Social Mobilisation & Collective Action Flashcards
STRUCTURAL INTERVENTIONS
- move focus away from individuals improving own health to creating contexts that support healthier behs/actions
- recognises that much ill-health = NOT caused by individual beh
- challenges individually focused health promotion (aka. those w/poorest health need to improve own health)
LINK & PHELAN (1995)
- social conditions as fundamental causes of disease
FUNDAMENTAL CAUSES - unequal distribution of resources
- material/political/social
MECHANISMS - link between fundamental causes/proximate factors (ie. stress/alcohol use)
- availability of alcohol outlets
PROXIMATE FACTORS - individual risks
- knowledge behs (ie. condomless sex)
= health issues (ie. HIV/AIDS acquisition)
BLAKENSHIP ET AL. (2006)
- structural interventions; concepts/challenges/opportunities for research
- critique of Link & Phelan (1995); for those who seek concrete strategies for promoting health (incl. HIV prevention strategies) conclusions = beyond realm of what’s possible to accomplish via public health interventions
- aka. what are the fundamental causes? (ie. patriarchy/capitalism)
BLAKENSHIP ET AL. (2000): STRUCTURAL INTERVENTIONS (INDIVIDUAL)
AVAILABILITY
- explicit restrictions on risky behs
- change risk calculus for individuals
- incentives to change
ACCEPTABILITY (NORMS FOCUSED)
- shaming campaigns
ACCESSIBILITY (UNEQUAL DISTRIBUTION OF RESOURCES)
- free access to resources to improve health (ie. helmets/condoms)
BLAKENSHIP ET AL. (2000): STRUCTURAL INTERVENTIONS (ORGANISATIONAL)
AVAILABILITY
- limit unsafe items (ie. tobacco selling rules) OR increase access to them (ie. seatbelts in cars)
ACCEPTABILTY (NORMS FOCUSED)
- organisational boycotts
- advertising law
ACCESSIBILITY (UNEQUAL DISTRIBUTION OF RESOURCES)
- changing service provision stuctures
- limiting sales alcohol around schools
BLAKENSHIP ET AL. (2000): STRUCTURAL INTERVENTIONS (ENVIRONMENTAL)
AVAILABILITY
- laws to promote health
- minimum age laws
ACCEPTABILTY (NORMS FOCUSED)
- social marketing campaigns
ACCESSIBILITY (UNEQUAL DISTRIBUTION OF RESOURCES)
- health care insurance
SOCIAL OR COMMUNITY MOBILISATION
- aka. classroom, club or collective?
- problem solving approaches
- working together to address health challenges
- assumption of having wider impacts when to those not directly involved
GRAM ET AL. (2018): WHY DO PEOPLE GET INVOLVED IN SOCIAL MOBILISATION?
- community mobilisation = interventions where local individuals collaborate w/external agents in identifying/prioritising/tackling causes of ill-health based on values of bottom-up leadership/empowerment
- BUT requires lots of individuals to work together for greater good oft w/little direct benefit to themselves
PROPOSED SOLUTIONS TO PARTICIPATION DILEMMAS
- SELECTIVE INCENTIVES
- SOCIAL INCENTIVES
- OUTSIZE STAKES, INTERMEDIATE GOALS & INTERDEPENDENCY
- INTRINSIC BELIEFS
PROPOSED SOLUTIONS TO PARTICIPATION DILEMMAS: SELECTIVE INCENTIVES
EXPLANATION
- tangible rewards for pps/penalties for non-pps
EXAMPLES
- stipends for volunteers (ie. free food/training/entertainment for group members)
- education on “hook” topics unrelated to primary purpose of self-help group to attract pps
PROPOSED SOLUTIONS TO PARTICIPATION DILEMMAS: SOCIAL INCENTIVES
EXPLANATION
- incentives generated by social interaction w/other community members
EXAMPLES
- opportunities for building individual social capital; displays of approval of participation/disapproval of non-participation by community members
PROPOSED SOLUTIONS TO PARTICIPATION DILEMMAS: OUTSIZE STAKES, INTERMEDIATE GOALS & INTERDEPENDENCY
EXPLANATION
- situations in which incentive structure DOESN’T produce participation dilemma
EXAMPLES
- wealthy patron willing to build clean water supply for whole village
- health/sanitisation club satisfied w/raising awareness rather than changing behs; troupe of activist street theatre performers who depend on each other for success
PROPOSED SOLUTIONS TO PARTICIPATION DILEMMAS: INTRINSIC BELIEFS
EXPLANATION
- psychological/moral rewards for participation/penalties for non-participation
EXAMPLES
- benefits of being able to express outrage/gain agency/feel part of greater cause/feel less lonely/express one’s identity/show solidarity/perform moral duty
PROPOSED SOLUTIONS TO PARTICIPATION DILEMMAS: CRITICAL MASS
EXPLANATION
- initial group of highly motivated pps sets off chain reaction that rapidly drives further participation up
EXAMPLES
- small initial group of street protestors against police inaction on violence against women successfully convince authorities to take action on case of domestic violence; aka. persuading other community members to join future protests
TREATMENT ACTION CAMPAIGN (TAC)
- core membership ~8000 BUT could mobilise widely:
1. academics/doctors/poor people/elderly - connected into national/global networks
- mixture symbolic protest & legal action
- WHY was TAC successful in achieving its goals?
CAMPBELL ET AL. (2010): HEEDING PUSH FROM BELOW
BUILT VOICE
- focused on small groups/critical thinking/collective agency among oft via HIV/ART knowledge
- connected to ideas of human rights
BUILT RECEPTIVE SOCIAL ENVIRONMENTS
- became well known/engaged w/media
- builds on ideas of anti-apartheid activism
- links to other organisations (ie. church/trade unions)
- strategically engaged in politics
SEX WORKER MOBILISATION
- sex workers face multiple health burdens/impacts
- sig higher HIV/AIDS rates compared to general population
- higher contexts where laws/structures aren’t supportive of sex work
SEX WORKER MOBILISATION: DEERING ET AL. (2014)
- violence = much higher
- lifetime prevalence of any/combined workplace violence ranges 45-75%; 32-55% over past year
SEX WORKER MOBILISATION: BEATTIE ET AL. (2020)
- high rates of poor mental health (systematic review; 42% depression; 21% anxiety; 20% PTSD)
- associated w/violence experience
SEX WORKER MOBILISATION: BEKSINSKA ET AL. (2023)
- high rates substance misuse
- 41% any harmful alcohol use
- associated w/low condom use & drug use
SEX WORKERS: FUNDAMENTAL CAUSES
FUNDAMENTAL CAUSES
- unequal distribution of resources
- material/political/social
MECHANISMS
- link between fundamental causes/proximate factors
- lack of legal recognition/criminalisation
- brothel keepers/managers
- lack of response from police to violence
- lack of condoms
PROXIMATE FACTORS
- individual risks
- knowledge/condomless sex/alcohol use
= health issues (ie. HIV/AIDS acquisition)
AVAHAN (2003-2012)
- reached 60k FSW; focused on HIV prevention
- intervention expanded outwards to address violence & other challenges sex workers faced working w/:
1. THE POLICE
2. SEX WORKERS
AVAHAN (2003-2012): THE POLICE
- local reinterpretations of laws around sex work
- 1-day sensitisation workshops for police (85 senior/3,500 other police officers received this)
- build ongoing links to police stations
AVAHAN (2003-2012): SEX WORKERS
- clarifying rights
- going to police stations to understand the process
