Adrienne Strong

Medical anthropology, maternal mortality, hospital ethnography, and dignity in women's health care

I am a medical anthropologist and Assistant Professor of Anthropology at the University of Florida with a joint Ph.D. from Washington University in St. Louis, USA and the Universiteit van Amsterdam in the Netherlands. I study maternal mortality and women's health in Tanzania, currently in the Kigoma region on a birth companionship program and the notions of ideal comfort, care, and support for pregnant women in labor. Before my current position, I was a National Science Foundation Postdoctoral Research Fellow with Columbia University's Mailman School of Health, in the Averting Maternal Death and Disability (AMDD) Program in the Heilbrunn Department of Population and Family Health and a Fellow at the Columbia Population Research Center.

My current book project, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, under contract with University of California Press, focuses on the inner workings of a government regional referral hospital in Tanzania, examining how institutional structures related to hierarchy, bureaucracy, historical precedents, communication and other factors, may influence the capacity of the institution to provide effective maternal healthcare during times of obstetric crisis. My research focuses on biomedical healthcare providers and administrators, groups that are often overlooked in the context of medical anthropology in sub-Saharan Africa. I contextualize the hospital ethnography with interviews, participant observation, and focus group discussions in communities throughout the region, as well as through the use of primary archival sources from the colonial and post-independence eras. This is the first ethnography to examine the issue of maternal mortality in a low resource setting from this perspective and in the setting of a biomedical facility, complementing the existing work of anthropologists of reproduction who have worked at the community level.

I worked in the Rukwa Region for my PhD fieldwork, which I conducted from January 2014- August 2015. From September 2010 through July 2011, I conducted research on access to healthcare services during pregnancy, birth, and the postpartum period in the Singida Region of Tanzania. My most recent project was about a birth companion pilot program in the Kigoma region of Tanzania from January through December 2018, which focused on the ways in which companions impact the social dynamics of health center maternity wards and the care provided in those settings. This project also included an 80-question cultural consensus survey and analysis around the cultural domain of care and support for pregnant women.

This is my personal website, which includes updates on my research, collaborations, conference presentations and papers, publications, teaching, and critical responses to current events related to women's health and reproduction.

Mentions and Public Anthropology

Paper Prize

Washington University Feature

Feature on Anthropology Department Website

Research Report on Global Health Hub

Photoessay on

Mention on Anthrodendum

Mention on Anthrodendum for fieldwork blog

General Life Update (because it's been too long since I last wrote)

Lots of things have been happening around here lately! In order to cover something in depth, I'm going to do a shorter, general update today and get back to a longer post, hopefully in the next week or so.

First, I am happy to report I have been awarded a Fulbright-Hays Doctoral Dissertation Abroad grant for this research! I found out last week and couldn't be more thrilled and grateful for the money and recognition. I am incredibly thankful for all my letter writers, proof readers, moral supporters and idea exchangers! Hopefully the money will start within the next month.

Second of all, for anyone who knows about my travails at the office of the Tanzania National Institutes for Medical Research, you will know how happy I am to have gotten the news today that my ethical clearance renewal certificate has finally been signed and is ready for pick up. This means, hopefully, that I won't have to deal with them again for quite some time! Hallelujah! They are my favorite bureaucracy to hate but I think they are trying to get themselves in order and I've seen some improvements in their communication and website of late. If anyone reading this ever needs advice on working with them to conduct medical research in Tanzania, let me know, I'm kind of an expert these days.

Third, one of my very good friends here and his wife just welcomed into this world a beautiful baby boy on Saturday. I'm so happy for them! Their three year old daughter seems to be excited about her role as a big sister, though she was dismayed when she was told she couldn't try to teach the baby how to read just yet.

I just finished writing the draft of a chapter for a textbook on maternal mortality which is set to come out next year sometime. I'm waiting for comments from the editor and reviewers but am very happy to have that off the docket for the moment. I am still working with the Medical Officer In Charge of the hospital to write a second chapter for the same book, which presents three case studies of maternal deaths that have occurred in the last year and offers some of our insights about how we might have prevented these deaths and what we need in the region in order to prevent similar deaths in the future. 

Since finishing the book chapter, I am back to collecting data again full force. Lots of good conversations in the last week and I've nailed down a research assistant who is diligently working to help me transcribe hours of recorded meetings, group discussions, and interviews. We're planning on going to some villages to talk with peripheral health care providers and community members starting within the next month. We have to get some trips in before the rains start again in November! 

My favorite unfolding line of inquiry at the moment has to do with uniforms. The maternity staff has been reprimanded by the hospital Patron (who is in charge of all the nurses) for not wearing proper uniforms. I think this deserves its own post so look for that later. It might not sound exciting but I think it actually encapsulates many of the challenges the nurses face, speaks to issues of provider morale and motivation, and the disconnect between maternity and the hospital administration. So, I'll leave you with that until next time! Back to the emails and transcriptions!



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