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Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea

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  • Shih, P.
  • Worth, H.
  • Travaglia, J.
  • Kelly-Hanku, A.

Abstract

In his conceptualisation of pastoral power, Michel Foucault argues that modern healthcare practices derive a specific power technique from pastors of the early Christian church. As experts in a position of authority, pastors practise the care of others through implicitly guiding them towards thoughts and actions that effect self-care, and towards a predefined realm of acceptable conduct, thus having a regulatory effect. This qualitative study of healthcare workers from two Christian faith-based organisations in Papua New Guinea examines the pastoral rationalities of HIV prevention practices which draw together globally circulated modern medical knowledge and Christian teachings in sexual morality for implicit social regulation. Community-based HIV awareness education, voluntary counselling and testing services, mobile outreach, and economic empowerment programs are standardised by promoting behavioural choice and individual responsibility for health. Through pastoral rationalities of care, healthcare practices become part of the social production of negative differences, and condemn those who become ill due to perceived immorality. This emphasis assumes that all individuals are equal in their ability to make behavioural choices, and downplays social inequality and structural drivers of HIV risk that are outside individual control. Given healthcare workers’ recognition of the structural drivers of HIV, yet the lack of language and practical strategies to address these issues, political commitment is needed to enhance structural competency among HIV prevention programs and healthcare workers.

Suggested Citation

  • Shih, P. & Worth, H. & Travaglia, J. & Kelly-Hanku, A., 2017. "Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea," Social Science & Medicine, Elsevier, vol. 193(C), pages 51-58.
    • Handle: RePEc:eee:socmed:v:193:y:2017:i:c:p:51-58
    DOI: 10.1016/j.socscimed.2017.09.049
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    References listed on IDEAS

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    1. Metzl, Jonathan M. & Hansen, Helena, 2014. "Structural competency: Theorizing a new medical engagement with stigma and inequality," Social Science & Medicine, Elsevier, vol. 103(C), pages 126-133.
    2. Parker, Richard & Aggleton, Peter, 2003. "HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action," Social Science & Medicine, Elsevier, vol. 57(1), pages 13-24, July.
    3. Crawshaw, Paul, 2012. "Governing at a distance: Social marketing and the (bio) politics of responsibility," Social Science & Medicine, Elsevier, vol. 75(1), pages 200-207.
    4. Waring, Justin & Latif, Asam & Boyd, Matthew & Barber, Nick & Elliott, Rachel, 2016. "Pastoral power in the community pharmacy: A Foucauldian analysis of services to promote patient adherence to new medicine use," Social Science & Medicine, Elsevier, vol. 148(C), pages 123-130.
    5. Murray, Laura R. & Garcia, Jonathan & Muñoz-Laboy, Miguel & Parker, Richard G., 2011. "Strange bedfellows: The Catholic Church and Brazilian National AIDS Program in the response to HIV/AIDS in Brazil," Social Science & Medicine, Elsevier, vol. 72(6), pages 945-952, March.
    6. Brijnath, Bianca & Antoniades, Josefine, 2016. "“I'm running my depression:” Self-management of depression in neoliberal Australia," Social Science & Medicine, Elsevier, vol. 152(C), pages 1-8.
    7. Kelly-Hanku, Angela & Aggleton, Peter & Shih, Patti, 2014. "‘We call it a virus but I want to say it's the devil inside’: Redemption, moral reform and relationships with God among people living with HIV in Papua New Guinea," Social Science & Medicine, Elsevier, vol. 119(C), pages 106-113.
    8. Derick W. Brinkerhoff & Volker A. Hauck, 2010. "The role of churches in creating social capital and improving governance in Papua New Guinea: Lessons for working in fragile situations," Public Administration & Development, Blackwell Publishing, vol. 30(1), pages 49-65, February.
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    Cited by:

    1. Butler, Clare, 2019. "Working the 'wise’ in speech and language therapy: Evidence-based practice, biopolitics and ‘pastoral labour’," Social Science & Medicine, Elsevier, vol. 230(C), pages 1-8.

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