly, paramedics working in high-risk areas of Cape Town are being caught in the crossfire, and in 2018, there was an attack on a paramedic crew nearly every week. These attacks are a symptom of much deeper, complex societal issues. Clearly, we require new approaches to better understand the complexity as we collectively find a way forward. It is in this context that we are collaborating with paramedics, poets, and filmmakers to tell human stories from the frontline thereby bringing the lived experiences of healthcare workers into policy making processes. In this commentary, we share a series of poems and a poetry-film that form part of a larger body of work focused on the safety of paramedics, to catalyze discussion about the possibilities that arts-based methods offer us as we seek to better understand and engage with complex social issues that have a direct impact on the health system.

Full English poetry translation. (DOCX 26â kb)

This chapter reports on research being conducted in the Western Cape to understand the province’s... more This chapter reports on research being conducted in the Western Cape to understand the province’s particular experience of health-system transformation since 1994. P rovincial governments in South Africa have a critical responsibility in terms of population health, yet few provincial-level analyses of health-system development have been undertaken. This chapter reports on research being conducted in the Western Cape to understand the province’s particular experience of health-system transformation since 1994, set against wider national experience. The research is being undertaken collaboratively by the authors of this chapter, a team of Western Cape provincial health managers and researchers.

Social Science & Medicine (1982), 2020

This paper reports a study from Cape Town, South Africa, that tested an existing framework of eve... more This paper reports a study from Cape Town, South Africa, that tested an existing framework of everyday health system resilience (EHSR) in examining how a local health system responded to the chronic stress of large-scale organizational change. Over two years (2017-18), through cycles of action-learning involving local researchers and managers, the authorial team tracked the stress experienced, the response strategies implemented and their consequences. The paper considers how a set of micro-governance interventions and mid-level leadership practices supported responses to stress whilst nurturing organizational resilience capacities. Data collection involved observation, in-depth interviews and analysis of meeting minutes and secondary data. Data analysis included iterative synthesis and validation processes. The paper offers five sets of insights that add to the limited empirical health system resilience and EHSR literature: 1) resilience is a process not an end-state; 2) resilience...

International journal of health policy and management, 2021

Community health systems (CHSs) have historically been approached from multiple perspectives, wit... more Community health systems (CHSs) have historically been approached from multiple perspectives, with different purposes and methodological and disciplinary orientations. The terrain is, on the one hand, vast and diverse. On the other hand, under the banner of universal health coverage (UHC) and the Sustainable Development Goals (SDGs), a streamlined version of 'community health' is increasingly being consolidated in global health and donor communities. With the view to informing debate and practice, this paper seeks to synthesise approaches to the CHS into a set of 'lenses,' drawing on the collective and multi-disciplinary knowledge (both formal and experiential) of the authors, a collaborative network of 23 researchers from seven institutions across six countries (spanning low, middle and high income). With a common view of the CHS as a complex adaptive system, we propose four key lenses, referred to as programmatic, relational, collective action and critical lenses. ...

BMJ

and colleagues draw on experiences from Kenya and South Africa to consider the practice, benefits... more and colleagues draw on experiences from Kenya and South Africa to consider the practice, benefits, and challenges of research co-production for strengthening health systems on 15 December 2021 by guest. Protected by copyright.

International Journal of Health Policy and Management

The coronavirus disease 2019 (COVID-19) pandemic has exposed the wide gaps in South Africa’s form... more The coronavirus disease 2019 (COVID-19) pandemic has exposed the wide gaps in South Africa’s formal social safety net, with the country’s high levels of inequality, unemployment and poor public infrastructure combining to produce devastating consequences for a vast majority in the country living through lockdown. In Cape Town, a movement of self-organising, neighbourhood-level community action networks (CANs) has contributed significantly to the community-based response to COVID-19 and the ensuing epidemiological and social challenges it has wrought. This article describes and explains the organising principles that inform this community response, with the view to reflect on the possibilities and limits of such movements as they interface with the state and its top-down ways of working, often producing contradictions and complexities. This presents an opportunity for recognising and understanding the power of informal networks and collective action in community health systems in tim...

International Journal of Gynecology & Obstetrics, 2011

Objective: To assess the effectiveness and safety of the administration of misoprostol, an orally... more Objective: To assess the effectiveness and safety of the administration of misoprostol, an orally active prostaglandin, in addition to routine uterotonic therapy as part of the active management of the third stage of labor. Methods: The present study was a hospital-based, decentralized, multi-center, randomized, placebocontrolled, double-blind trial. We enrolled 1103 women (out of a target sample size of 1180) at 4 hospitals in South Africa, Uganda, and Nigeria. Participants received a sublingual dose of 400 μg of misoprostol or a placebo, in addition to standard active management of the third stage of labor, after vaginal birth. Results: The baseline characteristics of the participants were comparable. The difference in the primary outcome of blood loss of 500 mL or more within 1 hour of randomization was not significant between the 2 groups (misoprostol 22/546 [4.0%] versus placebo 35/553 [6.3%]; relative risk, 0.64; 95% confidence interval, 0.38-1.07). Shivering and pyrexia occurred more frequently in the misoprostol group. No maternal deaths occurred. Conclusion: The present study did not confirm a beneficial effect of administering 400 μg of misoprostol, in addition to routine uterotonic therapy, during the third stage of labor, but was consistent with other trials showing a cumulative modest benefit. Where routine uterotonics are available for prophylactic use, any potential benefit of misoprostol might not outweigh the likelihood of adverse effects. Trial registered on clinical trials.gov: NCT 00124540.