Decolonising the global to local movement: Time for a new paradigm

ABSTRACT

Mama Amaan Project (MAP) delivered perinatal education and doula services to underserved refugee and immigrant communities in Seattle, Washington. MAP presented at a ‘global to local (glocal)’ workshop for US-based global health agencies redirecting their experience and resources to address domestic health crises. Glocal models reference Global South anti-colonial social transformations through Primary Health Care (PHC) – ‘health for all as a right’ and investment in strong public sectors. As Black women working in our communities, we resisted labelling MAP glocal. Western donors and NGOs appropriate PHC’s community participation narratives, meanwhile implementing World Bank/IMF economic structural adjustment health system cuts – thereby shifting austerity-related resource shortfalls to communities. In US contexts of neoliberal shrinking social safety nets and workers’ rights, similar strategies to address austerity-related health disparities are promoted as ‘global to local’. Projects like MAP cannot substitute quality public services. They expose gaps and build community empowerment to demand quality healthcare. Drawing on MAP and ‘global health’ experience in Mozambique, we call for re-embracing PHC’s activist values – agitating for health as a universal human right for all, rather than putting the burden and blame on underserved communities. We propose decolonising the ‘glocal’ paradigm by embracing ‘transnationality’, ‘relationality’ and ‘mutuality’.

KEYWORDS:

• Global to local
• austerity
• primary health care (PHC)
• decolonisation
• perinatal care

Acknowledgments

The authors thank Jonathan Sugarman for catalysing this conversation and encouraging us to put these ideas on paper; the staff of Health Alliance International, especially Tracy Woodman and Adam Grenato; the Somali Health Board; Washington Parent's Trust; the Mama Amaan research team; the Somali community and care providers who serve them; and James Pfeiffer, for tireless, careful reading and inspiration.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by funding from the University of Washington Population Health Initiative and Seattle Global to Local.