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Research Article

You have to do some dhora-dhori’: achieving medical maternal health expectations through trust as social practice in Bangladesh

orcid-imageJanet E Perkinsemail-imageJanet E Perkins

Janet E Perkins is a Research Fellow in the Department of Social Anthropology at the University of Edinburgh. Her research focuses on the social and cultural dimensions of biomedical technologies, particularly those designed to reshape pregnancy and childbirth, child health care, poisoning diagnosis and treatment, and global health practice. Her research is primarily focused on Bangladesh, however she has also collaborated in health programs and research in Sri Lanka, Burkina Faso, Pakistan and Afghanistan. Outside academia, she spent nearly a decade working in global health programming and policy in the non-profit sector and with the World Health Organization.

email-image janet.perkins@ed.ac.uk

Abstract

In contrast to prevailing conceptualisations of ‘trust’ as an object in popular and political discourses, this article takes the concept of trust as future-oriented practice as a launching pad for understanding relationships between people and medical systems in Bangladesh. Based on ethnographic fieldwork in Bangladeshi peri-urban and rural spaces, it focuses on expectations related to advanced maternal biomedical technologies delivered through medical institutions. These technologies have recently come to dominate practices and expectations around pregnancy and childbirth care and women’s navigations of health systems to realise these expectations. Within this context, trust in institutions in the public or private health sectors remains peripheral to women’s experiences of accessing desired maternal health resources. Rather, women leverage social connectedness through the patronage-related practice of dhora-dhori, translated as mutual grasping or holding. Dhora-dhori is based on social rootedness, trust in that rootedness, and reciprocity. Women act as embedded agents within their families to appeal to various social connections through dhora-dhori to tactically access desired services and resources, with the expectation that this will result in better care at a lower cost, whether in public or private health sectors. It is through such practice that women and families work to realise their expectations of care through institutions, collapsing distinctions between ‘trust’ in personal relationships and ‘trust’ in institutions, as it is through intimate relationships that relationships with medical institutions are engaged.

Keywords

trusthealth systemsmaternal healthchildbirthethnographyBangladesh
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Published on: 19 December 2023
Volume: 11
Issue: Supplementary issue 6
Article ID: 031
Pages:31 - 48
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© The author(s) 2023.
Cite this article
Perkins (2023), ' You have to do some dhora-dhori’: achieving medical maternal health expectations through trust as social practice in Bangladesh ', Journal of the British Academy, 11(Supplementary issue 6): 031 https://doi.org/10.5871/jba/011s6.031

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Normal View Dyslexic View

You have to do some dhora-dhori’: achieving medical maternal health expectations through trust as social practice in Bangladesh

orcid-imageJanet E Perkinsemail-imageJanet E Perkins

Janet E Perkins is a Research Fellow in the Department of Social Anthropology at the University of Edinburgh. Her research focuses on the social and cultural dimensions of biomedical technologies, particularly those designed to reshape pregnancy and childbirth, child health care, poisoning diagnosis and treatment, and global health practice. Her research is primarily focused on Bangladesh, however she has also collaborated in health programs and research in Sri Lanka, Burkina Faso, Pakistan and Afghanistan. Outside academia, she spent nearly a decade working in global health programming and policy in the non-profit sector and with the World Health Organization.

email-image janet.perkins@ed.ac.uk