In recent years there has been a major shift in attitudes to community involvement in health care. Approaches that saw communities primarily as passive recipients of health care have given way to those which seek to make more of the potential that more active community participation might offer for enhanced accountability and improved responsiveness of services. With this shift has come a greater emphasis on issues of governance and on institutional dimensions of participation, whilst the introduction of partnership models in the health sector has further increased debates about participation in health care. In 1999 the IDS Participation and Health and Social Change groups convened a workshop to share experiences of the use of participatory approaches in enhancing accountability in the health sector and to explore some of these challenges. The fifteen articles in this Bulletin reflect some of the richness of experience on the ground in building effective participation as well as some of the many issues that arise in moving towards more active citizen engagement with service provision. They draw experience from current work in countries such as Zimbabwe, Cambodia, China, Nepal, Zambia and Pakistan to reflect on links between participation, accountability and improvements in health.
This edition of the IDS Bulletin features papers by researchers and practitioners associated with the Development Research Centre on Citizenship, Participation and Accountability (Citizenship DRC), an international research partnership dedicated to exploring the new forms of citizenship which are needed to make rights real for poor people.|The Citizenship DRC brings together over 50 researchers from research institutions and civil society groups based in Bangladesh, Brazil, India, Mexico, Nigeria, South Africa and the U.K. It encourages collaborative work across national, institutional and disciplinary boundaries. Researchers have formed thematic working groups, and each group has its own website to share experiences.|This issue is split into the following sections:|1. Meanings and Expressions of Rights and Citizenship: - Citizenship, Affiliation and Exclusion: Perspectives from the South - Agendas in Encountering Citizens in the Nigerian Context - Making Rights Real in Bangladesh through Collective Citizen Action - Citizenship, Science and Risk: Conceptualising Relationships across Issues and Settings|2. Concepts and Practices of Participation: - Locating Citizen Participation - Linking Citizenship, Participation and Accountability: A Perspective from PRIA - Deliberative Fora and the Democratisation of Social Policies in Brazil - Citizenship and the 'Right to Education': Perspectives from the Indian Context - Participation of Indigenous and Rural People in the Construction of Developmental and Environmental Public Policies in Mexico|3. Dimensions of Accountability: - From Responsibility to Citizenship? Corporate Accountability for Development - Who speaks for Whom? A look at civil society Accountability in Bioprospecting Debates in Mexico
Across the world, as new democratic experiments meet with and transform older forms of governance, political space for public engagement in governance appears to be widening. A renewed concern with rights, power and difference in debates about participation in development has focused greater attention on the institutions at the interface between publics, providers and policy-makers. Some see in them exciting prospects for the practice of more vibrant and deliberative democracy; others raise concerns about them as forms of co-option, and as absorbing, neutralising and deflecting social energy from other forms of political participation, whether campaigning, organising or protest. The title of this Bulletin reflects some of their ambiguities as arenas that may be neither new nor democratic, but at the same time appear to hold promise for renewing and deepening democracy. Through a series of case studies from a range of political and cultural contexts û Brazil, India, Bangladesh, Mexico, South Africa, England and the United States of America, contributors to this Bulletin explore the interfaces between different forms of public engagement. Their studies engage with questions about representation, inclusion and voice, about the political efficacy of citizen engagement as well as the viability of these new arenas as political institutions. Read together, they serve to emphasise the historical, cultural and political embeddedness of the institutions and actors that constitute spaces for participation. The bulletin comprises the following articles: Citizen participation in the health sector in rural Bangladesh: perceptions and reality by Simeen Mahmud; Citizenship, community participation and social change: the case of Area Coordinating Teams in Cape Town, South Africa by John J. Williams; Institutional dynamics and participatory spaces: the making and unmaking of participation in local forest management in India by Ranjita Mohanty; Brazil's health councils: the challenge of building participatory political institutions by Vera Schattan P. Coelho; Civil society representation in the participatory budget and deliberative councils of SÒo Paulo, Brazil by Arnab Acharya et al.; The dynamics of public hearings for environmental licensing: the case of the SÒo Paulo ring road by Angela Alonso and Valeriano Costa; Power, participation and political renewal: issues from a study of public participation in two English cities by Marian Barnes et al.; A sea-change or a swamp? New spaces for voluntary sector engagement in governance in the UK by Marilyn Taylor et al.; AIDS activism and globalisation from below: occupying new spaces of citizenship in post-apartheid South Africa by Steven Robins and Bettina von Lieres; Social strategies and public policies in an indigenous zone in Chiapas, Mexico by Carols Cortez Ruiz; Increasing space and influence through community organising and citizen monitoring: experiences from the USA by Andy Mott. The abstracts for each separate article can be found on http://www.ids.ac.uk/ids/bookshop/bulletin/bull352.html
Concepts and methods of ‘participation’ are used increasingly to shape policy and deliver services. Such approaches throw new light on complex interactions within and between society and state institutions at all levels. They lead to questions about how different kinds of knowledge and values shape policy choices. What are the societal and political processes through which power operates that inform whose voice is heard and whose is excluded? What is power? Is it about making people act against their best interests; or is it the glue that keeps society together? What are the connections between power and social change? These questions are at the core of research and teaching by the Participation, Power and Social Change Team at IDS, and this IDS Bulletin presents current work on the practice of power in development and the entry points for change. Contributions to this issue, and ways in which power is interrogated, are very varied – despite a shared commitment to exploring its meaning for social change. In categorising power in the way the team has, the intention has not been to offer a comprehensive or exclusive framework for analysis. Rather, a positive spiral between reflection and transformation is constructed, concluding that the role of the action researcher/teacher is to explore with others how power can be harnessed for change, and to work alongside them in tracing and learning from the myriad of micro-level efforts, successes and failures.
This article makes a case for using participatory communication in research. It introduces participatory communication as a citizen-led approach to both creating and expressing knowledge: within research this means that researchers are not simply responsible for generating information and communicating about it, neither are they acting alone. From this perspective the emphasis of participatory communication is on communicating rather than extracting or delivering information. Participatory methods can communicate research findings in new ways and add depth and meaning to articulations of knowledge. This knowledge can easily get ‘lost in translation’ when findings are synthesised or communicated through conventional research outputs alone.