Echoing calls from Nesta and The Lancet to “burst the biomedical bubble,” Sonar-Global aims to promote more extensive collaboration between the social and the medical sciences. However desirable, interdisciplinary research projects are challenging. Just some of the problems that I encountered over the past decade include distinct and sometimes obscure disciplinary “languages” and jargon, implicit disciplinary hierarchies, disagreements about the relevance of a research problem, or different and sometimes incompatible approaches to doing research.
Such frictions are symptomatic of deeper-rooted disciplinary divides, like researchers’ attitudes towards ambiguity. Project management and communication tools like having a project mediator with experience in interdisciplinary work or a clear role allocation for every project member can offer short-term relief. But to address deeper-rooted divides rather than just the symptoms of interdisciplinary friction requires institutional solutions and increased socio-medical research capacity, for instance through research internships at the training and early career stage.
Overcoming such problems is tricky but rewarding. To give you a glimpse of the opportunities resulting from a successful collaboration between the medical and social sciences, here are three examples from our recent work on antimicrobial resistance in Southeast Asia:
We recently integrated a social research study into a clinical trial of point-of-care biomarker tests to guide antibiotic prescriptions on the primary care level in Thailand and Myanmar. Qualitative research surrounding the clinical trial did not only help us to understand what fever and antibiotics meant for trial participants (and therefore how data from the trial’s case report forms should be interpreted). It also enabled a broader assessment of the intended and unintended outcomes of the biomarker test and how perceived infectious disease risks, the health system context, and healthcare demand influenced the operation of these trials across countries.
As part of a large-scale health behaviour survey, we organised public engagement workshops with 25 to 35 participants in five villages in Thailand and Laos. The workshops were designed to share information about drug resistance and to learn from the villagers themselves about their understanding and uses of medicine, rather than to change behaviours or “mobilise communities.” And yet, a comprehensive social research assessment demonstrated how a villager in Thailand gained so much confidence in the subject that she started selling antibiotics, while in Laos information about the workshops appeared to circulate mostly among more privileged segments of the villages. At the same time, insights from the villagers also enabled our team to formulate and test new hypotheses about people’s attitudes and uses of antibiotics.
Social scientists, too, stand to gain from closer integration into public health research and practice. Although our initial task was to inform medical research activities, our research team uncovered new questions of relevance in global health and beyond. Do social networks reinforce entrenched behaviours? What are substitutes for antibiotic use if we look at the problem from a strategic marketing perspective? What can we learn from antibiotic use for a more general social theory of human behaviour? Through such reflections, our research team has now reached a point where we combine development studies and behavioural sciences approaches to ask whether precarious living conditions in low- and middle-income countries may contribute to drug resistance.
If we can bridge the gaps successfully, then interdisciplinary collaboration between the medical and social sciences does not only offer constructive and unconventional routes for tackling global health challenges. It can also create new impulses for social theory within and beyond health.
Social context of point-of-care biomarker tests
Health behaviour survey protocol
Marco J Haenssgen is a social scientist with a background in management and international development and experience in aid evaluation, intergovernmental policymaking, and management consulting. His research emphasizes marginalization and health behavior in the context of health policy implementation, technology diffusion, and antimicrobial resistance with a geographical focus on Southeast Asia.
Follow @HaenssgenJ on Twitter.