Who Are We To Care? Exploring The Relationship between Participation, Knowledge And Power in Health Systems - Barbara Kaim
This paper is dedicated to those many people who live in countries where health systems are failing to meet the needs of the majority, and where people with less power – whether health care providers, individuals, families or communities - have few structured opportunities to express their concerns openly and critically. It is aimed at those who work as health facilitators and activists at community level, civil society organisations, government personnel and anyone else interested in the rights of ordinary citizens to participate in decisions and have access to the resources that determine the way their country’s health system functions. The paper is divided into three sections: The first focuses on how the interaction between people’s participation, knowledge and power effects the functioning of health systems. The following section pays particular attention to approaches we can use to build a more just and equitable health system. The final section concludes by asking a series of questions to provoke and deepen our thinking on ways we can overcome obstacles to achieving this goal, at both community level and as we move from the local to the global as a strategy for change. Each section blends discussion on concepts and issues with descriptions of experiences and case studies from around the globe, especially from countries in Latin America, Asia and east and southern Africa, where a wealth of material describes the impact of neoliberalism and globalisation on health systems, and attempts to build alternatives.