A taxonomy of global health: a qualitative analysis at a large academic health sciences centre

• Main Authors: Dr. Barry N Pakes, MD MPH PhD, Donald C Cole, MD MSc
• Format: Article
• Language: English
• Published: Elsevier 2014-05-01
• Series: The Lancet Global Health
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214109X15700537

Background: Despite numerous published definitions of global health, both colloquial and academic notions of global health vary widely. We developed a taxonomy of global health for use at one of the largest academic health science universities in North America. This taxonomy should provide a conceptual and organisational framework with which to efficiently align educational programmes and research projects, and to enhance collaboration and strategic planning. Methods: The initial phase of this research programme involved data from a variety of sources: postgraduate physician trainee applications to global health programmes and trainee surveys, clinician applications to global health continuing education programmes, minutes of faculty meetings from the School of Public Health Global Health Division Faculty, and stated academic interests and publications of global health faculty. Data were open coded with accepted qualitative methods. Frequencies were noted and inductive analysis was used to develop the taxonomy. Findings: Three axes of classifying global health emerged from the data—one practical, one conceptual, and one relational. The practical axis refers to the so-called target or location of global health interventions or activities; these included countries with low or middle incomes traditionally considered so-called international health, and marginalised or vulnerable populations in inner cities, aboriginal peoples, immigrants and refugees, and very low-income groups. The conceptual axis showed disciplinary tensions, for example, the role of technology versus an emphasis on social determinants of health. The varying understandings of notions of justice, equity, equality, and fairness were also prominent. The relational axis focused on partnerships, interdisciplinarity, and inclusion of alternative local and non-traditional perspectives on health issues. Interpretation: The concept of global health cannot, and perhaps ought not, be rigidly defined. Our empirically derived taxonomy of global health deserves testing by others, as does its application in the organisation of global health activities at our and other academic health sciences centres. Funding: None.