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'If no one else stands up, you have to': a story of community participation and water in rural Guatemala
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0002-8052-479X
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0001-7087-1467
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0001-7234-3510
2011 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 4, Article nr 6412- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Access to water is a right and a social determinant of health that should be provided by the state. However, when it comes to access to water in rural areas, the current trend is for communities to arrange for the service themselves through locally run projects. This article presents a narrative of a single community's process of participation in implementing and running a water project in the village of El Triunfo, Guatemala.

METHODS: Using an ethnographic approach, we conducted a series of interviews with five village leaders, field visits, and participant observations in different meetings and activities of the community.

FINDINGS: El Triunfo has had a long tradition of community participation, where it has been perceived as an important value. The village has a council of leaders who have worked together in various projects, although water has always been a priority. When it comes to participation, this community has achieved its goals when it collaborated with other stakeholders who provided the expertise and/or the funding needed to carry out a project. At the time of the study, the challenge was to develop a new phase of the water project with the help of other stakeholders and to maintain and sustain the tradition of participation by involving new generations in the process.

DISCUSSION: This narrative focuses on the participation in this village's efforts to implement a water project. We found that community participation has substituted the role of the central and local governments, and that the collaboration between the council and other stakeholders has provided a way for El Triunfo to satisfy some of its demand for water.

CONCLUSION: El Triunfo's case shows that for a participatory scheme to be successful it needs prolonged engagement, continued support, and successful experiences that can help to provide the kind of stable participatory practices that involves community members in a process of empowered decision-making and policy implementation.

Place, publisher, year, edition, pages
Järfälla, Sweden: CoAction Publishing, 2011. Vol. 4, Article nr 6412- p.
Keyword [en]
community participation, community organization, water projects, Guatemala, social development councils
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-48351DOI: 10.3402/gha.v4i0.6412ISI: 000299012700010PubMedID: 21977011OAI: oai:DiVA.org:umu-48351DiVA: diva2:448907
Available from: 2011-10-18 Created: 2011-10-18 Last updated: 2017-12-08Bibliographically approved
In thesis
1. The role of social participation in municipal-level health systems: the case of Palencia, Guatemala
Open this publication in new window or tab >>The role of social participation in municipal-level health systems: the case of Palencia, Guatemala
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Social participation has been recognized as an important public health policy since the declaration of Alma-Ata presented it as one of the pillars of primary health care in 1978. Since then, there have been many adaptations to the original policy recommendations, but participation in health is still seen as a means to make the health system more responsive to local health needs, and as a way to bring the health sector and the community closer together.

Aim: To explore the role that social participation has in a municipal-level health system in Guatemala in order to inform future policies and programs.

Methods: The fieldwork for this study was carried out over eight months and three field visits between early January of 2009 and late March of 2010. During this time, 38 indepth interviews with provincial and district-level health authorities, municipal authorities, community representatives and community health workers were conducted. Using an overall applied ethnographic approach, the main means of data collection were participant observation, in-depth interviews, group discussions and informal conversations. The data was analyzed in two different rounds. In the first one we used documentary analysis, role-ordered matrices and thematic analsis (see papers I-IV) and in the second round, thematic analysis was utilized.

Results: We found four themes that frame what the role of social participation in the municipality of Palencia is. The first theme presents the historical, political and social context that has contributed to shaping the participation policies and practices in Guatemala as a whole. The second theme takes a deeper look at these policies and how they have been received in the municipality of Palencia. The third theme presents data regarding the three situated practices of participation, each occurring at a different level: municipal, community and the individual level. Finally, the last theme presents reflections on what it means to participate to the people that were involved in this study.

Conclusion: In the process of social participation there are two different and complementary kinds of power that depend on the amount and the kind of resources available at each level of the participation structure. Stakeholders that have higher levels of power to formulate policies will have better access to financial, human and material resources while stakeholders that have higher levels of power to implement policies will have resources like community legitimacy, knowledge of local culture, values and mores, as well as a deep understanding of local social processes. The coordination of financial, human and material resources is just as important as the legitimacy that comes from having community leaders involved in more steps of the process. True collaboration can only be obtained through the promotion and creation of meaningful partnerships between institutional stakeholders and community leaders and other stakeholders that are working at the community level. For this to happen, more structured support for the participation process in the form of clear policies, funding and capacity building is needed.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2012. 71 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1517
Keyword
Social participation, community participation, community heath workers, primary health care, Palencia, Guatemala
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-59865 (URN)978-91-7459-470-6 (ISBN)
Public defence
2012-10-19, Bergasalen, Byggnad 27, NUS, Umeå, 09:00 (English)
Opponent
Supervisors
Funder
FAS, Swedish Council for Working Life and Social Research, 2006-1512
Available from: 2012-09-28 Created: 2012-09-26 Last updated: 2015-04-29Bibliographically approved

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