Difficulty: Intermediate | Prerequisites: Module 3 notes on Alma-Ata, selective PHC, and neoliberalism.
Module 4 shifts the question from "what happened in global health policy" to "how should anthropologists study global health." Two articles set up a productive tension: Janes and Corbett lay out a structured, applied framework with four research domains, while Pigg argues for a more critical, observational stance that resists rushing to intervene. This debate, applied vs. critical anthropology, runs through the entire course and shows up whenever you are asked how social science should relate to health policy and practice. You need the Module 3 material (Alma-Ata, SPHC, neoliberalism) as background, because both articles respond to the same policy landscape.
Janes and Corbett define global health as a field linking health to global processes and propose four domains where anthropology can contribute. Pigg pushes back, arguing anthropologists should observe global health "in-the-becoming" rather than jumping straight to applied solutions. The course treats both approaches as valuable: applied work measures and monitors, while critical work asks whether we are measuring the right things.
Global health (as defined by Janes and Corbett)
An area of research and practice that links health outcomes to global processes, including trade, migration, governance, and environmental change. It positions health as inseparable from political, economic, and social systems.
In simple terms, global health is not just "medicine in other countries." It is the study of how worldwide forces shape who gets sick and who gets treated.
Four domains of anthropological contribution (Janes and Corbett)
The four areas where anthropology can engage with global health: (1) health inequities and social determinants, (2) global technoscience, (3) global health policies, and (4) civil society organisations.
Think of these as four lenses anthropologists can use to examine the same global health landscape from different angles.
Global health in-the-becoming (Pigg)
Pigg's concept that global health is not a fixed object to be studied but an ongoing, emergent process. Anthropologists should observe how global health is constructed, contested, and redefined in real time, rather than accepting existing definitions as given.
In simple terms, Pigg says: do not take "global health" at face value. Watch how it is being made and remade, and ask who benefits from each version.
Applied approach (to global health anthropology)
An orientation that prioritises practical engagement: measuring, monitoring, and intervening in health issues. Janes and Corbett's four-domain framework exemplifies this. The goal is to reduce global health inequities and contribute to development.
Think of it as the "roll up your sleeves" school: define the problem, collect data, propose solutions.
Critical approach (to global health anthropology)
An orientation that prioritises observation, reflexivity, and questioning the assumptions built into global health interventions. Pigg's "sitting, not doing" stance exemplifies this. The goal is deeper understanding before (or instead of) action.
Think of it as the "step back and think" school: before you intervene, understand why the problem looks the way it does and who framed it that way.
Social determinants of health
The non-medical factors that influence health outcomes: income, education, employment, housing, discrimination, political structures. A core concept across medical anthropology and public health.
In simple terms, your health depends on far more than whether a doctor is available. It depends on whether you can afford to see one, whether your neighbourhood is safe, and whether the system is built for people like you.
Global health is defined as an area of research and practice linking health to global processes.
Anthropology's contribution is organised into four domains:
Health inequities and social determinants: studying how poverty, racism, gender, and political structures produce unequal health outcomes.
Global technoscience : examining how medical technologies, pharmaceuticals, and scientific knowledge travel across borders and are adapted (or resisted) locally.
Global health policies : analysing how international policy frameworks (WHO guidelines, donor priorities, trade agreements) shape what gets funded and who gets treated.
Civil society organisations : understanding the role of NGOs, advocacy groups, and community organisations in shaping health agendas from below.
Ultimate goal: reduce global health inequities and contribute to political, economic, and cultural development.
This is an applied framework: it assumes anthropologists should actively engage with health systems and policy, not merely observe them.
Pigg criticised Janes and Corbett's framework as too neatly defined and too quick to prescribe action.
Core argument: anthropologists should study global health "in-the-becoming," treating it as an emergent, contested process rather than a stable object with clear boundaries.
"Sitting, not doing" : Pigg's metaphor for the value of sustained observation over immediate intervention. Taking action too quickly risks reproducing the very power structures anthropologists should be questioning.
The critical approach does not reject action altogether. It argues that understanding should precede intervention, and that some problems look different once you have watched them long enough.
The applied approach (Janes and Corbett) pushes for measurement, monitoring, and practical engagement. It asks: what can anthropology do about health inequity right now?
The critical approach (Pigg) pushes for reflexivity and deeper analysis. It asks: are we framing the problem correctly, and whose interests does our framing serve?
The course position: both are important. Applied work without critical reflection risks perpetuating harm; critical work without practical engagement risks irrelevance.
"Pigg thinks anthropologists should do nothing." "Sitting, not doing" does not mean inaction. It means sustained observation and critical analysis before (or alongside) intervention. Pigg is arguing for a different kind of engagement, not disengagement.
"Janes and Corbett's four domains are separate, non-overlapping fields." In practice the domains overlap significantly. A study of an NGO (civil society) distributing antiretrovirals (technoscience) in a country under SAPs (global policy) to address HIV disparities (health inequities) touches all four at once.
"Applied and critical approaches are opposed and mutually exclusive." The course treats them as complementary. The exam-relevant position is that both are needed: applied work that is critically informed, and critical work that remains relevant to real health problems.
"Global health is just international medicine." Janes and Corbett specifically define it as linking health to global processes (trade, governance, migration), which is broader than delivering medical services across borders.
⚠️ Be able to name and briefly describe all four of Janes and Corbett's domains. This is a standard recall question.
⚠️ Understand Pigg's critique in your own words: what exactly does she think is wrong with Janes and Corbett's approach, and what does she propose instead?
⚠️ "Global health in-the-becoming" is a distinctive concept. Be ready to define it and explain why Pigg considers it important.
⚠️ The applied vs. critical tension is likely to appear as an essay or short-answer question. Prepare a position that acknowledges both sides.
⚠️ Connect this module back to Module 3: how do the policy failures discussed there (SAPs, user fees, commodification) illustrate why Pigg's critical stance might be necessary?
True or False: Janes and Corbett define global health as the delivery of medical services to developing countries.
Fill in the blank: The four domains of anthropological contribution are health inequities and social determinants, global __________, global health __________, and civil society __________.
True or False: Pigg's concept of "sitting, not doing" means anthropologists should avoid fieldwork in health settings.
Fill in the blank: Pigg argues anthropologists should study global health "__________" rather than treating it as a fixed object.
True or False: The course concludes that applied and critical approaches are both important to global health anthropology.
Answers: 1. False (they define it as linking health to global processes). 2. technoscience; policies; organisations. 3. False (it means sustained observation before/alongside intervention). 4. in-the-becoming. 5. True.
Q: What are the four domains Janes and Corbett identify for anthropological engagement with global health, and what is their stated goal?
A: The four domains are (1) health inequities and social determinants, (2) global technoscience, (3) global health policies, and (4) civil society organisations. Their goal is to reduce global health inequities and contribute to political, economic, and cultural development.
Q: How does Pigg's approach differ from Janes and Corbett's, and what does "global health in-the-becoming" mean?
A: Pigg argues that Janes and Corbett define global health too neatly and move too quickly to applied action. "Global health in-the-becoming" means treating global health as an emergent, contested process that anthropologists should observe and analyse as it unfolds, rather than accepting existing definitions and jumping to intervention.
Q: Explain the distinction between applied and critical approaches in global health anthropology. Why does the course treat both as necessary?
A: The applied approach (Janes and Corbett) focuses on measuring, monitoring, and practically addressing health problems. The critical approach (Pigg) focuses on questioning assumptions, observing how problems are framed, and understanding power dynamics before intervening. Both are necessary because applied work without critical reflection can reproduce harmful structures, while critical work without practical relevance risks having no impact on the problems it studies.
Q: Give an example of how Module 3's discussion of neoliberal health policy supports Pigg's argument for a critical approach.
A: Selective PHC and structural adjustment were presented as practical, evidence-based solutions (applied logic), yet they worsened health access for the poorest populations. Pigg would argue this illustrates why rushing to "do something" without critically examining whose interests a policy serves can cause more harm than careful observation.
This module pairs directly with Module 3: the policy history there (Alma-Ata, selective PHC, neoliberalism) provides the concrete examples that Module 4's theoretical frameworks are meant to analyse. Janes and Corbett's "health inequities" domain maps onto the structural adjustment discussion; Pigg's critique maps onto the question of why those policies failed despite appearing rational.
The applied vs. critical debate resurfaces throughout the course whenever anthropologists are asked to advise, evaluate, or participate in health interventions. It also connects to broader anthropological discussions about positionality, power, and the ethics of fieldwork in settings of inequality.
Janes and Corbett, Pigg, global health anthropology, anthropology of global health, applied anthropology, critical anthropology, global health in-the-becoming, sitting not doing, four domains of anthropological contribution, health inequities, social determinants of health, global technoscience, global health policy, civil society organisations, NGOs and health, medical anthropology, reflexivity, positionality, ANT 3478, ANT3478, Module 4