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‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala
Growing interest in how marginalised citizens can leverage countervailing power to make health systems more inclusive and equitable points to the need for politicised frameworks for examining bottom-up accountability initiatives. This study explores how political capabilities are manifested in the a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9073391/ https://www.ncbi.nlm.nih.gov/pubmed/35508334 http://dx.doi.org/10.1136/bmjgh-2022-008530 |
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author | Hernandez, Alison Hurtig, Anna-Karin San Sebastian, Miguel Jerez, Fernando Flores, Walter |
author_facet | Hernandez, Alison Hurtig, Anna-Karin San Sebastian, Miguel Jerez, Fernando Flores, Walter |
author_sort | Hernandez, Alison |
collection | PubMed |
description | Growing interest in how marginalised citizens can leverage countervailing power to make health systems more inclusive and equitable points to the need for politicised frameworks for examining bottom-up accountability initiatives. This study explores how political capabilities are manifested in the actions and strategies of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala. Qualitative data were gathered through group discussions and interviews with initiative leaders (called defenders of the right to health) and initiative collaborators in three municipalities. Analysis was oriented by three dimensions of political capabilities proposed for evaluating the longer-term value of participatory development initiatives: political learning, reshaping networks and patterns of representation. Our findings indicated that the defenders’ political learning began with actionable knowledge about defending the right to health and citizen participation. The defenders used their understanding of local norms to build trust with remote Indigenous communities and influence them to participate in monitoring to attempt to hold the state accountable for the discriminatory and deficient healthcare they received. Network reshaping was focused on broadening their base of support. Their leadership strategies enabled them to work with other grassroots leaders and access resources that would expand their reach in collective action and lend them more influence representing their problems beyond the local level. Patterns of representing their interests with a range of local and regional authorities indicated they had gained confidence and credibility through their evolving capability to navigate the political landscape and seek the right authority based on the situation. Our results affirm the critical importance of sustained, long-term processes of engagement with marginalised communities and representatives of the state to enable grassroots leaders of accountability initiatives to develop the capabilities needed to mobilise collective action, shift the terms of interaction with the state and build more equitable health systems. |
format | Online Article Text |
id | pubmed-9073391 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-90733912022-05-18 ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala Hernandez, Alison Hurtig, Anna-Karin San Sebastian, Miguel Jerez, Fernando Flores, Walter BMJ Glob Health Original Research Growing interest in how marginalised citizens can leverage countervailing power to make health systems more inclusive and equitable points to the need for politicised frameworks for examining bottom-up accountability initiatives. This study explores how political capabilities are manifested in the actions and strategies of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala. Qualitative data were gathered through group discussions and interviews with initiative leaders (called defenders of the right to health) and initiative collaborators in three municipalities. Analysis was oriented by three dimensions of political capabilities proposed for evaluating the longer-term value of participatory development initiatives: political learning, reshaping networks and patterns of representation. Our findings indicated that the defenders’ political learning began with actionable knowledge about defending the right to health and citizen participation. The defenders used their understanding of local norms to build trust with remote Indigenous communities and influence them to participate in monitoring to attempt to hold the state accountable for the discriminatory and deficient healthcare they received. Network reshaping was focused on broadening their base of support. Their leadership strategies enabled them to work with other grassroots leaders and access resources that would expand their reach in collective action and lend them more influence representing their problems beyond the local level. Patterns of representing their interests with a range of local and regional authorities indicated they had gained confidence and credibility through their evolving capability to navigate the political landscape and seek the right authority based on the situation. Our results affirm the critical importance of sustained, long-term processes of engagement with marginalised communities and representatives of the state to enable grassroots leaders of accountability initiatives to develop the capabilities needed to mobilise collective action, shift the terms of interaction with the state and build more equitable health systems. BMJ Publishing Group 2022-05-04 /pmc/articles/PMC9073391/ /pubmed/35508334 http://dx.doi.org/10.1136/bmjgh-2022-008530 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Hernandez, Alison Hurtig, Anna-Karin San Sebastian, Miguel Jerez, Fernando Flores, Walter ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala |
title | ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala |
title_full | ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala |
title_fullStr | ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala |
title_full_unstemmed | ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala |
title_short | ‘History obligates us to do it’: political capabilities of Indigenous grassroots leaders of health accountability initiatives in rural Guatemala |
title_sort | ‘history obligates us to do it’: political capabilities of indigenous grassroots leaders of health accountability initiatives in rural guatemala |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9073391/ https://www.ncbi.nlm.nih.gov/pubmed/35508334 http://dx.doi.org/10.1136/bmjgh-2022-008530 |
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