Abstract
Health systems all over the world are in a process of transition and may even need a paradigm shift for sustainable development. This is where activism may play a role. This study focused on why some physicians become activists and how these physicians have either achieved successes or failed to do so. This study is inspired by grounded theory. Semi-structured, in-depth interviews were conducted to evaluate the experiences of seven purposefully sampled physician-activists from the Netherlands. Our research suggests that activism originates from an awareness of problems in the area of health inequalities, resulting in moral discomfort combined with a strong drive to speak up against perceived failings, even when personal risks may be involved. Activists that were most successful in achieving political and health changes meandered effectively along the borders of the system, taking care to preserve ties with supporters within that system and, at the same time, taking a relatively isolated position while using strategies to oppose the system. Diverging too much from the system resulted in measures taken by the system to silence them. Successful activism may be regarded as a social and professional skill that may be learned.
Highlights
Health systems all over the world are in a process of transition and may even need a paradigm shift for sustainable development, “development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs” [1], and to comply with the Sustainable Development Goals (SDGs) by
We suggest potential improvements in which systems could help the development of health activism
The participants regarded activism as successful if it causes a system to change in such a way that resistance disappears and the formerly activist goal is accepted
Summary
Accepted: 30 August 2021Health systems all over the world are in a process of transition and may even need a paradigm shift for sustainable development, “development that meets the needs of the present generation without compromising the ability of future generations to meet their own needs” [1], and to comply with the Sustainable Development Goals (SDGs) by2030 [2,3,4,5,6,7]; systemic transition is a complex process [1,8,9] that has “a long-term timeframe covering a period of one or two generations” [8].Globally, and in the Netherlands, there are major and urgent health issues that are related to the SDGs and have been the center of attention in the past few years, such as the affordability of the healthcare system, sexual and reproductive health and rights, patientcentered care, climate effects on health, and the effects of health systems on pollution in general, lifestyle diseases, and the increase in alcohol and tobacco consumption. 2030 [2,3,4,5,6,7]; systemic transition is a complex process [1,8,9] that has “a long-term timeframe covering a period of one or two generations” [8]. Since the end of 2019, an additional concern has been the control of the COVID-19 pandemic and how to prevent future pandemics. To solve these major and often urgent health issues, there is a need for drastic systematic change [10], which makes the long-term timeframe of a transition undesirable. Activism is the use of direct and noticeable action, “action that goes beyond what is conventional or routine” [11,12,13], Published: 7 September 2021
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