State-society nexus in Brazil and Venezuela and its effect on participatory governance efforts in health and other secto
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(2020) 19:173
REVIEW
Open Access
State-society nexus in Brazil and Venezuela and its effect on participatory governance efforts in health and other sectors Qamar Mahmood1* and Carles Muntaner2
Abstract Introduction: Participatory governance is about state and society jointly responsible for political decisions and services. The origins and trajectory of participatory governance initiatives are determined by the socio-political context and specifically the nature of state-society relations. Participation by communities in health interventions has been promoted globally as a strategy to involve citizens in health decision-making but with little success. Such participatory governance in health should be seen not as a strategy alone but as a political project in which organized communities challenge the status-quo in health. Methods: This paper deals with the wider socio-political context of participatory governance initiatives. It uses comparative politics literature to analyze socio-political context in Brazil and Venezuela, historically spanning half century prior to 2015, to assess whether it was conducive to participatory governance. The focus of this paper’s analysis particularly is on the socio-political changes that were taking place in Brazil and Venezuela in the decades of the 1980s and 1990s. Those decades formed the bedrock on which the two countries experienced democratization and a socialist transformation that has lasted well into the first decade of the twenty-first century. The situation in the health sector is also described for the two countries showing a parallel trajectory to the wider political context and that reflected the political ideology. For this assessment, we use a contemporary framework called the ‘socialist compass’ which links dynamics of power relations in various ways among three domains of power, namely, state power, economic power, and social power. Socialist compass can be used to assess whether such reforms are moving towards or against social empowerment. Conclusion: Our analysis reveals that both Brazil and Venezuela were moving in the direction of social empowerment until at least the year 2015, just before the political turmoil started engulfing the left-leaning regimes in both the countries. Keywords: Participatory governance, Latin America, Health inequalities, Brazil, Venezuela
Introduction This paper argues that the socio-political context, specifically state-society relations, affects participatory governance initiatives or reform processes in health and other social sectors. Numerous reform processes in health have focused on community participation to improve * Correspondence: [email protected] 1 International Development Research Centre, Ottawa, Canada Full list of author information is available at the end of the article
health with the goal of achieving Health for All (HfA) and ensure greater equity in health. Ideologically, participation has different meaning for different actors in the society. From a leftist point of view, it is about reconstruction of a bro
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