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Communities, health‐care organizations and the contingencies and contradictions of engagement: A case study from Chile
- Source :
- Health Expectations, Vol 23, Iss 1, Pp 229-237 (2020), Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Context Despite a growing interest in service‐user involvement in mental health services, the interaction between health institutions and local groups is only beginning to receive attention, particularly in global south settings. Objective Looking at a participatory initiative in Chile, this study explores how, under unfavourable administrative conditions, health organizations approach and work with communities. Methods We interviewed policy‐makers (5), local professionals (10), service users and community representatives (6) linked to a concrete participatory initiative. Participant observation in relevant meetings helped to enrich the interpretations. Thematic analysis was applied to interview transcripts and field notes. Findings The findings present a sequence of actions starting with the creation of a network of community‐based groups. A set of problems ensued, related to the group's diversity, internal representation, decision‐making and funding processes. In response, processionals implemented simultaneously bureaucratic and democratic adjustments, developing a vision of community that ignored the particularities—including the motivations—of local groups. Discussion and conclusion Based on these findings, we argue that participatory initiatives should be studied as on‐going achievements shaped by broad policy orientations and local configurations of interest. In the process, they produce ad hoc forms of knowledge and visions of community that provide orientation to the agents involved.
- Subjects :
- media_common.quotation_subject
Context (language use)
Participant observation
decision making
service‐user involvement
03 medical and health sciences
0302 clinical medicine
Political science
Health care
Humans
030212 general & internal medicine
self‐help groups
Chile
Qualitative Research
media_common
community‐institutional relations
Vision
Motivation
lcsh:R5-920
business.industry
Delivery of Health Care, Integrated
030503 health policy & services
lcsh:Public aspects of medicine
Public Health, Environmental and Occupational Health
Administrative Personnel
Citizen journalism
lcsh:RA1-1270
mental health services
Public relations
Mental health
Original Research Paper
Organizational Case Studies
organizational
Thematic analysis
community participation
0305 other medical science
business
lcsh:Medicine (General)
Original Research Papers
Diversity (politics)
Subjects
Details
- Language :
- English
- ISSN :
- 13696513 and 13697625
- Volume :
- 23
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Health Expectations
- Accession number :
- edsair.doi.dedup.....b296568e5050eb3596b1293254b657d9