SANTINELLES in West Africa: Conceptual Underpinnings

The SANTINELLES project (2012-2015) in Bobo Dioulasso (Burkina Faso) and Saint-Louis (Senegal) employed a comparative transdisciplinary approach to highlight three inter-related processes in the production of health... [ view full abstract ]

The SANTINELLES project (2012-2015) in Bobo Dioulasso (Burkina Faso) and Saint-Louis (Senegal) employed a comparative transdisciplinary approach to highlight three inter-related processes in the production of health inequalities: inequalities in exposure to health risks, socio-spatial inequalities in health status, and the effects of socio-spatial inequalities on meeting health needs. Examining these processes in each research site allowed us to evaluate the links between vulnerability, risk, and inequality and to understand the socio-spatial production of health. This paper explains how we operationalized these key concepts to design a multi-sited, multi-method comparative research project. We will highlight the following dimensions of the project: (1) our assertion that health inequalities in urban neighborhoods reflect the social production and management of urban space; and therefore it is these processes that reveal the genesis of urban health disparities; (2) by using a variety of bio-markers, both infectious and non-infectious, we measured the prevalence of intra-urban health disparities and produced health profiles of subgroups to demonstrate how the accumulation of pathologies affects particular segments of the urban population; (3) we examined access to health care in a holistic fashion, considering relations of solidarity (among neighbors, across generations), understandings of illness and disease etiology, gender relations, geographic proximity to biomedical facilities, medical pluralism, and the influence of therapy managing groups; and (4), we argue that urban space and urban settings reflect historical, social, political, and environmental processes, and the convergence of these factors produces health disparities. Our approach moves beyond merely measuring socio-spatial health inequalities to develop a more robust concept of the socio-territorial production of health.

Key words: chronic disease, West Africa, socio-territorial processes, health inequalities

Note-This paper abstract is submitted as part of the panel “Socio-territorial approaches to health: a multi-disciplinary study of urban health inequalities in West Africa.”