Is it Heuristics in Use or ‘Ritualistic and Instrumentalist’ in Purpose? Neoliberal Philosophy and the Use of KAPS (Knowledge, Attitude and Practise Surveys) in a Least Developed Nation

1. BACKGROUND

This article focuses on the use of KAPS by an epistemic community and attempts to discern whether it has a heuristic use and purpose or is it just serving some ritualistic and instrumentalist purpose. Ritualistic or instrumentalist is concerned with positions (or perspectives on the world) that are more ‘useful,’ and hence, more ‘correct,’ than others in facilitating the accomplishment of one’s individual goals. Universities are marketers of knowledge rather than primary producers of knowledge and the individual academician has to work in a competitive work environment where the 'publish or perish culture’ [1] prevails and selling or promoting one’s self is highly desirable. Instrumentalization forces the researcher to see research only as a means to achieve certain specific needs for personal benefits. The reification of research makes researchers to undeniably follow the relentless laws of the market and leads researchers to leap from topic to topic in search for funding rather than following a sustained, self directed research program [2]

KAPS has been in use since the 1950’s and since then its use has increased manifold. KAPS was initially used in family planning and population studies but over the time it has been used for understanding community perspectives regarding various issues, conditions and behavioural practices, moreover, the beginning of an international aid driven approach towards development and the need for monitoring also led to an increase in using KAPS and even today it is a popular method adopted. The author is not questioning its validity and neither has any doubt about its reliability and use in various contexts. But, like any other methods or tools it too has limitations, and if used in certain contexts based on the existing reality of the researched sample, it tends to create findings akin to ‘epistemic pollution’ [3] or even ‘bullshit’ [4].

Based on the characteristics of heuristics, the use of KAPS is application of heuristics. The Oxford English Dictionary defines heuristics as methods learnt from experience to solve problems by finding practical ways to deal with them. Shah and Oppenheimer, have proposed that all heuristics possess either one or more processes for effort reduction such as - examining fewer cues, reducing the intricacies linked with retrieving and storing cue principles, simplifying the weighting principles for cues, integrating fewer information and probing fewer options. What is called as heuristics can differ from researcher to researcher and also many heuristics exemplify a variety of different characteristics. Heuristic assumptions do not signify reality since by their nature it is restricted to a sample of the whole that is supposedly representative of the whole, but even then its use is inevitable [5]. Different individuals can use different heuristics to approach a common issue and this difference in selection of heuristics depends primarily on the individual’s experience. Heuristics is purely a practical act but its selection, and use is based on one’s philosophical assumptions.

Philosophical assumptions underlie all research and they shape the research question, hypotheses, methodology, method, finding and recommendation. Though philosophical assumptions shape all the components of a research they are mostly invisible and remain so unless made explicit by the researcher or until a philosophical analysis of it is done and which is what we are trying to do here. Philosophizing is an important activity and to philosophically analyse and critique a research means to look at the different stages of research based on logical argumentations and reasonableness. Research philosophy itself comprises broadly of the ontological, epistemological and axiological which results in the methodology and the methods. Other terms such as paradigm, worldview, theoretical have also been used with more or less the same meaning. The philosophy that exists at any given time is an outcome of the prevailing ideology, ism, structure, worldview or belief system. The ism that exists and shapes the current world order has been identified as neoliberalism.

Unlike many other isms, neoliberalism does not usually reveal itself and neither is it visible to an individual, no matter what their qualifications are. The users of the term have been labelled as having Trotskyite tendencies, but the author contends that the word neoliberalism has been used by individuals from varied ideological and philosophical leanings. The central presupposition of neoliberalism consists of the ‘rational self-interested individual’, 'free market economics’, a ‘pledge to laissez-faire’ and a pledge to ‘free trade’ [6]. Neoliberalism has formed our cognition and it promotes, ‘neoliberal ideologies that stresses individual-level resolution making about economics and healthcare [7]. Neoliberal vision and application has unswervingly implicated in shaping the way health is promoted [8] and beliefs are shaped [9]. The human being is transformed into an entrepreneur (self-entrepreneur) who is in rational pursuit of self-interest and seeks maximisation of expected-utility. Also looking for opportunism in all settings, optimising behaviour and strategic behaviour should be pursued by all humans in the market. Neoliberalism regime has been described as a wicked and exacting environment [10] for those that do not follow its ways.

Various works on neoliberalism and its influence on different entities such as, ‘neoliberal governmentality’ [11-14], ‘neoliberal technologies’ [15, 16], ‘neoliberal philosophy’ [17], ‘neoliberal citizen’ [18] [11], ‘neoliberal logic’ [19-22], ‘neoliberal university’ [23-25],’‘neoliberal academia’ [26], ‘neoliberal subject’ [27-29],’ neoliberal strategies’ [30-32], ‘neoliberal reforms’ [33-35] and ‘neoliberal axioms’ [36], have been conceptualised.

2. RESEARCH UNDER NEOLIBERALISM – ASSUMPTIONS AND TRAITS

3. UNDERSTANDING AND CONCEPTUALISING THE RESEARCHED

Understanding the researched sample thoroughly is vital for any scientific enquiry but the decision on what needs to be researched and why is also crucial. Both problem identification and solution recommendation has been a perennial task of research and more particularly for researches done on health conditions. However, before any particular problem is identified and any solution recommended it is essential to know the existing conditions, for without an in-depth understanding the whole endeavour becomes very superficial in nature. Here the focus is on the research papers presented in two conferences. The research paper is an outcome of the philosophical underpinnings of the concerned researcher or a team of researchers. The research and researcher is not just an independent mereological product, rather both are affected by ‘dispositifs’ existing at the proximate and distant levels who through the use of related ‘apparatuses’ and ‘technologies’ create and maintain certain research traditions and practices.

The individual research presentations made at the, ‘First (2015) and ‘Second (2016) National Summit of Health and Population Scientists’ organised by the NHRC (National Health Research Council) are the most basic and primary form of data here. The researched here are those researches or studies that have used the KAP Survey methodology to know about various existing conditions. Various other methods of sampling could have been done but the author reasons that selecting an epistemic community and philosophically assessing their research presentations or which can also be called an epistemic object can provide insights into the ways policies are made, into the ways problems are perceived and solutions proposed. Based on the features that describe an epistemic community the researchers, scientists, professionals and health workers who made presentations at the conference organised by NHRC can be collectively described as an epistemic community. An ‘epistemic community is politically neutral’ ‘is closely incorporated, restricted in number, with great continuity and members have approximately equal status and power’, [123] ' its members have no particular history as a whole, but share ideas’, [124] ‘plays a strong role in shaping which policies are selected in highly specialized policy arenas’, and they also produce policy-relevant knowledge about intricate technical issues and combine various characteristics, political initiative and scientific objectivity’ [125] [126] in issues surrounded by uncertainty and the data they generate has to offer answers (in reply) to specific issues; they have to produce utilizable knowledge' [127].

Mainly ‘four central aspects—shared underlying ideas, shared principled philosophies, shared ideas of legitimacy, and a general policy enterprise’ characterise an epistemic community’ [128]. Epistemic communities arise from different epistemes. Foucault defines episteme, retrospectively, as the strategic apparatus that allows filtering out from all possible statements those that are acceptable within scientificity (not scientific culture) and of which one can say that they are true or false. The episteme is the “apparatus” that enables separation, not the true from the fake, but what can and cannot be characterized as scientific and non-scientific [129]. Epistemes give continuity and maintain the epistemological prior assumptions that establish what is recognized by the society as ‘justified true belief’ or knowledge in any historical epoch. It has also been described as a ‘unitary body of theory’, which tends to privilege some knowledge whilst subjugating certain others and ranking them low in its hierarchical paradigm. Epistemes are formed through an inner structure which is given in things as the inner law and hidden network [130].

Basically, episteme is the “historical a priori that bases knowledge and its discourses and embodies the condition of its prospects within a particular historical milieu [131]. Epistemes are ‘comportments of justifying, elucidating, resolving problems carrying out enquiries, designing and verifying different types of products or results’ [132]. An episteme informs our manner of perceiving which is our world view or Weltanschauung. Leading epistemes or world views get articulated to some extent by establishments, such as healthcare, and through specific scientific disciplines such as public health, endocrinology, psychiatry etc [132].

The epistemes that exist are the result of various historical, social, political, economic, and cultural factors. Though the influence of the present worldview is most on an episteme, the historical processes cannot be excluded when trying to understand an episteme, an ‘epistemic process’, an ‘epistemic culture’ and an ‘epistemic object’. The historical stage that Nepal went through was different from countries that were colonised. Though Nepal was never colonised it has been affected by it and its remnants can still be seen for instance in ‘lahure’ (armed forces) recruitment. The 100 years purpose isolation of Nepal and its people by the Rana oligarchy which also got tacit support as a result of the pact with the East India Company and later the British government led to a condition where ‘nothing happened’. In the 1950’s, when the oligarchic rule ended the literacy rate in 1950 was approximately two percent [133].

The dismal educational and economic conditions led to high dependence on other nations. The year 1956 marks the actual beginning of the modern era in the history of educational planning in Nepal. When education did begin all the disciplines were adopted from neighbouring India which in turn was principally following, that Paulo Freire called the banking system of education. Under the banking theory Freire believed that students were seen as passive objects to be influenced by the teacher, and he further argued that banking edification demobilized people in the existing power realm by making them adopt the dominant cultural, social, political status quo of the prevailing culture. Along with a rigid caste system, poverty, illiteracy and its ruling elites seeing its citizens as commodities to be sold and consumers to be sold to, the nation as a welfare concept has largely been absent.

Since 1950’s when Nepal first opened itself up to the ideas of modernity to the present a lot of changes have occurred. Professions that were the domain of only foreigners earlier have been adopted by hundreds and thousands from the native population. The university is where higher education level is available and also researchers acquire their skills. Over the years beginning from the 1980’s and 1990’s the nature of these universities have been transforming itself in tune with ‘neoliberal reforms’. The neoliberalised universities are seen to be displaying characteristics like, ‘reduction in public funding for universities’, ‘separation of teaching and research with the latter increasingly privileged as a source of external revenue’, ‘the replacement of peer review with market-based mechanisms’, the ‘tyranny of relevance’, and the ‘formidable strengthening of intellectual property protections’ [2].

The existing neoliberalised university system has a ‘performance paradigm’ that has researches completed as a key ‘performance indicator’. The universities and its changing nature has been characterised as, ‘schizophrenic’ or ‘multiple personality disorder university’ [134] and when universities are seen through concepts such as ‘epistemic violence’, ‘epistemological violence’, ‘structural violence’, ‘ontological violence’, universities seem to embody a transnational elite that lay down the standards that must be adhered to for anything to be considered worthy of scientific recognition and to be accepted as knowledge. The tripartite partnership between the government, university and industry has been conceptualised as ‘Triple Helix’ system where market based values hold prominence. The ‘Triple Helix’ is country specific, regional specific, and discipline specific and even university specific. Despite its variability the ‘Triple Helix’ creates one common role of universities around the world, which is its role as a ‘supplier of knowledge and human capital’ [135].

The human whom themselves are a capital and many a times also an investment in a neoliberal system has to use the skills acquired to generate more capital (publications, workshops, grants, inventions, patents) and as a result a higher position. Here the focus in on research and researcher who eventually compose an epistemic community. Epistemic communities have their own levels of connections where some maybe more international in scope where it comprises of researchers from all over the world and there may be others who may be restricted to a nation or a couple of nations. The epistemic community that NHRC brings together is national in scope though a handful of researchers were from Bangladesh and India. Here the particular epistemic community discussed focuses on researches done on health issues which have social, cultural, political and economic relevance which further influences the way policies are planned, solutions sought and it influences public perceptions too.

Way back in 1979 in the first edition of the book, ‘Use and misuse of social science research in Nepal’ the authors raised the issue about misuse of researches and the dominance of the questionnaire method that was prone to fabrication [136]. After more than four decades when the second edition of the book was published the authors lamented that ‘the country of Nepal passed through various changes at the social, political and economic levels but one thing remained in practise which is the ‘development agencies and projects for the most part continued to use, indiscriminately and uncritically, questionnaire surveys to gather information for their policies and projects in Nepal’ [136, 137]. More recently others have also expressed the fact that the vast preponderance of articles were on quantitative research, generally questionnaire-type surveys [138]. Views that public health needs a paradigmatic shift [138] and calls for making health a public health agenda has also been made [139]. Others have discussed issues that echo a political economy of research approach such as – on sources of funding, setting of the research agenda, review costs, research capacity development of Nepal, research findings and the politics behind it and issues related to upcoming ethical and regulatory agendas [140].

Lately, others have shown that public health research has largely focused on family planning, HIV/AIDS, sexual and reproductive health, maternal health, women’s health, nutrition, child health and general health, each representing roughly eleven percent of the overall publications [141]. The vast preponderance of researches was quantitative in nature, by and large questionnaire type surveys and the qualitative researches few in number were based on face to face interviews and focus group discussions [141]. Researchers and the amount of research done have increased not just in Nepal but all over the world and this increase can be attributed to the setting of new audit criteria that values the number of publications and the amount of external research grants generated when evaluating a faculty for promotion also many researches are planned and done by various organisations for acquiring grants as a result of which satisfying the criteria of grant making bodies become more important even if it decreases its relevance to the local context. The incorporation of the, ‘publish or perish’ belief has facilitated the mechanisms through which the individual pursues a range of enterprises that must be done in order to achieve a particular goal. The ‘neoliberal self-enterprise technologies’ adopted views individuals as makers of research and generator of funds and their advancement depends on fulfilling the set criteria.

Neoliberalism has been very supportive of studies that are reductionist and methodologically individualist but, neoliberalism itself does not affect only a part of a system. In fact when any system is neoliberalised the whole ensemble of that system is affected. Here when discussing on research the higher educational environment is crucial in the way researchers are trained. The current BPH (Bachelor Public Health) and MPH (Master Public Health) curriculum provides students with a hands-on understanding of health systems and trains them to work as district public health practitioners, but does not sufficiently train them to work as an academicians, researchers and public health leaders’ [142], this phenomenon can also be seen in other health science disciplines.

Depending upon the social, economic and political situation of a nation, the quest for free-market reform and neoliberalism can have varied affects and consequences. Neoliberal values like, ‘survivor of the fittest’ philosophy has taken hold in all sectors including academic, research and education. The process of ‘ naturalisation of socially produced risk’ [143], ‘normalisation of social divisions’ and ‘neutralization of negative health impacts’ [144] are some of the processes that have been identified to have occurred under neoliberalism. Wayne Brekhus (1998) referred to this as the process of ‘unmarking’ problems so that what was marked as clear and evident becomes virtually unnoticed and, by virtue of that, ‘unremarkable’. The dominant discourse in the health professions is, ‘micro level’, ‘individualized’ biomedical ‘and ‘depoliticized’ and, ‘this belief sees health as the nonexistence of illness or disease in persons and pursues to advance quantifiable features of their lives through the reduction of risk issue via indicators of morbidity and mortality’ [144]. Those espousing this world view typically accept that efforts against disease are empirically advantageous and necessitating no additional rationalization: the epidemiology (the fact) is normally believed to ‘articulate for itself’.

In the conceptual framework, (Fig. 1) the individual forms the core that consists of a population group or cohort and various health issues and conditions affect the population. These issues and conditions are taken up by concerned researchers, scientists, experts and policy makers who belong to various disciplines and combine to become an episteme. Here the episteme as shown in figure one is encircled by neoliberalism which sets the boundaries from within which an episteme works.

4. METHODOLOGICAL FRAMEWORK

The methodological approach (Fig. 2) adopted is based on ‘dialectical and critical reflexivity’ [145], ‘critical realism’ [146], ‘phenomenological’ [147, 148], ‘existentialist’ [149]and an approach of more recent origin which the author holds combines all of the above mentioned approaches an ‘autoethnographic research’ approach [150] The type of research sample that this study deals with can also be called as a ‘discourse analyses’ and here the study follows an ‘abductive’ approach to analyse the discourse by ‘moving back and front amongst empirical data, research literature and developing theory’ to have an understanding of the structures and apparatuses that influences the way researches are done. The researches selected are individually approached by the author and by ‘interrogating, deconstructing and decentring’ [151] each research is assessed of its connection to the reality on the ground level and the extent to which the researches have a pragmatic heuristic value. The author does not ‘step out of the world’, is not ‘detached’ from the existing reality and acknowledges her/his native belongingness. The methodological steps proceed with the assumption that all the researchers based on the existing ground reality felt the importance and the genuine need for doing a research, and all the researches were done with a genuine intention towards studying things right, recommending things right and making things right.

The basic unit of focus, observation and analysis of this paper are the research abstracts presented at the two conferences. The books of abstracts are available on the NHRC website. The summit/conference brings researchers scholars’ practitioners, scientists and policy makers from all over the country. More than two hundred research findings were presented in the two conferences held in 2015 and 2016.

Findings and recommendations are the end result of all researches and based on these, viable solutions are sought, policies are made and programs conducted. The end result is the result of the research questions asked, hypothesis made, methodologies, methods followed and tools used, all of which make up the research process. But even before the first step is taken in the research process there is ‘a-prior condition’ that shapes the understanding as to what needs research and builds the rational and justification for any proposed research. This ‘a prior’ understanding of a researcher is the research philosophy which is regarded as the bedrock of any research and is implicit in all research. This implicit part that informs any research is invisible and unless made explicit by the researcher or until philosophical enquiry is done.

Any situation can be looked at from different angles and using different methods provide different types of answers. Researcher’s contradictory ontological and epistemological stances frequently lead to dissimilar research approaches to a similar case [152]. Based on pragmatism ‘the most essential determinant of the research philosophy adopted is the research query’ and it also guides the other aspects of research. The ‘ontological nature of reality’, the ‘epistemological nature of knowledge’ and the ‘axiological position of the researcher guides the ‘research questions and the hypothesis which also serves as an extension of the research question’ [153], and hence forth the methodologies, methods, results and recommendations [154]. It is impossible to do any kind of research without being (often implicitly) committed to ontological and epistemological positions [155].

The foremost step was to identify all the research abstracts having the word knowledge in its title, in keywords or if it had assessing knowledge as its objective. Altogether twenty-one research abstracts met the inclusive criteria. Each study was scrutinized and its, research objectives and the research questions were identified. The methodology and methods used to answer the research questions and fulfil the objectives were examined. And, the conclusions, discussions, recommendations made by each research were sought out. Each research was approached with the following questions.

• What are the stated objectives, justification, rational, aim, purpose and the research questions?
• What or who are the subjects of study of the research?
• What are the methodologies and methods followed in the research?
• What type of data does the methodology aim to generate?
• What are the findings of the research?
• What are the recommendations of the research?

The information obtained from each research was then analysed from a philosophical perspective based on an existentialist, phenomenological and empirical experiences of the author. An autoethnographic method of research approach was adopted when analysing and reflecting on each case. Based on a basic categorisation of the philosophical stages which include an ontological, epistemological and axiological part the questions asked during analysis were as follows.

• What are the ontological assumptions?
• What are the epistemological assumptions?
• What are the axiological assumptions?

And

• What are the methodological assumptions?

The first question on ontological assumptions deals with one of the most important components of our vision of the world and is so elemental that we barely question them. They are central to any investigation in any discipline [42, 43, 46]. The neoliberal ontological project takes for granted ‘homo economicus’ as primary representation for personal conduct which occur from subject’s economic rationality functioning in a world of ‘perfect information’ and ‘static concepts of equilibrium’ [104]. Neoliberalism ‘relies on individualist ontologies of calculative and calculable agency’ [156].

The second on epistemological assumptions deals with what is profoundly entrenched in the culture and world view of society and determines the acknowledgment of a crisis and if the reasons of the crisis are named [157-159]. Neoliberal epistemological approach studies the objects of inquiry by disassembling them into basic components and studies their articulations in isolation [160]. The central axiom that neoliberal epistemology holds is that knowledge is by definition fragmentary, imperfect and socially dispersed’ [161].

The third question on axiological assumptions looks at the values or moral and ethics in the research. Axiology is the theory of values, and values are facets of human conduct that developed during evolution, giving us objectives, goals and opinions that direct our actions through our knowledge [162]. Axiological orientations of researchers are applied to the concerns and problems of the real world contexts within which they work [163]. The axiological assumption of logical-positivist research is that it is unbiased in contrast to naturalistic research, in which the researcher recognizes his values and predispositions as well as the value nature of the information collected from the ground [164]. Although ontology epistemology and axiology have been presented separately, there have been claims that they cannot be considered separable, because axiology, epistemology, and ontology co-evolve [165].

The fourth question on methodological assumption is regarding how the researcher can go about finding out what it is that he or she considers can be identified, based upon aforementioned epistemological assumptions [159]. ‘Methodological assumptions specify which research methods and techniques are considered suitable for the collection of legitimate empirical proof and obviously depend on how the reality of a theory is ascertained’ [166]. Under neoliberal positivist methodology an inherent predisposition towards the individual as the nucleus of contemporary consumer culture [167], which believes a scientifically acceptable action theory has to give exact predictions and explanations exist [168]. The neoliberal methodology is determined by individualism which again is influenced by reductionism and at least 10 modes of individualism such as ontological, logical, semantic, epistemological, methodological, axiological, praxiological, ethical, historical, and political have been identified [169]. The methodological assumption is a product of the ontological, epistemological and axiological assumptions and is evident in the research questions and methodological approaches selected [170].

After all of the above steps the task to seek answers to the research question as mentioned in the title was undertaken. The principal research question was, what heuristic use and value does the research have? Or is it just satisfying some ritualistic purposes? By its nature the question is loaded with value laden notions but then all questions are value laden and more over being so does not reduce the importance of the question.

Contradictory to heuristic use is the ritualistic use of research. By ritualistic use the author means those researches that serve only some instrumentalist purpose such as improving one’s performance measures, obtaining a research grant or filling up the bio data. The author is not saying that these should be done away with and as though it can be done away with. Rather the concern is here that researchers when doing research is serving only some instrumentalist ritualistic purposes, what are the costs incurred by the society at large? Perhaps no other discipline holds the amount of ramification it can have that public health has on the everyday lived experiences at the individual and population level when, researches seemingly heuristics in use is intended only for some ritualistic purpose.

As mentioned earlier, the steps that lead to the findings are reflexive in nature, dialectical in process and critical in its approach. Reflexivity involves a ‘constant comparison method’ [171] with the existing ground reality and is not based only on any fixed canonical priors. Basically reflexivity incorporates ‘historical sensitivity’, ‘radical doubt’, ethical imperative where one is able to recognise ‘the hidden aspects of the other’s and one’s own natural understanding’ and ‘go beyond and get behind oneself and our own norms’ [119]. The ‘dialogic meditation’ in a reflexive analysis allow researchers to understand human action and human condition more closely. By incorporating reflexivity when doing research we can avoid a condition of ‘reflexive paralysis’ in which the mechanist, repetitive, ritualistic and instrumentalist trend in research is seen and by ‘systematized reflexivity’ we can avoid being ‘rational fools’ of neoliberalism.

A dialectical process in thinking involves an awareness of the broader social, cultural, political, economic and other forces that influences how one thinks. It ‘recognizes the ordered nature of culture-bound rationalisms’ or ‘regional rationalisms’ and endeavors to go past instant experience to attain ‘scientific experience’ [172]. ‘It engages consecutive experience of high and low, communitas and composition, homogeneity and segregation, egalitarianism and inequality, lesser to higher status and in dialectics the opposites, as it were, shape one another and are reciprocally requisite ’ [173]. Open mindset, intellectual inquisitiveness, suppleness, intellectual integrity, methodological skepticism, perseverance, objectivity and deference for viewpoints are the attitudes contained in critical thinking’ [174]. In the context of experts being critical involves having a flexible attitude towards learning, not believing that strategies and techniques are epitomes, includes ‘averting of atomistic outlook of logical errors in individual logic ’, has an ‘apprehension about self deception with respect to reasoning’ manages to ‘depersonalize’ one’s world-view, involves ‘capability to efficiently analyse and solve problems, explain, organise and articulate thoughts, and make logical conclusions, and to contextualize the use of these capabilities to diverse germane issues’ and engages ‘a set of logical behaviors and capabilities which have to be used, cultivated and established—but only when such a context exists [46]’. It sees reality as hierarchically stratified ordered levels and is a suitable approach for the examination of any social phenomenon [46]. Much antipathy exists from those in authority and the hegemonic epistemes and many a times the existing hegemons were also seen with antipathy by the hegemons they may have replaced.

5. FINDINGS

Whether the researches had a heuristic use and value or were it just serving some individual instrumental needs of its creator or creators is a question which has to be understood by taking the existing local empirical grounded context in to account. The findings mentioned below are based on the lived empirical experiences and, from the view of a native existentialist phenomenological view. Being a native could bring various images about, who is a native? Even within Nepal we could be having an ‘etic’ or ‘emic’ viewpoint on various issues and in various regions amongst various individuals and communities. The arguments below could appeal or detest the reader, many could point at the lack of definitive scales to measure, the generalist character of the arguments and even be accused of ‘armchair research’ but nonetheless honest reflexive philosophizing is important for any discipline or even an episteme to shed its weakness and cure its myopic gaze (Table 1).

CONCLUSION

One could be doing one’s job honestly, sincerely and with a belief about doing well. But, then the work that one does has not resulted in desired changes. When digging for water if after a certain depth if no water is found then the digger shifts to a newer location and starts digging again until water is found. Like the digger a scientist or a researcher too looks to fulfil certain objectives and tries to provide newer solutions. But unlike the digger who knows when water is found and can stop the latter does not have that luxury. Scientists and researchers have to continually update one’s self by adopting strategies, techniques and other relevant developments so as to produce scientifically valid and correct work and when it comes to human behaviour and health the area that it covers is all encompassing.

Scientists and researchers working on issues related to health have to not only be updated with developments in one’s concerned discipline but also have to keep one’s senses open to developments in other disciplines for the need of a multidisciplinary, interdisciplinary and transdisciplinary approach has been deemed essential [215, 216]. The researches that have been dealt with in the findings section above have a focus on health issues and various cohorts were researched and the individuals who constituted the cohorts were from various sectors ranging from adolescents to professionals and children to mothers. All the researches have the ‘individual’ as its focus and indeed the individual is ultimately at the focus of most researches on health issues. But, the ways an individual lives at various stages of life and the barriers and solutions that prevent or enable them to act in certain recommended ways can be many a time located far away from them. For instance going back to the case of the digger who has dug in a hundred different places looking for water to no avail and cursing his/hers fate, when in fact a water bottle company has managed to appropriate all the ground water through use of machinery power.

Based on the nature of the work one does and the ways that it affects those at the receiving end is varied in consequences and implications, also in between these two many other levels exist. Here the focus is on researchers or more specifically an epistemic community and the product it produces i.e. a research publication or presentation and when taken collectively can be said to constitute a discourse. The methodological process and the statistical tools used are not of concern here, since they are an outcome of the research objectives, rationales or hypothesis which is based on one’s assumptions and inferences which again is influenced by one’s philosophical underpinnings. Though philosophical underpinnings are mostly invisible it is omnipresent and influences use of heuristics in approaching a problem in order to seek a solution but many a times these seemingly heuristics could be only fulfilling some ritualistic purposes.

Based on existentialist, phenomenological and empirical experiences when the twenty one researchers were analysed adopting an autoethnographic approach one common theme that was discerned is that all the researches proceeded with the assumption that individuals were ignorant and they needed to be taught. Apart from the researches on blood donation in table 4 and appraisal of knowledge and attitude of clinicians to research writing in table 6, all of the other researches were done on populations who traditionally have been associated as ignorant, lazy, careless and unmotivated. Also the two researches on traditional healers and their practices are different than other researches since they were not done on behaviours that have been recommended to be done in certain ways based on some ‘procrustean’ standard among various cohorts at various stages in life. Though different than the remaining seventeen researches the acceptance of neoliberalism is apparent in all of them. They all take the ‘a prior’ structure of neoliberalism as given and accepted for instance on research and clinicians the need for researches as an important indicator of performance capability is treated as an axiom.

The seventeen researches have a common objective of assessing, identifying or evaluating knowledge on different habits, practices and perceptions. The perception that, lack of knowledge is what causes various negative conditions affecting health, and educating the populace will bring about desired change prevails among the researchers. From a distance the research looks perfectly reasonable, with high quality of evidence, rigour and its methodology seemingly flawless. The problems in the researches arise when viewing its particulars reflexively, critically and philosophically based on existential, phenomenological and empirical experiences. These problems are a result of many other conditions and these in turn by other conditions.

The genesis of these conditions can be traced back to colonial times and the increasing dominance of the Western Newtonian Cartesian system of science. Debating on the western system is not the scope here. Neoliberalism can influence any system be it Asian, African or European and also any discipline/subject be it Ayurveda or be it modern allopathic. The seventeen researches follow an epidemiological approach that rests on the, ‘social world homogeneity assumption’, [217, 218] and follows the ‘dose response inquiry’ despite it being recognized as essentially contextual (developmental or historical) rather than universal [219]. All the researches adopted a quick fix methodology and a hurried approach. The assumption made is that the populations researched would give honest, correct and valid answers when approached.

Questionnaires and interviews were used to obtain information on knowledge possessed and indeed it can provide reliable data, but when used to gauge behavioural practices the results can be misleading since they can easily be influenced by the ‘social desirability bias’. The rational choice theory which treats humans as rational beings, expects all humans to act based on interest maximisation and when it comes down to one’s health the individual should take specific measures so as to stay healthy. The questionnaire in affect assumes that knowledge leads to action. Hence if a pathological condition occurs within a community it must be because the individual ignored or had not known about the risk factor. The structure within which the individual exists is deemed as a level playing field where all humans should compete for the opportunities made available by the market.

As for assessing the heuristic or ritualistic use and purpose of the researches concerned it is essential that the assessment be made by taking the existing lived empirical locally grounded reality of the researched. Also when considering the existing local conditions it is imperative that the global, macro or structural forces that affect it be taken in to account for if these are not taken into account the strong possibility of the research being detached, separated, deproblematized, decontextualized and dissocialized from the researched population. The line that separates when attempting to assess heuristic use from ritualistic use of any research is prone to any procrustean objective that the reviewer who embarks on the task of assessment holds. To have an open mind and an honest intention without preconceived plans of interpreting the study as per one’s desire is essential for attaining scientific credibility in one’s analysis. The consequences when researches are just fulfilling some ritualistic purpose are dire for countries like Nepal where development has been the prime focus with much inflow of foreign loans, grants and aids, both corruption and stagnating human development occurs.

Research is done to discover new facts or information through careful methodological procedures. With the passage of time much change has occurred in the ways researches are done and also the reasons for doing a research have changed in accordance with human needs and interests. In Nepal as in other least developed nations the burgeoning trend of researches and journal publications have been due to the establishment of ‘logocentric ‘and ‘Eurocentric’ ‘character of the main part of the knowledge produced and taught in the universities around the world’, ‘the introduction of managerialism from western neo-liberal universities’, the establishment of the ‘enterprise university’, and ‘the audit feature for neoliberal managing of universities that gives significance to publication indicator and fundamental research’. The character that most universities have acquired around the world has been very aptly described as the ‘schizophrenic university’ paradigm where an ‘institutional fascination with research rankings’ exist and as a result ‘individuals and institutes acquire yet better care in the building and preservation of fabrications ’ and ‘playing the rating game’ which also leads to ‘opacity and complicity’. The separation of university education from the local contexts has seen the ‘tyranny of relevance’ and this has resulted in devising one’s academic research expertise to cater to the needs of the distanced rather than the needs of the immediate and near, the result of which has been that researches when seen from afar seem methodologically sound with the results generated by the latest software but when viewed by keeping the grounded reality of the researched it seems to have no pragmatic value resembling a piece of work which is ‘bullshitting’ or just producing ‘epistemic pollution’.

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