The Convergence of Emic and Etic Views: A Health Governance Model
The maternal and child health situation in any population is the reflection of health services available to the same population. Coincidence of having extremely poor level of such situations (IMR and MMR being highest for decades) vis-à-vis a lagging health service system both in terms of delivery and utilization, Orissa, an eastern state of India presents a typical example. Often studies have tried to understand these problems as an outsider’s perspective (Etic) without putting the service providers and users views (Emic) in a common platform ignoring the probability of convergence of ideas. Against these backdrops, the current study aims to examine the emic and etic approaches possibly involved in governance, delivery and utilization aspects of maternal & child health system. A fieldwork based primary study was conducted taking a district as a case for generalization. Samples were selected through a proportional sampling design. Both quantitative and qualitative information were gathered from health service providers at different levels, right from ANM (nurse) to doctors and Director (policy makers). The results have been quite eye-openers. The availability of doctors, medicines, quality (effectiveness) rather than quantity, health and hygiene information etc. have emerged to be significant factors for better service utilization. In service delivery and governance aspect, the perception of grass root level and area level service provider in planning, implementation and program level are found to be important factors. Finally, a convergence of the emic and etic views at all level of service providers and users has created a ground to possibility of focused interventions in service delivery design.
Keywords: Emic Views, Etic Views, Governance, Convergence, Orissa, India, Health Care
Dr. Satyajeet Nanda
Associate Professor, Social and Development Communication, Mudra Institute of Communications Research