Author(s): Maryam Khan, Mehek Ali, Qadeer Baig, Aneeta Pasha, and Kausar S. Khan

resumen:

The Community Engagement Centre (CEC) has been active across a range of diverse urban and rural populations throughout Pakistan and works closely with marginalised communities.

 

The collective nature of Pakistani culture and its social inequities has required the CEC to recognize the intersections that shape contexts and situations, to promote local ownership, empower communities to identify and utilize existing resources for sustainable change, and improve health outcomes. Through an immersive community engagement (CE) strategy, CEC utilises participatory tools to collect stories from communities to understand their lived experiences, barriers and enablers to access, and the dynamics of power that influence these.

 

To understand this complex relationship, a Catalytic Framework that examined the intersections within communities’ narratives was developed. Preliminary review of community narratives collected as part of programmatic operations yielded four significant elements: (1) unique, individual circumstances, (2) aspects of identity, (3) types of discrimination (if present), and (4) larger structures that reinforce exclusion (or enforce inclusion). A unique feature identified within the process of CE was the role of ‘catalysts’ – one or many people who may have transformative potential at any of these levels due to their influence, active facilitation, or agency.

 

This novel framework enables an understanding of the threads of experience and identifying the elements and structures that impact lives of Pakistan’s diverse population. It works by recognizing the visible intersections of class, identity, gender, and power, as well as questioning what remains unarticulated, and thus promotes meaningful community engagement across different cultures and fields.

artículo:

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Introduction

One of the greatest challenges to development work – be it for education, health, or other programmes – lies in gaining an intrinsic understanding of the relevant populations’ stakeholders and their unique perspectives. By attempting to construct the reality of these groups through basic demographics and limited statistics, programmes risk ‘symptomizing’ them, i.e., over-simplifying their situation, stereotyping, and minimizing their traits onto a negative or hopeless spectrum; for example, symptomizing the poor as ‘non-agentic,’ ‘lazy,’ and ‘un-resourceful’ (Toro & Yoshikawa, 2016). The norm is to organise findings from communities into digestible statistics, which may reduce rich and valuable information into a number that does not expand upon the contexts or the circumstances it represents. This epistemological privilege granted to empirical science and data has contributed to the suppression of non-scientific knowledge and consequently, the groups whose practices and cultures were formed by such knowledge (de Sousa Santos, 2015). Statistics, although valuable, typically do not answer fundamental questions about the nature of communities’ experiences or social dynamics which inform development work.

 

Deductions made from statistical data without the inclusion of, or unsupported by non-scientific knowledge or qualitative data, can perpetuate reductionist approaches, creating the illusion that programmes can ‘save’ communities by providing an intervention or product that is ‘much needed.’ As a methodology, community engagement aims to counter this by building equitable partnerships between organizations and local communities to facilitate shared goals, such as community representation in research, feedback in service provision mechanisms, or ensuring smooth operations (Pratt, Cheah, & Marsh, 2020). It does so by applying the values of community psychology, which takes a multi-level ecological perspective and recognizes the need to concentrate on individuals, their communities, and their relationships (Fox, Prilleltensky, & Austin, 2009).

 

The Community Engagement Centre (CEC) – a joint-venture of Interactive Research and Development (IRD), Pakistan and the Indus Hospital & Health Network’s Global Health Directorate (GHD-IHHN) – has collaborated with and engaged communities across several districts in Pakistan since 2017. It worked closely with low-resourced communities (identified as any populations that are systematically neglected) where IHHN’s health facilities provide services and IRD’s public health programs operate. Historically, public health has taken a prescriptive approach towards working in communities, whereby community stakeholders are considered ‘target populations’ that are to be intervened upon to ‘save’ them from poor health outcomes, especially in impoverished settings. This perspective strips local communities of their agency and power and reinforces structures of reliance on external funding or intervention, disabling sustainable solutions. The CEC was conceived on the grounds that community engagement could remediate this ‘symptomisation’ of communities by encouraging a community-driven and context-dependent approach to collaboratively designing and co-implementing health systems and programs with the populations involved. It was hoped that through this, organisations could gain an enriched and immersive understanding of the unique ecologies of communities they seek to serve and thus collaborate with them, moving away from conceptions of ‘target populations’ towards a more patient- or community-centered ethos. The CEC worked to bridge necessary public health programmes with the nuanced contexts and existing resources in communities of interest, which can help inform strategies for implementation, innovation, and meaningful engagement that places local needs at the heart of all endeavours; i.e., to work with, rather than on, those affected and with lived experiences of adverse health conditions. The CEC enabled this through identifying local agents for change who may act as catalysts, such as community members and residents, Community Health Workers, Mental Health Lay-Counsellors, and Student Advocate

 

Community engagement in development, as an approach, borrows and aims to put into practice the valuable considerations of community psychology; “to solve problems for and with” communities, and create a ‘conscious strengthening’ (Montero, 2012). It explores specific ecological contexts of problems that emerge through oppressive social conditions at different levels of analysis and interventions, and how change occurs over time (Prilleltensky, 2001). Conversely, it also explores ecological contexts that enable positive change through inclusive and equitable practices. In addition to considering links between communities and wider social structures, it also aims to examine the relationships within communities experiencing injustices or promoting resourcefulness and cohesion.

 

The CEC acknowledges that true community engagement has transformative potential; attention to context and transcending of positivist epistemologies can provide us a pathway to understand how social injustice or cohesion is manifested and whether and how existing systems, including that of scientific research, may perpetuate inequality. The foundation of its operations are grounded in a belief similar to Boaventura’s (2015) idea of social emancipation; that by granting equal opportunity to the different kinds of knowledge that exist and maximising their contributions, knowledge and conceptions of power can be decolonised. Researchers, academics, and concerned organizations can utilize this understanding to engage in second-order change: change of the system’s values, structures, power arrangements, and allocation of resources.

 

However, one potent criticism of research in community psychology that could carry over to community engagement work, has been that it operates under a positivist epistemology, and that consequently quantitative research and experimental designs are privileged over other forms of enquiry. This can be amended by learning about communities through participatory engagement, utilising research approaches that are critical in their epistemic, ontological, and methodological underpinning that can oppose the enduring hegemony of positivism (Prilleltensky, 2001; Breen & Darlaston-Jones, 2010).These values are what immersive community engagement attempts to reinforce  in practice. All social practices involve knowledge, and the production of knowledge is a social practice (de Sousa Santos, 2015). Considering this, our knowledge of low-resourced communities, if taken purely from statistical data and inferences formed from these, would be incomplete and flawed. To remedy this, CEC has historically utilised participatory research tools and activities, collecting qualitative data in the form of narratives and stories to co-create and understand the social experience of communities. However, interpreting these experiences has been a challenge, particularly in ensuring that the knowledge gained from their interpretations of the social experience of any given community is reflective of the reality and includes the storytellers as part of the analytical and reflexive process.

 

As part of this work, the CEC discovered a need for a unique framework that could: (i) help community workers and program teams arrive at a contextualised understanding of engagement with low-resourced communities and inequalities, and (ii) explain the manifestation of action amidst the multiple, intersecting identities of a collective experience. We identified that a potent way to do this - rather than viewing differing experiences as deviating from norms based on dominant groups - is by incorporating an intersectional methodology into qualitative analysis.

 

Applying intersectionality to community engagement

Intersectionality was originally developed to describe analytic approaches that considered the meaning and consequences of multiple categories of social group membership (Cole, 2009). As a ‘travelling concept’, it has taken on new meanings in different contexts. The original debate was characterized by a strong emphasis on power relations; “a matrix of domination” which explored intersecting patterns of the different structures of power and position (Christensen & Jensen, 2012). It was coined originally by Kimberlé Crenshaw, who used the metaphor of ‘intersecting roads’ to describe the ways in which racial and gender discrimination compounded each other (Dhamoon, 2010).

 

Early articulations focused on the experiences of groups holding multiple disadvantaged statuses. In doing so, they highlighted the ways that analyses considering categories independently (such as race, gender) may be limited because in reality, power positions associated with these categories are experienced simultaneously. A corollary to this is that some members belonging to disadvantaged groups may also hold privileged identities within that group (Cole, 2009); for example, men in poor households having more power than women in those households.

 

Traditional quantitative approaches in psychology that use just one identity lens may result in hypotheses about group dynamics that reinforce the hierarchies that intersectionality seeks to disrupt, reinforcing the process of ‘symptomizing’ marginalised groups, such as women of colour, who deviate from the norm (Toro & Yoshikawa, 2016). By challenging the long-standing value that the best theory and explanations for phenomena are those that are most parsimonious, the concept of intersectionality goes beyond reducing group experiences to a single dimension. Intersectionality can also dispel misconceptions about marginalised populations perpetuated by the use of quantitative measures originally developed with mainstream samples and highly specified research focuses, with the potential for misrepresentation that this brings (Stein & Makowski, 2004). It can inform strategies for engagement and service provision by recognizing the multiple identity categories occupied by every individual (Cole, 2009) and how intersecting identities shape relationships and outcomes (Warner, Settles, & Shields, 2016).

 

This is congruent with the interests of community engagement, as intersectionality can help us arrive at a contextualized understanding of social representations, such as how people live and work in organic social groups. This enables communities, researchers and other development workers to adapt approaches to innovate in contexts based on these specific dynamics.

 

In order to construct a framework that takes into consideration (i) the existence and interdependence of social categories, (ii) their ecological value and influence, (iii) the existence of injustices and inequalities in said ecology, and (iv) the presence of a penetrating force (‘catalyst’) across multiple identities, we propose a Catalytic Framework for intersectional analysis, grown from the context of our community engagement efforts in Pakistan that can further add to the field of community psychology.

 

Creating a catalytic framework for intersectional analysis

From a social constructionist perspective, reality varies for individuals with different identities and intersectionality thus challenges the psychologist’s ability to derive a single, parsimonious theory or explanation. It requires researchers to consider the social context and the role of power and social structural factors. This, aptly described, as the “noise of interlocking identities and social structures”, is an important and interesting aspect of the intersectionality approach (Warner, Settles, & Shields, 2016). Through this, one can expose structures of inequality; for example, by demonstrating how consensual versions of reality maintain the status quo while there is evidence of discord in suppressed experiences.

 

One of the CEC’s prime concerns was to examine the reality of the contexts in which individuals exist and their influence on the construction of social experience, especially in the context of low-resourced communities. The researchers propose four elements, any combination of which can be found in a given social experience: (1) unique, individual circumstances, (2) aspects of identity, (3) types of discrimination, and (4) larger structures that reinforce exclusion (or enforce inclusion). Furthermore, we suggest that the presence of a ‘catalyst’ at any of these levels can transform the social experience (see Figure 1).

 

Figure 1. The four intersecting areas of social experience through the intersectional Catalytic Framework

 

Concerned with the construction of social experience, Christensen and Jensen (2012) highlight that the analysis of life stories is important in intersectionality research because it is through narratives that people draw on different categories in reflecting on their lives. Narratives are where people ‘play lead roles and write the script’, thereby signifying the important characteristics and identifiers of their lives (Christensen & Jensen, 2012; Bruner, 1990). Identity is therefore a sum of which stories humans tell of themselves in relation to social categories such as gender, class, and ethnicity; intersectionality is ultimately related to belonging – as people’s life stories are based on belonging to and identifying with such categories (Marková, 2007; Howarth, 2006). The concept of the “dialogical self”, the theoretical understanding that identity emphasizes that individuals speak from different “I”-positions throughout their narrative, also offers potential in the studies of intersectionality (Linell, 2009; Christensen & Jensen, 2012; Mead, 1934; Gillespie, 2012). Using the dialogical approach, intersectionality can be explored in narratives by examining how people stress their different affiliations in their life stories. The CEC has turned to the narratives and stories created by communities and collected by Community Health Workers to understand these aspects in the development of the Catalytic Framework.

 

The Catalytic Framework in Steps

Step 1: Frame the research question

The first step towards an intersectional catalytic analysis is the formulation of a clear research question (Drisko, 2005). As the CEC works closely with low-resourced communities and engages them to be agentic and take action to improve their lives, the main question asked is: “What challenges do we (low-resourced communities) experience in our aspirations towards change?” The secondary question is: “To what extent do certain social categories enable agency more than others?”

 

The term ‘low resource’ is relative; in the face of a challenge presented within a community, there may be characteristics or resources that community members possess to tackle said challenges, though perhaps not all of these are available at a given time. This is where the identification of existing resources amongst diverse community members can foster localized solutions via active collaboration.  This consideration is compatible with the catalytic framework as various intersections across categories can enable successful resolution of a challenge.

 

Step 2: Intersectional analysis of narrative

The second step involves applying the framework to qualitative data; in this case, narratives. The narratives are first read and sorted into the categories as outlined in Table 1.

 

Table 1. Elements of the narratives in the Intersectional Catalytic Framework.

 

A. Type of narrative.

First, the narrative must be identified as a story that is either group-based – involving multiple parties – or individual, wherein a unique person’s social experience is described.

 

B. Type of experience.

Utilizing the dialogical approach, the social experience can be discerned on two levels on which the narrator(s)’s “I”-positions would differ; as an “I” or a “We”:

1.  The collective experience (“We”).

A story that is shared, retold by either multiple stakeholders belonging to a collective identity or a specific individual who identifies as belonging to the collective group. This can aid in understanding who is really telling the story.

2.  The individual experience (“I”).

An individuals’ experience with a narrative, which could be group-based or unique to a specific person who is part of that group. This can aid in understanding the impact of a shared narrative at an individual level.

Identifying the type of experience (‘I’ or ‘We’) occurring is the next part of analysing the narrative.

 

C. Is there a catalyst?

If narratives are where individuals play the ‘lead role and write the script’, the catalyst is the ‘plot-twist’. This concept came about after CEC practitioners made observations that communities and individuals are often catalysed into action, by either other community members, Community Health Workers, or by themselves through self-reflection or circumstantial shift. We thus hypothesize that these catalysts begin actions that may take place across one, multiple, or all intersections of the narrative. We anticipate that the extent of a catalyst’s effect depends largely on the power differentials, positionality, typology of action, and receptiveness of the community. Hence, the catalysed action is impacted by the intersecting aspects  that are enabling or disabling in the narrative.

 

D.  Which areas of social experience are influenced?

The final categorisation requires identifying the ecological areas in the narrative. This includes investigating the pre-existing experiences or structures that influence the narrative, as well as whether action takes place in one area or intersects over multiple areas of social experience (see Appendix A for a short example). Any combination of the four aspects of social experience can thus be present (see Figure 1).

 

Step 3: The “other” question

The third step in our methodology is asking Mary Mastuda’s famous “other question” (Lutz, 2015):

“When I see something that looks racist, I ask ‘where is the patriarchy in this?’ When I see something sexist, I ask ‘where is the heterosexism in this?’ When I see something that looks homophobic, I ask ‘where is the class interest in this?’”

Matsuda’s question means that one needs to avoid: (1) the narrow focus on one social category and related source of (dis)advantage, and (2) the mentioning of multiple differences without taking them into account in the analysis of the social experience at hand. This comes after the elements of the story have been identified and helps to unpack the different pieces of the story, including those that have been silenced or concealed in the narrative. These can be brought to light by reflecting on the story alongside community members and with researchers’ context-enriched understanding.

 

Step 4: Narrator’s insight

The fourth step is to pay particular attention to categories that the narrators highlight themselves (for instance, identity, structural forces, circumstances). This does not mean that the highlighted category is the most important; instead, it might reveal the facet through which the individual feels most marginalized and is therefore most defended (Lutz, 2015).

 

Conversely, one could look for facets that foster strength and efficacy within experiences, such as one’s role in a community (as a Community Health Worker, parent, or elder), infrastructural availability(such as proximity to facilities or access to public transport) or the circumstances surrounding the event (including having personal connections or resources). This can inform analysis by highlighting the individual’s or collective’s source of power.

 

Discussion

The proposed framework for an intersectional approach to qualitative analysis of experiences in low-resource contexts is a much-needed development for community engagement. It is one that attempts to dissect and understand the lived social experience in its true ecological sense; it challenges the researcher’s ability to derive a single, universally-applicable theory of human behaviour, and to consider instead the particularities of a social context and the role of power and social factors at play in it  We argue that an integral way to do this would be to include communities in the interpretations of their stories and experiences to generate knowledge.

 

The Catalytic Framework accepts and acknowledges that individuals and communities do not exist in isolation from one another, and neither exists without the multitude of social experiences  and structures of the social world surrounding them (Dhamoon, 2010; Christensen & Jensen, 2012). The framework is  intended to aid in building an ecology of knowledge, which plays a key role  in granting equal opportunities to different kinds of knowledge and experience (de Sousa Santos, 2015). Knowledge can be housed in a myriad of ways and take different shapes - community participation ensures that it is molded into its truest essence. Thus, inclusion through an intersectional approach can transcend representation; it can repair misconceptions engendered by the erasure of minority groups and the subgroups within them by highlighting contexts unique to them (Cole, 2009).

 

Findings on groups’ or individuals’ experiences through this methodology will expectedly depart from the norms of dominant groups. The aim is to provide an understanding even of the most marginalized experiences such as those of low socioeconomic groups and ethnic, religious, linguistic, and gender minorities (Cole, 2009). If community psychology endorses that context is everything, then community engagement as a methodology can only increase appreciation for how culture, context, and community shape human behaviour and can provide the reference point for efforts to learn about and be useful to the local communities that health and development workers seek to serve. Embodying such knowledge allows the voices of those traditionally silenced and erased to be celebrated, and by viewing the “matrix of domination” critically, a better and more nuanced understanding of privilege can be developed (Christensen & Jensen, 2012).

 

In light of this, the inclusion of the element of a ‘catalyst’ is novel to this framework as it links with the vision and goals of community engagement. Earlier identified as the ‘plot twist’, untangling the threads of narratives and identifying the typologies in which the catalyst acts – whether successfully or not – can shed light on the efficacy of development workers’ engagement efforts, as well as the strength and agency of communities themselves. The catalyst allows researchers and community members alike to track change overtime by identifying gradual shifts, allowing for knowledge exchange, replication, and/or adaptation for future successful endeavors. As an approach that roots itself in community psychology, it is not static or frozen, and is instead a means of understanding and knowledge building that is constantly being transformed and re-built depending on the shifts in context (Montero, 2012). Developments in the use of such critical and postmodern methodologies can provide a roadmap for informing interventions in a community that enable second-order change (Campbell, 2014; Campbell & Scott, 2012; Campbell & Burgess, 2012). By understanding the role of identity in shaping experiences and the meaning we derive from them, social groups and collective relationships can be better understood helping to bridge psychological with sociological and political levels of analysis (Campbell & Jovchelovitch, 2000). This aids in the design and deployment of appropriate innovations in development work that move away from ‘saviour’ modalities, and rather advance agency and justice for those occupying multiple identities and experiencing various forms of (dis)advantage.

 

The Catalytic Framework has been developed by exploring narratives collected by the CEC’s Community Health Workers who work in public health across Pakistan, emphasizing an implementation-based approach that can be relevant for other development sectors. The advantage of taking an outcome harvesting approach towards developing the Catalytic Framework is that it emphasizes true context rather than presumptions about the efficacy of community engagement. Since the CEC’s scope was informed by the presence of IRD or IHHN services across specific districts in Pakistan, it is possible that the stories and narratives shared were influenced by Community Health Worker representation in the area.  However, since health workers were recruited and hired from within local contexts, it is likely that there was no bias in story collection or consolidation. Moreover, several stories also showcased unsuccessful outcomes, emphasizing that the Catalytic Framework can be applied regardless of result achieved and serves to inductively identify enablers and disablers of social cohesion. As such, the framework aims to be both inclusive and flexible. Additionally, our expectation is that other collectivist cultures, similar to Pakistan’s, would benefit from application of such an analytical methodology. While we refrain from making assumptions, we can expect cultures which are less collectivist are still likely to face the same areas of social experience and structural challenges, albeit more as individuals than as a collective. Furthermore, due to certain nuances in Pakistani culture and tradition from which this framework was involved and to prevent our work from being restricted, we attempted to keep the four areas of social experience broad in the range of experiences they can capture (such as those of people with varying gender and sexual identities or displaced populations). Further testing of this framework in diverse development sectors such as education, social change, and economic empowerment, as well as other cultures would prove useful to gauge its efficacy and replicability. As an implementation framework, this may serve to inform development sector practitioners about the typology of innovations most appropriate for their specific context, as well as the potential role and impact of agents for change.

 

References

Bruner, J. (1990). Autobiography and Self. In J. Bruner, Acts of Meaning (pp. 99-138). Cambridge, MA: Harvard University Press.

 

Campbell, C. (2014). Community mobilisation in the 21st century: Updating our theory of social change. Journal of Health Psychology, 19(1), 46-59.

 

Campbell, C., & Burgess, R. (2012). The role of communities in advancing the goals of The Movement for Global Mental Health. Transcultural Psychiatry, 49(3-4), 379-395.

 

Campbell, C., & Jovchelovitch, S. (2000). Health, community and development: Towards a social psychology of participation. Journal of Community & Applied Social Psychology, 10(4), 255-270.

 

Campbell, C., & Scott, K. (2012). Community health and social mobilisation. In R. Obregon, & S. Waisbord, Handbook of Global Health Communication. London: Wiley-Blackwell.

 

Christensen, A.-D., & Jensen, S. Q. (2012). Doing Intersectional Analysis: Methodological Implications for Qualitative Research. Nordic Journal of Feminist and Gender Research, 20(2), 109-125. doi:10.1080/08038740.2012.673505

 

Cole, E. R. (2009). Intersectionality and Research in Psychology. American Psychologist, 64(3), 170-180. doi:10.1037/a0014564

 

de Sousa Santos, B. (2015). Epistemologies of the South: Justice Against Epistemicide (1st Edition ed.). New York: Routledge.

 

Dhamoon, R. K. (2010). Considerations on Mainstreaming Intersectionality. Political Research Quarterly, 1(14).

 

Drisko, J. (2005). Writing Up Qualitative Research. Families in society: the journal of contemporary human services, 86(4).

 

Fox, D., Prilleltensky, I., & Austin, S. (2009). Critical Psychology: An introduction (Second Edition ed.). SAGE.

 

Gillespie, A. (2012). Position exchange: the social development of agency. New ideas in Psychology, 30, 32-46.

 

Gillespie, A., Howarth, C. S., & Cornish, F. (2012). Four Problems for Researchers Using Social Categories. Culture & Pyschology, 18(3), 391-402. doi:10.1177/1354067X12446236

 

Howarth, C. (2006). A social representation is not a quiet thing: Exploring the critical potential of social representations theory. British journal of social psychology, 45(1), 65-68.

 

Linell, P. (2009). Rethinking language, mind and world dialogically. IAP.

 

Lutz, H. (2015). Intersectionality as Method. Journal of Diversity and Gender Studies, 2(1-2), 39-44.

 

Marková, I. (2007). Social identities and social representations. In I. Marková, Social representations and identity (pp. 215-236). New York: Palgrave Macmillan.

 

Mead, G. H. (1934). Mind, self and society: From the standpoint of a social behaviorist. Chicago: University of Chicago Press.

 

Montero, M. (2012). From complexity and social justice to consciousness: Ideas that have built a Community Psychology. Global Journal of Community Psychology Practice, 3(1), 1-13.

 

Pratt, B., Cheah, P. Y., & Marsh, V. (2020). Solidarity and Community Engagement in Global Health Research. The American Journal of Bioethics, 20(5), 43-56.

 

Prilleltensky, I. (2001). Value-Based Praxis in Community Psychology: Moving Towards Social Justice and Social Action. American Journal of Community Psychology, 29(5), 747-778.

 

Stein, C. H., & Makowski, E. S. (2004). Asking, Witnessing, Interpreting, Knowing: Conducting Qualitative Research in Community Psychology. American Journal of Community psychology, 33(1/2).

 

Toro, J. D., & Yoshikawa, H. (2016). Invited Reflection: Intersectionality in Quantitative and Qualitative Research. Psychology of Women Quarterly, 40(3), 347-350.

 

Warner, L. R., Settles, I. H., & Shields, S. A. (2016). Invited Reflection: Intersectionality as an Epistemological Challenge to Psychology. Psychology of Women Quarterly, 40(2), 171-176. doi:10.1177/0361684316641384

 

Witteloostuijn, O. v. (n.d.). Applying Intersectionality as a Method. Utrecht University, Gender Studies. Utrecht University.

 

Appendix A

Duba Lashari, Gurmani, Punjab

 

The story was written in third-person by a CHW from Gurmani. It was translated into English and summarized for the purpose of this appendix. Consent was taken from the community to share their experience in public forums. All italic quotes are dialog that has been translated to English.

 

Duba Lashari was one of 24 communities that the CHWs visited over a period of time in Gurmani. The community welcomed them and shared their life experiences, along with the desire to collaborate closely with the CHWs. The community showed the CHWs that there was no clean drinking water in their area; they filled a bottle of water from a tap and asked the CHWs to hold on to it for some time to ‘watch what happens’. In a few hours, the CHWs witnessed the water turning a murky yellow-brown shade. One of the CHWs sampled it and found that it also tasted strange.

 

The community then elaborated on how this water was a part of their daily life and diet and was causing digestive illnesses along with skin problems, especially in their children. The CHWs also asked about water filters nearby, and the community shared that the closest one was 5 to 6 kilometres away and required motorbikes or rickshaws to access in order to carry back enough water for everyone. The community also shared their feelings and experiences around the issue: politicians who wanted their votes would leave them with false promises to fix their water problem, the government had never taken any notice and would not change anything now.

 

“Our faith has been removed from these politicians and the government. We are poor people and they don’t care about us.”

 

As farm-hands and labourers who work primarily on farmland, the CHWs then asked if they had considered asking the feudal lord of their area for assistance to which one community member responded:

 

“We are simple workers while he is a man of power. What if he is offended by our complaint and takes away our livelihood?”

 

Many agreed with him. In an open discussion with the community, the CHWs raised some points about the community’s positionality: their role as workers in the fields was in fact a position of power, and the feudal lord would have no reason to remove them from work as he required their labour for his own livelihood. Moved by this, the men in the community decided that they would approach the feudal lord as a group. As one person shared:

 

“By collecting our strength, we decided we would go to him together and try.”

 

Over a period of a few days, the community approached the feudal lord about the water issue and requested for a solution – within two weeks, a tube well was installed in their village for the community to have a clean water source.

 

Step 1: Identifying the research question

1. To what extent do certain social categories and phenomenon (such as feelings and ideas) enable agency more than others?
2. What gives these their sense of power?

Step 2: Intersectional analysis of narrative

 

Type of narrative: Group based, involving the community and CHWs altogether

 

Type of experience: Collective experience; the community affected by unclean drinking water. The CHWs become an extended part of this experience when they witness the water change colour and taste it.

 

Areas of social experience and locating the catalyst

* Red dots indicate catalysts identified by the researchers and community.

Figure A1

fotos

Figure 1: The Four Intersecting Areas of Social Experience Through the Intersectional Catalytic Framework

Table 1: Elements of the Narratives in the Intersectional Catalytic Framework

Figure A1: Areas of social experience and locating the catalyst

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autores

Maryam Khan, Mehek Ali, Qadeer Baig, Aneeta Pasha, and Kausar S. Khan

Maryam Khan is presently a Chevening Scholar at The University of Edinburgh pursuing an MSc in Psychological Research. She began her career in development as a program associate for Resource Development at the Community Engagement Centre (CEC) in 2018. She holds a BSc (Hons) in Psychology. Her research interests are grounded in understanding the impact of social class and poverty across a range of behaviours including health-seeking behaviour and inter-group interaction in the Global South. She endeavours to decolonise the bridge between academic theory and community-centred research and is passionate about bringing subjects like Community and Social Psychology to young minds in Pakistan. You can find her on twitter: @MaryamAli_Khan

 

Mehek Ali is a program manager for Resource Development at the Community Engagement Centre (CEC) of Indus Hospital & Health Network (IHHN). She has worked in education, mental health, and community-based innovations in Pakistan since 2012. She has led the design and implementation of several community projects focusing on adolescent wellbeing, women’s empowerment, community engagement, and learning paradigms.

 

Qadeer Baig is the Director of the National Deworming Program and the Youth Engagement Program at IRD Pakistan. He is overseeing the roll out of programs that provide services to youth and simultaneously leverage their social networks to improve health access. He is working to adapt and expand upon Rutgers’ Kiran Program to integrate with IRD and Indus Health Network health services. The program is also being piloted this year in other large urban centers in Pakistan, and among special populations including prison inmates and transgenders. Qadeer has actively contributed to research and the national discourse on NGO governance and management, sexual and reproductive health and rights (SRHR) for youth, and gender violence. He has represented civil society at the UN Commission on Population & Development, MDGs and SDGs. He has served on the Board of the Hashoo Foundation. He serves as Chair of the Board of Family Education Services Foundation, Pakistan, and CEO of the re-established and rejuvenated NGO Resource Centre, Karachi.

 

Aneeta Pasha is the Country Director of IRD Pakistan. She is a Fulbright scholar, with a MA in Social Sciences from the University of Chicago with a concentration in anthropology.  She is a development professional with over 16 years of programmatic and research experience working in the development sector in Pakistan in the areas of sexual and reproductive health, and mental health.  In 2014, Aneeta established IRD’s mental health program that aims to increase access to mental health services at the community level by increasing demand for services through awareness raising and community engagement, capacity building for a task-sharing approach that uses community health workers to deliver mental health interventions and finally, wide scale service delivery in low-income communities and health facilities.  In addition, Aneeta is also Co-founder of the Community Engagement Center and a member of the WHO – Civil Society Task Force on TB.

 

Kausar S. Khan serves as co-director at IRD Pakistan and technical advisor for several community-based projects including Sujaag and PIECEs. She has over 20 years’ experience in community-based work with urban and rural poor, with focus on child malnutrition, women’s empowerment and community participation. Her areas of research include health equity, promotion, health disparities and inequality, public health education and communication and healthcare quality.

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