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The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil

How is neoliberalism implicated in concrete health vulnerabilities? How do macro-level political economy, policy and institutions translate into everyday experiences? Drawing on Marxist, feminist and International Political Economy critiques of everyday life, the article advances an everyday politic...

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Autor principal: Nunes, João
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Routledge 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077346/
https://www.ncbi.nlm.nih.gov/pubmed/32256198
http://dx.doi.org/10.1080/09692290.2019.1625800
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author Nunes, João
author_facet Nunes, João
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description How is neoliberalism implicated in concrete health vulnerabilities? How do macro-level political economy, policy and institutions translate into everyday experiences? Drawing on Marxist, feminist and International Political Economy critiques of everyday life, the article advances an everyday political economy of health focused on four key components: power, agency, intersectionality and the mutual implication of the global and the local. These components enable a nuanced investigation of concrete experiences of health and disease, and of the local implementation of health policies in the context of neoliberalism. The framework is applied to the case of the 2015 public health response to Zika in Brazil, and specifically to the role of community health workers, close-to-community healthcare providers tasked with bridging the health system and vulnerable groups. The everyday practice of these workers, and their working conditions overwhelmingly characterized by precarity and low pay, reveal the presence of global neoliberal dynamics pertaining to the reconfiguration of the Brazilian state as healthcare provider in a context of encroaching austerity, privatization and narrowly-defined cost-efficiency. These dynamics impacted detrimentally upon the effectiveness of the Zika response.
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spelling pubmed-70773462020-03-30 The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil Nunes, João Rev Int Polit Econ Original Articles How is neoliberalism implicated in concrete health vulnerabilities? How do macro-level political economy, policy and institutions translate into everyday experiences? Drawing on Marxist, feminist and International Political Economy critiques of everyday life, the article advances an everyday political economy of health focused on four key components: power, agency, intersectionality and the mutual implication of the global and the local. These components enable a nuanced investigation of concrete experiences of health and disease, and of the local implementation of health policies in the context of neoliberalism. The framework is applied to the case of the 2015 public health response to Zika in Brazil, and specifically to the role of community health workers, close-to-community healthcare providers tasked with bridging the health system and vulnerable groups. The everyday practice of these workers, and their working conditions overwhelmingly characterized by precarity and low pay, reveal the presence of global neoliberal dynamics pertaining to the reconfiguration of the Brazilian state as healthcare provider in a context of encroaching austerity, privatization and narrowly-defined cost-efficiency. These dynamics impacted detrimentally upon the effectiveness of the Zika response. Routledge 2019-06-27 /pmc/articles/PMC7077346/ /pubmed/32256198 http://dx.doi.org/10.1080/09692290.2019.1625800 Text en © 2019 The Author. Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Nunes, João
The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
title The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
title_full The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
title_fullStr The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
title_full_unstemmed The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
title_short The everyday political economy of health: community health workers and the response to the 2015 Zika outbreak in Brazil
title_sort everyday political economy of health: community health workers and the response to the 2015 zika outbreak in brazil
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077346/
https://www.ncbi.nlm.nih.gov/pubmed/32256198
http://dx.doi.org/10.1080/09692290.2019.1625800
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