Ruth Prince' project on ‘Universal health coverage and the public good in Africa’ has explored how African governments are experimenting with expanding forms of social and financial protection and welfare on a continent still suffering from effects of structural adjustment and state austerity. 

Universal Health Coverage in Unequal Systems

Moves towards universal health coverage, defined by the WHO as ‘ensuring everyone has access to the healthcare they need without financial hardship’, appear to endorse greater state responsibility for the welfare of its citizens. However, such moves take place in health systems that are already deeply stratified and inequitable and amidst state-sponsored expansion of private health care and financial capitalism, all of which water down visions of ‘universal’ towards minimalist interventions targeted at particular beneficiaries, such as ‘the poor’.

Prince' research in Kenya explored attempts to expand formal systems of protection as they took shape in these unequal landscapes, through following civil servants and health workers as they tried to translate policies into practices and through following the experiences of ordinary citizens as well as ‘beneficiaries’. 

Informal Solidarity and Social Protection

In this talk, Prince turns to the other side of the coin and examines informal forms of solidarity and socio-economic support and how these intersect with more formal systems of social protection, in contexts where many citizens experience their social networks or membership of various mutual aid or savings groups as more reliable than formal systems such as health insurance.

Ruth Prince draws upon fieldwork in Kenya to explore the ways in which people seek out, invest in, and negotiate social relations and networks, as well as associations and mutual aid groups amidst increasing precarity, socioeconomic vulnerability and class closure. The local idiom of ‘pressure’ (see Schmidt 2022, 2024) offers insights into the interactions between economic, health and medical precarities and how these are reshaping and limiting solidarities and the relations and networks they are embedded in. As livelihoods are being squeezed, forms of solidarity and their boundaries are being carefully negotiated.

About Ruth Prince

Ruth Prince is professor of medical anthropology at the University of Oslo. From 2018-24 she led an ERC-funded project, ‘Universal Health Coverage and the Public Good in Africa’, studying relations between healthcare, welfare, the state, and citizenship in Africa (UNIVERSAL HEALTH).

Her research explored the Kenyan state’s experiments with expanding health insurance, access to health care, and social protection, following the aspirations and efforts of Kenyan state bureaucrats and medical professionals, as well as how people negotiate formal and informal forms of social protection and mutual support.

She also co-leads two collaborative research projects: one on ‘Pesticides and Protection in Tanzania’, which explores the afterlives of dieldrin spraying in Pare Valley, Tanzania (Epidemic Traces), the other on the afterlives of the Covid-19 pandemic in Kenya (Epidemics and African Health Systems). 

Recent publications include an article in American Ethnologist on Private health care and the vulnerable middle class in Kenya (2023), a special issue in Social Anthropology/Anthropologie Sociale (2022) on Curious Utopias, and a special issue in Social Science and Medicine (2023)on Health for all?.

Livestream

If you are not able to join in person, you can also follow the talk and discussion via the livestream.