Why we need intersectional research to better understand the socio-cultural drivers of antibiotic resistant infections and optimise antibiotic use
Dr Esmita Charani
Division of Infectious Diseases and HIV Medicine
Dept of Medicine UCT/GSH
Antibiotic prescribing is a social process, and to optimise prescribing practices we need to understand the sociocultural drivers at play. For the last five years, Division of HIV Medicine and Infectious Diseases researchers have been collaborating with Indian and UK institutions to understand the influence of socio-cultural drivers on antibiotic resistant related health-seeking and health providing behaviours. The social science aspect of this research was led by Dr Esmita Charani who spent extensive time at UCT, working with colleagues here and in India investigating the influence of the social network for patients and care givers on infection related care. At UCT, the research applied novel qualitative visual mapping tools for describing team communication based on hierarchical roles of staff and its impact on infection-related care. The research has led to a successful PhD studentship, which is currently underway by Candice Bonaconsa, as well as two Thutuka fellowships for the UCT researchers. The work led to interesting findings in relation to the role that family members play in infection in India where the wider social network of the patient is relied upon for care giving in hospital settings. As the programme of research expanded, the need to take an intersectional lens to the study of antibiotic resistance and infections became evident to the research team, particularly in context of the rich qualitative data that described the experiences of healthcare workers and healthcare users.
Dr Charani’s interest in equity and representation in infection-related global health research led to a study of how visual representation through the images we use in global health provides a window into the need for intersectional approaches that consider how current practices stigmatise and marginalise populations. The team developed a framework which has received widespread attention and led to changes in editorial practices across the Lancet journals. Having worked with UCT since 2018, Dr Charani submitted a successful Wellcome Trust Career Development Fellowship via UCT in 2022. The fellowship officially began in October 2023 and will focus on studying the sociocultural determinants of health-seeking and health providing behaviours in relation to antibiotic resistant and drug resistant infections. This work is planned across South Africa and India and is linked to the CAMO-Net programme of work (Prof Mendelson SA PI) also funded by the Wellcome Trust. Following on from this and with further funding from the Wellcome Trust, the team have been partnering with Eh!Woza, led by CIDRI-Africa’s Dr Anastasia Koch and Ed Young, an Artist and PhD student at UCT, to work with youth in Khayelitsha and explore what equitable representation means to different communities. This builds on additional grants awarded to the department to Prof Dlamini and Dr Charani to investigate power and representation in global health. Dr Charani as led the team through an additional successful grant via the WHO and UNICEF Programme for Research and Training in Tropical Diseases grant to build on their community engagement and stakeholder mapping work in India and South Africa working with Eh!Woza and the One Health Trust in India.
Date: 16 November 2023