The 130th Annual Meeting of APHA

4044.0: Tuesday, November 12, 2002 - 8:30 AM

Abstract #45018

Creating a Participatory Framework in Community Health and AIDS Care in Chiang Mai, Thailand

Vincent Del Casino, PhD, Department of Geography, California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, 5629852357,

Objective: To examine community outreach programs for people living with HIV/AIDS (PLWHA) in rural Thailand. Methods: An 18-month ethnographic study of one key non-governmental organization (NGO) in two phases. Phase one included the collection of data at the key NGO and in its outreach areas. Phase two focused the study on one of the target areas of the NGO and on how programs implemented by the NGO and in the community "worked" after the NGO "went home." Findings: NGOs make a lot of assumptions about the participatory potential of local rural communities, relying on a romanticized notion of the "community." They often fail to take into account the rigid hierarchical structure of local governance and the impact that hierarchy has on the efficacy of outreach programs for PLWHA. Gender and class relations, in particular, mediate much of the dialogue between PLWHA and local administrative personnel. Policy Implications: NGOs need to be more cognizant of the contested nature of local social relations if they are to seriously affect change. Programs have to focus on creating participatory structures that do not mimic, but instead gradually contest, the historical center of power at the local level. To do this, sometimes NGOs have to bypass local administrative authorities. Moreover, addressing the care of PLWHA means also addressing the cultural and social inequities that are part and parcel of the everyday lives of PLWHA in rural Thailand.

Learning Objectives:

Keywords: Community Health, Health Care Restructuring

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Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

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The 130th Annual Meeting of APHA