“Popular” health and the state: Dialectics of the peace process in El Salvador

Smith-Nonini, Sandy

doi:10.1016/s0277-9536(96)00216-x

Cited by 12 publications

(8 citation statements)

References 16 publications

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“…The author's experience supports the contention that the VHW is not a threat to the livelihood of health professionals, as is claimed by some (Smith‐Nonini, 1997). In fact, the main competitor of the VHW is not a health professional, but the untrained drug peddler, who is often called the village doctor by members of the community (Ahmed et al., 2009).…”

Section: Methodssupporting

confidence: 72%

A Concept Development of the Village Health Worker

Benskin

2012

Nursing Forum

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Section: Methodssupporting

confidence: 72%

A Concept Development of the Village Health Worker

Benskin

2012

Nursing Forum

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“…First, politicians may be champions or hindrances for CHW programmes. Given the 'moral legitimacy that attaches to healthcare', 59 it is perhaps unsurprising that politicians are often outwardly supportive of CHW programmes, even treating the provision of health services as a platform for political propaganda. 59 Sustained political support has been posited as one of five key governance 'outputs' essential for effective governance of national CHW programmes in an empirically derived framework.…”

Section: Local Political Contextmentioning

confidence: 99%

“…Given the 'moral legitimacy that attaches to healthcare', 59 it is perhaps unsurprising that politicians are often outwardly supportive of CHW programmes, even treating the provision of health services as a platform for political propaganda. 59 Sustained political support has been posited as one of five key governance 'outputs' essential for effective governance of national CHW programmes in an empirically derived framework. 60 Nonetheless, while political support can ensure consistent funding, political interference in a programme can undermine equity-oriented downward accountability.…”

Section: Local Political Contextmentioning

confidence: 99%

The community health worker as service extender, cultural broker and social change agent: a critical interpretive synthesis of roles, intent and accountability

Schaaf¹,

Warthin

Freedman

et al. 2020

BMJ Glob Health

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This paper is a critical interpretive synthesis of community health workers (CHWs) and accountability in low-income and middle-income countries. The guiding questions were: What factors promote or undermine CHWs as accountability agents? (and) Can these factors be intentionally fostered or suppressed to impel health system accountability? We conducted an iterative search that included articles addressing the core issue of CHWs and accountability, and articles addressing ancillary issues that emerged in the initial search, such as ‘CHWs and equity.’CHWs are intended to comprise a ‘bridge’ between community members and the formal health system. This bridge function is described in three key ways: service extender, cultural broker, social change agent. We identified several factors that shape the bridging function CHWs play, and thus, their role in fomenting health system accountability to communities, including the local political context, extent and nature of CHW interactions with other community-based structures, health system treatment of CHWs, community perceptions of CHWs, and extent and type of CHW unionisation and collectivisation.Synthesising these findings, we elaborated several analytic propositions relating to the self-reinforcing nature of the factors shaping CHWs’ bridging function; the roles of local and national governance; and the human resource and material capacity of the health system. Importantly, community embeddedness, as defined by acceptability, social connections and expertise, is a crucial attribute of CHW ability to foment local government accountability to communities.

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“…In the 1970s, the country was under a strong military repression and ranked among the 5 most unhealthy countries. 13 The doctorto-patient ratio was the lowest in Latin America. Eighty percent of rural peasants had no potable water, and 60% had no access to health services.…”

Section: El Salvador and Its National Public Health Systemmentioning

confidence: 99%

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018)

et al. 2020

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In 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009-2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.

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“Popular” health and the state: Dialectics of the peace process in El Salvador

Cited by 12 publications

References 16 publications

A Concept Development of the Village Health Worker

A Concept Development of the Village Health Worker

The community health worker as service extender, cultural broker and social change agent: a critical interpretive synthesis of roles, intent and accountability

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009–2018)

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