Public health promotion in Bangladesh through the community health clinics: A Foucauldian analysis

Abstract

The system of community health clinics in Bangladesh is contributing largely to improving the public health status of rural communities in Bangladesh. The significant success of this health promotion program leads medicine to its summit of power to influence the prevalent power structure in rural Bangladesh. A critical analysis of this paradigm shift is demanded in the context of public health. A Foucauldian analysis of the public health scenario of Bangladesh is most relevant in this context. In the paper, I propose a critical analysis of the public health apparatus of Bangladesh as manifested in the community health clinics, from the Foucauldian perspective of Discipline, Body, Power, and Space. Definitely, Foucault’s historical analysis of health in eighteenth century Europe in his Power/Knowledge is instrumental in the analysis of the medicalization of family in the public-private partnership model of Community Health Clinics. However, his other writings such as Discipline and Punish and Madness and Civilization are also relevant to the analysis of: a) how self-subjection becomes an element in the empowerment process of the public health initiative in Bangladesh; b) how the concept of hygiene and new diseases serve as a means of social control in the politics of medicine; c) how medicine accumulates morals like trust, solidarity, and common good in its normative role to the exercise of bio-power; and, finally d) how rural space becomes an important phenomenon of medicine in contemporary Bangladesh. It is taken for granted that the community health clinics are contributing positively to improving the public health condition. However, many stories are untold in this picture of health promotion. In this paper, I analyze the public health promotion program of Bangladesh in light of the above questions to understand the power structure and the paradigm shift of the body politic in terms of health.