Professional Pastoral Work in a Kenyan Clinical Network: Transposing Transnational Evidence-Based Governmentality

Abstract

The Foucauldian concepts of governmentality and pastoral power have been used to explain the way health professionals internalise evidence-based practices in health care generally and clinical networks more specifically. However, we know little about the work, practices and process involved in developing and implementing an ‘evidence-based governmentality’ outside the West, particularly in Low and Middle Income Counties (LMICs), where governmentality often has a different transnational character. We explain the development and implementation of a Western transnational evidence-based governmentality in a clinical network in Kenya, using a decentred analytical approach. We highlight the essential work of medical professional ‘pastors’, with experience of both health care in Kenya and evidence-based medicine in Western High-Income Countries, in transposing this governmentality into health care in a LMIC in a way improving clinical care.