Global Health and Development, Primary Health Care, Community Health Workers, Health Systems, Food Insecurity, Water Insecurity, Mental Health, Maternal and Child Health, Religion, Morality, and Ritual
Ethiopia, United States
At Oregon State University, I am a core faculty member of the Anthropology program within the School of Language, Culture & Society. I am also an adjunct faculty member in Global Health, Public Policy, and Humanitarian Engineering 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.
I am a biocultural medical anthropologist interested in the labor and lives of the most marginalized health workers within health systems around the world. My colleagues and I are particularly interested in community health workers or CHWs: women and men who engage in primary healthcare, community organizing, and advocacy, both inside and outside of clinics and hospitals. I focus on answering a range of questions through a mix of ethnography, survey, and other methodologies:
How do CHWs bring about impacts on population health
at the individual level (helping people get well)?
at the structural level (organizing communities to change and resist harmful policies and practices)?
Why are community health workers themselves suffering from forms of psychosocial distress?
How do CHWs organize, build coalitions, and seek influence over the conditions of their own employment?
How do big 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 readily-recognized global health problems of the 21st century: the massive lack of effective health workers in contexts of poverty, particularly health workers who understand the lives, dignity, and power of marginalized peoples.
Community health workers, 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 face insecure employment and are paid at levels that keep them in poverty.
My research with CHWs began in Ethiopia in 2006, and more recently has turned to examine what is happening in the United States, including Oregon. My colleagues and I use ethnographic methods to forefront the voices of CHWs as they narrate their emotional and social labor and lives, including their intense work with marginalized people and their efforts to organize communities and convince employers and other health system actors to change policies that stifle their power and effectiveness. I aim to document the ways in which CHWs build relationships with stigmatized people, reconcile family disputes, confront death, challenge forms of discrimination, and pressure authority figures, by drawing on constellations of values, desires, and emotions encouraged by families, religious teachings, and mentors. This kind of care work is crucial to our wellbeing and yet massively undervalued within modern health systems.
My collaborators and I also use a mix of in-depth qualitative work, surveys and quantitative methods to illuminate the forms of distress and deprivation that CHWs experience. This aspect of our work has shown that large numbers of CHWs in urban and rural Ethiopia face chronically insecure access to basic resources including land, food, and water, which generate forms of psychological suffering that well paid and empowered health workers do not have to face.
From 2012 to 2016 I was Co-Principal Investigator (with Svea Closser, Middlebury College) on a research project focusing on Ethiopia's rural cadres of paid and unpaid CHWs, known as Health Extension Workers and Women's Development Army leaders, respectively. Funded by the National Science Foundation, this project highlights the importance of gendered power inequalities and social norms—from household to transnational policy levels—in shaping the daily and structural hardships that community health workers face.
More recently, I have partnered with the Oregon Community Health Worker Association to advance our understanding of CHWs, their impacts on population health, and the challenges they face here in Oregon. Founded in 2011 to provide a unified voice to empower and advocate for CHWs in Oregon, today ORCHWA is a vibrant and well-connected membership organization led and directed by CHWs themselves. ORCHWA supports CHWs to obtain training, build social networks, and collaborate with each other as well as with community, government, and private-sector institutions. ORCHWA also educates public health and health system professionals about the value of CHWs, and lends its voice to important policy change initiatives. In addition to assisting ORCHWA in its efforts to evaluate and study the impacts of CHWs in Oregon, I also aim to provide opportunities and support to CHWs who want to pursue degrees in anthropology, public health, and allied disciplines.
To learn more about my work in Ethiopia, check out this story from Public Radio International and this short YouTube video. You can also check out my commentary in the Bulletin of the World Health Organization and these reviews of my recent book, The Lives of Community Health Workers.
Another area of collaborative research in which I’m involved targets the daily lack of access to water experienced by people around the world. My colleagues and I are interested in understanding the political, cultural and ecological determinants of water insecurity, and demonstrating the multiple negative impacts of water insecurity on individual and social wellbeing. My doctoral student Yihenew Tesfaye and 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 interested in working with diverse students who have traditionally faced social, economic, and linguistic barriers to achieving college degrees in the US. I have mentored undergraduate and graduate students at OSU through an array of projects involving multiple methodologies in diverse geographical contexts. And I have served on the committees of numerous public health (MPH), anthropology (MA, PhD), and engineering (MS) graduate students. I am very interested to work with students who question the intersections between health and society, with a focus on health workers, food and/or water insecurity, mental health, women's health, disability, and social wellbeing.
In recent years, graduate students working with me have received research and writing support from the National Science Foundation’s Cultural Anthropology Program, the Sasakawa Young Leaders Fellowship Fund, the OSU President’s Commission on the Status of Women, the OSU URSA Engage Program, and the OSU Diversity Advancement Pipeline Fellowship. I am committed to assisting students in their quests to finance their research and degrees.
I currently serve as the main advisor for the following OSU Anthropology graduate students:
PhD: Yihenew Tesfaye
MA: Massarra Eiwaz, Micknai Arefaine, and Rachel Kingsley
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).
2018 Maes, K., Svea Closser, Yihenew Tesfaye, Yasmine Gilbert, and Roza Abesha. "Volunteers in Ethiopia's Womens' Development Army are more deprived and distress than their peers: cross-sectional survey data from rural Ethiopia." BMC Public Health.
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)