Health Care Delivery and New Infrastructure Development: REG Supplement to Study the "Bottom Road" and Associated Changes in Health Provisioning and Health Perceptions in Zambia's Gwembe Valley

Health impacts of mobility have been well documented by a broad range of scholarship. From the link between the spread of HIV and transport corridors, to the ways that human migration into new ecosystems exposes people to new diseases, it is clear that human mobility is intertwined with health and wellbeing. The proposed research is an exploratory ethnographic investigation of changing health dynamics in rural communities where a new road eases mobility, brings opportunities for increased economic activity, and facilitates access to previously restricted ecosystems. In this project an MA student (Alyssa Farmer) in Anthropology at the University of Kentucky will examine how a new road (the “Bottom road” in the Middle Zambezi River Valley, constructed in 2016) impacts provisioning of health care and the perceived health for people living in the Gwembe Valley of Zambia. This REG project will be carried out in conjunction with Lisa Cliggett’s currently funded research project on “The Economic and Social Impacts of New Infrastructural Development in Rural Areas.” Prior to the 2016 construction of the “Bottom Road” two established rural health care centers existed along the Kariba Lakeshore – each accessed by different primary supply roads from opposing ends of the Gwembe Valley (southern access via the Monze town feeder road, northern access via the Lusaka-Chirundu feeder road). Residents living in the approximately 80 miles of lakeshore communities between these two centers were forced to walk, bicycle or motorbike over rough trails when in need of health care. With the new road, district health centers can now send health teams on day trips to rural communities to offer basic health services, as well as establish new health posts in these communities. Residents can also more easily access services as needed, due to ease of mobility on the new corridor, including public transport and a paved surface. In this context of eased health care access, this research project asks “how does the construction of a new road impact health care delivery, and local people’s perceptions of their overall health?” Through participant observation and semi-structured interviews with residents and health care workers in three Gwembe communities (2 where Cliggett will be conducting research, and the government center where district health offices are found) Alyssa Farmer will document: 1) recent changes in Zambian government health provisioning (new clinics, health posts, or visiting health care providers) along the road corridor, 2) document health care providers views about how the road impacts the health (for better and worse) of the communities previously isolated from easy health care access and 3) document local people’s perceptions of their community’s health status. This research contributes to emerging scholarship on the social, economic and symbolic impacts of infrastructure development.