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In the name of COVID-19: legitimizing the exclusion of community participation in Ecuador's health policy.
Torres, Irene; López-Cevallos, Daniel.
  • Torres I; Fundación Octaedro, El Zurriago E8-28, Quito 170505, Ecuador.
  • López-Cevallos D; School of Language, Culture and Society, Oregon State University, Corvallis, OR 97330, USA.
Health Promot Int ; 36(5): 1324-1333, 2021 Oct 13.
Article in English | MEDLINE | ID: covidwho-2284361
ABSTRACT
Global shifts toward a disease-oriented, vertical approach to health has involved limiting the right for communities to participate in decision-making. Ecuador's authoritarian legacy has forced civil society and social organizations to adopt 'coping strategies', while large protests recently derived into violent struggles. The country has been severely hit by the COVID-19 pandemic amid corruption scandals involving hospital and food purchases by government during the response. This study critically examines how Ecuador's government took into consideration 'community participation' as a value and tenet of health promotion. Our systematic textual analysis focuses on 53 consecutive resolutions by the National Emergency Operations Committee (EOC) leading the decision-making processes, which, explicitly requires community participation. Results show that the 'lifecycle' of the central government's evolving policy framing centered on law enforcement and the private sector, followed by the social sector. Further, there is no evidence of stakeholders from civil society or organizations taking part in decision-making. Having legitimized the exclusion of community participation in Ecuador's response to the COVID-19 pandemic, it is possible that the government will fail to consider the wider social implications of its impact. In particular, the limits to local governments becoming informed and making decisions without mediation by the National EOC will further impede community participation in health decision-making in the future. This implies that local knowledge and experiences will also not inform health policy.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Qualitative research / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: South America / Ecuador Language: English Journal: Health Promot Int Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: Heapro

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Qualitative research / Systematic review/Meta Analysis Limits: Humans Country/Region as subject: South America / Ecuador Language: English Journal: Health Promot Int Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: Heapro