State, Community, and Primary Health Care
State, Community, and Primary Health Care
Empowering or Disempowering Discourses?
The chapter reconstructs a narrative of health services development in post-Independence India by examining relationships of the state, community, and Primary Health Care approach through existing literature. It combines materialist explanations with analyses of bureaucratic power and cultural hegemony to explain the maldistribution of health care. It argues that a critical analysis of the bio-politics and political economy of health care over the past century must consider five ‘missing links’ in the dominant discourse of HSD policy, that is, the unaffordability of the Euro-American institutional model of over-medicalized health care; the validity of plurality of knowledge; the dominant culture and ethics of health care providers; the prevalent physical, social and cultural iatrogenesis; and complexity of ‘the community’.
Keywords: Primary Health Care, Institutional health care model, Iatrogenesis, Politics of knowledge, Community, Empowering/Dis-empowering Discourses
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