Global Health and Development, Primary Health Care, Community Health Workers, Health Systems Strengthening, Food Insecurity, Water Insecurity, Mental Health, Maternal and Child Health, HIV/AIDS, Religion, Morality, and Ritual
Ethiopia, Sub-Saharan Africa, North America
I am a biocultural medical anthropologist interested in links between health workers, health policy, and health outcomes. At Oregon State University, I am a core faculty member of the Anthropology program within the School of Language, Culture & Society, and I direct the Applied Anthropology Graduate Program. I am also an adjunct faculty member in Humanitarian Engineering, Global Health, and Public Policy at Oregon State. Prior to joining OSU, I was a postdoctoral fellow at Brown University’s Population Studies & Training Center, an interdisciplinary demography center specializing in the study of population, health and development.
My colleagues and I are particularly interested in community health workers: women and men who engage in healthcare, community organizing, and advocacy at the community level, both inside and outside of clinics and hospitals. I study the well-being of community health workers themselves, the impacts of their work on population health, and the processes by which they seek influence over health policies and the conditions of their own employment. I also study how big global health institutions -- governments, NGOs, think tanks, donors, and foundations -- structure the quantity and quality of available community health worker jobs.
This work is rooted in one of the most central global health problems of the 21st century: the massive lack of health workers in contexts of poverty. Understanding this problem, and developing solutions to it, requires navigating connections between population health, politics, and society. Community Health Workers or CHWs, because of their intimate relationships with vulnerable community members, are thought to be uniquely capable of filling in massive labor gaps in health care systems around the world, thus improving health and reducing suffering in vulnerable populations. But around the world, many community health workers live in poverty, are poorly compensated, and lack secure employment. There are many reasons for this. One is the particular model of partnership that guides many of today’s global health initiatives, in which wealthy institutions provide drugs, medical technologies, and well-paid experts, while poor communities are expected to provide cheap labor. We live in a world with an extremely unequal distribution of wealth and power, and government and non-governmental health organizations are often unable or unwilling to provide better job conditions for CHWs.
Since 2006, my research has focused on CHWs in Ethiopia. Using data from surveys, participant observation, and in-depth interviews, my colleagues and I have shown that people become CHWs partly because they seek to uphold values of humble service to others in need. But people also hope that becoming a CHW will help them achieve freedom from economic insecurity within their own households. The research I conducted in Ethiopia's capital, Addis Ababa, during the 2007-8 global food crisis revealed that many CHWs experience moderate to severe household food insecurity, and that food insecurity is strongly associated with increased levels of psychological distress. From 2012 to 2016 I was Co-Principal Investigator (with Svea Closser, Middlebury College) on a research project funded by the National Science Foundation, focusing on Ethiopia's rural cadres of paid and unpaid CHWs, known as Health Extension Workers and Women's Development Army leaders, respectively. This project also focuses on the well-being of the health workers themselves, and their relationships with the communities they serve and the global institutions that rely on them. It highlights the importance of gendered power inequalities and social norms--from household to transnational policy levels--in shaping the experiences of community health workers. More recently, I have become an active member of the Oregon Community Health Worker Consortium, serving on the Research Team to advance our understanding of CHWs and the challenges they face here in Oregon.
To learn more about my work in Ethiopia, check out this story written by reporter Amy Costello and produced by Public Radio International’s program The World, and this short YouTube video that I produced with assistance from the Graduate School of Arts & Sciences at Emory University. You can also check out my commentary in the Bulletin of the World Health Organization, or this review of my recent book, The Lives of Community Health Workers.
My second area of research interest targets another grand challenge of our times: the daily lack of access to food and water experienced by people around the world. My colleagues and I are interested in measuring the complex experience of daily food and water insecurity, understanding the political, cultural and ecological determinants of food and water insecurity, and demonstrating the multiple negative impacts of food and water insecurity on individual and social wellbeing. I recently teamed up with a diverse array of colleagues to develop and apply measures of household water insecurity across the globe.
Assessing Oregon health system actors' willingness to partner with community health workers to address social determinants of health
Developing common metrics for evaluating community health worker programs in the U.S.
The Women’s Development Army in rural Ethiopia: discourses and experiences of health worker status, motivation, and well-being.
Water insecurity and psychological distress among women in Amhara, Ethiopia.
Examining the effects of polio eradication efforts on routine immunization and primary health care in Ethiopia.
Food Insecurity, well-being and motivations among volunteer HIV/AIDS caregivers in Addis Ababa, Ethiopia.
Working with graduate students
I am very interested to work with graduate students who question the intersections between health and society, with a focus on food and/or water insecurity, mental health, women's health, and social wellbeing. I am also very interested to work with students who question the roles of health workers in reducing health inequalities and poverty, and the constraints that CHWs face (and sometimes overcome) in improving their own job conditions. I am prepared to mentor graduate students in both qualitative and quantitative methods. I am particularly interested in the use of quantitative methods within ethnographic projects, and the use of ethnographic methods in implementation science -- that is, in projects studying the ground-level implementation of experimental and innovative protocols in health care and social service settings.
In recent years, graduate students working with me have been involved in projects in Ethiopia, Sierra Leone, and the United States, and have received research funding from the National Science Foundation’s Cultural Anthropology Program, and from the Sasakawa Young Leaders Fellowship Fund. I have served on the committees of numerous public health (MPH), anthropology (MA, PhD), and engineering (MS) graduate students.
I currently serve as the main advisor for the following OSU Anthropology graduate students:
PhD: Yihenew Tesfaye, Jamie Petts
MA: Massarra Eiwaz, Micknai Arefaine
2017. Maes, Kenneth. The Lives of Community Health Workers: Local Labor and Global Health in Urban Ethiopia. Routledge.
2015. Maes, Kenneth. Community Health Workers and Social Change: Global and Local Perspectives. Annals of Anthropological Practice 39(1).
2017 Closser, S, A. Rosenthal, J. Justice, K. Maes, M. Sultan, S. Banerji, H. Banteyerga, R. Gopinath, P. Omidian, and L. Nyirazinyoye. “Per Diems in Polio Eradication: Perspectives from Community Health Workers and Officials.” American Journal of Public Health.
2015 Maes, K., Svea Closser, Ethan Vorel, and Yihenew Tesfaye. “Using Community Health Workers: Discipline and Hierarchy in Ethiopia’s Women’s Development Army.” Annals of Anthropological Practice 39(1): 42-57.
2014 Maes, K. “Volunteers are not paid because they are priceless: Community health worker capacities and values in an AIDS treatment intervention in urban Ethiopia.” Medical Anthropology Quarterly 29(1): 97-115.
2014 Maes, K., S. Closser, and I. Kalofonos. “Listening to community health workers: How ethnographic research can inform positive relationships between CHWs, health institutions, and communities.” American Journal of Public Health 104(5): e5-e9.
2013 Maes, K. and Ippolytos Kalofonos. “Becoming community health workers: Perspectives from Ethiopia and Mozambique.” Social Science & Medicine 87: 52-59.
2012 Maes, K. “Volunteerism or labor exploitation? Harnessing and sustaining the volunteer spirit for AIDS treatment programs in urban Ethiopia.” Human Organization 71(1): 54-64.
2012 Stevenson, E.G.J., L. Greene, K. Maes, A. Ambelu, Y. Tesfaye, C. Hadley, and R. Rheingans. “Water insecurity in three dimensions: An anthropological perspective on water and women’s psychosocial distress in Ethiopia.” Social Science & Medicine 75: 392-400.
2010 Maes, K., C. Hadley, F. Tesfaye, and S. Shifferaw. "Food Insecurity and Mental Health: Surprising Trends among Community Health Volunteers in Addis Ababa, Ethiopia during the 2008 Food Crisis." Social Science & Medicine, 70(9): 1450-1457.
2010 Maes, K. "Examining Health-Care Volunteerism in a Food- and Financially-Insecure World." Bulletin of the World Health Organization, 88(11): 867-869.
2009 Hadley, C. and K. Maes. "A New Global Monitoring System for Food Insecurity." The Lancet, 374(9697): 1223-1224.
For a complete list of publications, see my Google Scholar page or click on my CV above.
Cross-Cultural Health & Healing (ANTH 574)
Anthropology and Global Health (ANTH 374 & 374H)
Peoples of the World: Africa (ANTH 315 & 315H)
Human Adaptability (ANTH 442/542)
Neuroanthropology (ANTH 461/561)
Nutritional Anthropology (ANTH 444/544)
Human Osteology Laboratory (ANTH 443/543)