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7th Annual Maastricht Symposium on Global and European Health

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Faculty of Health, Medicine & Life Sciences Maastricht University

40 Universiteitssingel

6229 ER Maastricht

Netherlands

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Since its introduction in medicine in the early 1990s the ideology that professional practices should be evidence-based is also applied to health policy and social welfare. Also in the field of global health there is a demand for policy and practice to be evidence-based. To guarantee quality for money funding organizations require that interventions and programs they fund have been proven to be effective, assuming that the impact of Global Health policy will improve global health outcomes if they are based on sound scientific evidence. This evidence based paradigm uses a specific definition of evidence, to which the Random Clinical Trial (RCT) is the “golden standard” of sound evidence. Other types of knowledge can count as evidence as well, but have a far less status. In this hierarchy of evidence ethnographic research insights barely count.


In the field of Global Health, however, important scholars have articulated serious critiques on the dominance of the particular way ‘evidence’ is defined in the evidence-based paradigm. Techniques to generate this evidence and to measure statically observable effects require specific and isolated outcome criteria. While such criteria can, in some clear cut cases, be defined for medical interventions, health outcomes of complex social interventions are rarely measurable in terms of well-defined but isolated variables. Furthermore, the assumption that evidence generated in one context can easily be transferred to another context is considered highly problematic as conditions in the new setting may differ and influence the effect of the intervention substantially. Serious concern is therefore expressed about the dominance of this ‘metric’ paradigm in the world of international development and the way in which quantitative result based methods are advocated and imposed by government donors and private foundations. These criticasters call for more room for robust alternatives for assessing impact, which are more grounded in the realities of every day practice and social change. Ethnographic evidence, for instance, is seen as an important alternative as it can provide much more in depth explanation on why interventions have (not) been successful. As ethnographic evidence is based on thorough interaction with communities it also generates valuable insights and starting points to improve program design and implementation. Herewith it shifts the direction of accountability. Instead of having to account “upwards” to donor organizations, accounting becomes more a grassroots issue that involves learning and advocacy, and that creates potential for empowerment and ownership of communities involved.


The issue of what kind of evidence is desirable and usefull in the context of Global health, and what kind of evidence may have (un)expected side effects will be the central focus of the 7th Global and European Health Symposium. The debate will be enlightened by the views from our guest speakers, with backgrounds in research, policy making, and NGOs and will be an excellent opportunity to exchange ideas and solutions. The Catherina Pijls key note lecture will be provided Helen Lambert, Professor in Medical Anthropology, Bristol Medical School UK. Further contributions to this symposium include:.Dr David McCoy, director of MedAct & professor Global Public Health at Queen Mary University London; Prashanth NS Institute of Public Health, Bengaluru, India & Emerging Voices 4 Global health network (EV4GH); representatives of other interest parties such as funding organizations.

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Faculty of Health, Medicine & Life Sciences Maastricht University

40 Universiteitssingel

6229 ER Maastricht

Netherlands

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