Tasks from here:
Susanna and Sarah: continue analysis specifically on own field notes and relevant from past years, email dave
Jean: continue Ecuador policy research and include PSRP for Ecuador, and send data discussed
John: continue high level development themes research
All: next meeting be prepared to start drafting…
Status Updates:
Susanna: relevant stuff pulled from data about health transition and blending of medical modalities, slight resistance, distrust
Sarah: Tena interview very important for setting up structure of paper. Lots of info! Esteban and Arturo stuff too.
Jean: reading policy papers from Ecuador to tease out role of state and/versus NGOs in providing healthcare.
John: in progress
Thoughts, theory and history to consider as we move forward…
· Policy reacting to people losing confidence in the state to restore health, so how do they do that…
o Espousing decentralization
o Promoting local knowledge and empowerment
§ Our data and literature support this…TENA: assessment is community based but organized under state
o National government: broad plan…implemented locally
o BUT contradiction…decentralization forces change at local level…(WB)
o Local communities aggregate needs to inform national policy
· What does participation look like…forced to engage with international funding agencies but tension with local wants/needs
· Countries relying on int’l aid
o Gov’t makes plan
o Revisions/sugg. Revisions by WB
o Think grant writing
o It you want $$$…do A B C
o Poverty reduction strategy papers (PRSP) produced by countries. Revised by WB.
· TENA: 2007: doctor, nurse, dentist in every community.
o Govt cant do it all. Must happen at local level
· NGOs being “pushed out”
o Not grouped with civil society
o Not explicit policy
o But excluded from conversation
· NGOs attempted to correct SAPs
· We as a state are taking back
o Some critique:
§ 90s stabilized econ
§ lost confidence in state
· NGOs fail in provding a comprehensive health plan
o Disarticulated according to niche of NGOs
o Tension with nationalist health care
· PRSP no funding from anyone. DFID, IMF, USAID, template?
o Positive outcome is development
o “Iron cage of democracy”
