Abstract
How is neoliberalism implicated in concrete health vulnerabilities? How do macro-level political economy, policy and institutions translate into everyday experiences? Drawing on Marxist, feminist and International Political Economy critiques of everyday life, the article advances an everyday political economy of health focused on four key components: power, agency, intersectionality and the mutual implication of the global and the local. These components enable a nuanced investigation of concrete experiences of health and disease, and of the local implementation of health policies in the context of neoliberalism. The framework is applied to the case of the 2015 public health response to Zika in Brazil, and specifically to the role of community health workers, close-to-community healthcare providers tasked with bridging the health system and vulnerable groups. The everyday practice of these workers, and their working conditions overwhelmingly characterized by precarity and low pay, reveal the presence of global neoliberal dynamics pertaining to the reconfiguration of the Brazilian state as healthcare provider in a context of encroaching austerity, privatization and narrowly-defined cost-efficiency. These dynamics impacted detrimentally upon the effectiveness of the Zika response.
Highlights
How is neoliberalism implicated in concrete health vulnerabilities? How do macrolevel political economy, policy and institutions translate into everyday experiences? Drawing on Marxist, feminist and International Political Economy critiques of everyday life, the article advances an everyday political economy of health focused on four key components: power, agency, intersectionality and the mutual implication of the global and the local
The framework is applied to the case of the 2015 public health response to Zika in Brazil, and to the role of community health workers, close-to-community healthcare providers tasked with bridging the health system and vulnerable groups
Is neoliberalism implicated in concrete health vulnerabilities? How do macro-level political economy, policy and institutions translate into everyday experiences? Speaking to this analytical challenge, this article develops an everyday political economy of health (EPEH) to explore the reproduction of ill health in the context of neoliberalism
Summary
KEYWORDS Everyday political economy; global health; community health workers; Zika; Brazil; neoliberalism They are a unique lens for observing the social, political and economic dynamics shaping the Brazilian health system and the implementation of policies therein, and how these system-level drivers play out on everyday experiences.
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