Intended for healthcare professionals

Rapid response to:

Education And Debate

Anthropology in health research: from qualitative methods to multidisciplinarity

BMJ 2002; 325 doi: (Published 27 July 2002) Cite this as: BMJ 2002;325:210

Rapid Response:

Seeing is believing: the value of anthropolgy in health research

Lambert and McKevitt's recent article(1) makes a number of important
points regarding the value of integrating a truly anthropological approach
in health research. It also raises new challenges to those steeped in the
positivist traditions still dominant in this area. Is the medical
fraternity really ready to adopt an anthropological paradigm focusing on
empirical particularity and social and cultural specificity? It is one
thing to run a focus group, or append a few touchy-feely questions to the
end of a interview schedule, or even to develop a multi-indicator
qualitative study as is the case in much of the highly fashionable rapid
assessments (2); but it is quite another to embrace wholeheartedly the
theoretical complexities of anthropology. This would mean moving away from
a bland acceptance of self-reports in the form of the spoken and written
word towards cultural and contextual interpretations and direct
observation. This is not a new line of argument, but what Lambert and
McKevitt (1)add to the debate is the call for theory not to be detached
from method. Anthroplogy without rationality and classification is like
epidemiology without probabilty and randomisation.

Anthropologists love to immerse themselves in the lifestyles and
mores of their research subject, classically for considerable periods of
time (3). Where this is not wholly viable then an ethnographic approach,
underpinned by anthropological theory can produce significant insights in
health research. This is certainly true in the field of research in which
I have been involved for the best part of two decades. Anthropology and
ethnography have highlighted the nuances of HIV risk-behaviour amongst
injecting drug users, noting, for example, the importance of drug
preparation techniques (4), cultural and contextual specificity (5) and
the sharing of injecting paraphernalia (6). Such research can provide
fascinating insights into behaviour and meaning, but can also have
practical and clinical ramifications and implications. There is certainly
an untapped potential for utilising the skills and theories of
anthropology in many areas of health research.

For those of us happily working in what has become a broad church of
health related qualitative research, the notion of a truly theorised
anthropolgy is an exciting prospect. For our epidemiological and clinical
colleagues this may be another difficult challenge. But then again, who,
ten years ago, would have predicted the respected medical press would be
giving so much careful thought and consideration to the role and status of
qualitative social science in mainstream health research?

1. Lambert H and McKevitt "Anthropology in health research: from
qualitative methods to multidisciplinarity." BMJ 2002;325:210-213.

2. Rhodes T, Stimson G, Fitch C et al "Rapid assessment, injecting
drug use and public health. Lancet 1999; 354:65-68.

3. Whyte W.F. "Street corner society." 1955; Chicago: University of
Chicago Press.

4. Grund J-P, Adriaans N and Blanken P. "Drug sharing and HIV
transmission risks: the practice of frontloading in the Dutch injection
drug users population." Journal of Psychoactive Drugs 1991;23: 1-10

5. Power R, "Rapid assessment of the drug injecting situation at
Hanoi and Ho Chi Minh City, Vietnam." Bulletin of Narcotics 1996;48:89-99.

6. Koester S, Booth R and Wiebel W. "The risk of HIV transmission
from sharing ater, drug mixing ci=ontainers and cotton filters among IV
drug users." International Journal of Drug Policy 1991; 1: 28-31.

Competing interests: No competing interests

14 August 2002
Robert M Power
Reader in Social Science
Department of STDs, Royal Free & University College Medical School, London, WC1E 6AU