Colouring Outside the Lines: Decolonized Approaches to Sexual and Reproductive Health

Abstract

Decolonization of global health as an approach to redressing historical inequities and power imbalances has been popularized in recent years due to its focus on centering community needs, knowledge, and experiences, and decentering western imperialism. It is of particular importance as an approach to sexual and reproductive health (SRH) research, which often focuses on taboo topics with vulnerable populations. Despite the increase in its use, the term decolonization still lacks a shared definition, and there is little guidance on how to apply it in practice. The goal of this thesis is to understand, explore, and apply the elements of decolonized research through the lens of SRH. This thesis contributes to a shared definition of decolonized research, and provides guidance for global health practitioners in its application in four chapters. First, a scoping review identifies the shared characteristics of decolonized research on SRH topics. Second, a decolonized arts-based study applies the findings from the scoping review, to explore the priority SRH needs of adolescent girls and young women in Cape Town, South Africa. Third, a methods paper explores the methodological findings from the previous chapter, including the development of a novel data collection method, and provides guidance for other researchers. Finally, an arts-based chapter shares experiences surrounding the project from the perspective of the researchers and community members in South Africa. The findings from these studies illustrate the importance of researchers and implementors prioritizing community-owned approaches to research that focus on long-term sustainable change, acknowledging and redressing the impact of historical inequities and power imbalances. Applying decolonized research methodologies leads to greater justice and equity for communities, as well as more valid and reliable data. Future research should continue to explore a standardized definition of decolonized research methodologies and a framework for incorporating these strategies into global health research and praxis.