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The necessary contradictions of ‘community-led’ health promotion: a case study of HIV prevention in an Indian red light district

By Flora Cornish and Riddhi Ghosh

Abstract

Health promotion interventions with marginalised groups are increasingly expected to demonstrate genuine community participation in their design and delivery. However, ideals of egalitarian democratic participation are far removed from the starting point of the hierarchical and exploitative social relations that typically characterise marginalised communities. What scope is there for health promotion projects to implement ideals of community leadership within the realities of marginalisation and inequality? We examine how the Sonagachi Project, a successful sex-worker-led HIV prevention project in India, has engaged with the unequal social relations in which it is embedded. Our ethnographic study is based on observation of the Project's participatory activities and 39 interviews with a range of its stakeholders (including sex worker employees of the Project, non-sex-worker development professionals, brothel managers, sex workers’ clients). The analysis shows that the project is deeply shaped by its relationships with non-sex-worker interest groups. In order to be permitted access to the red light district, it has had to accommodate the interests of local men's clubs and brothel managers. The economic and organisational capacity to run such a project has depended upon the direct input of development professionals and funding agencies. Thus, the ‘community’ that leads this project is much wider than a local grouping of marginalised sex workers. We argue that, given existing power relations, the engagement with other interest groups was necessary to the project's success. Moreover, as the project has developed, sex workers’ interests and leadership have gained increasing prominence. We suggest that existing optimistic expectations of participation inhibit acknowledgement of the troubling work of balancing power relations. Rather than denying such power relations, projects should be expected to plan for them

Topics: HN Social history and conditions. Social problems. Social reform
Publisher: Elsevier
Year: 2007
DOI identifier: 10.1016/j.socscimed.2006.09.009
OAI identifier: oai:eprints.lse.ac.uk:47785
Provided by: LSE Research Online

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Citations

  1. (2005). Acquisition and assistance policy directive 05-04. Retrieved
  2. (2001). Beyond participation: Strategies for deeper empowerment.
  3. (2005). Boundary workers and the management of frustration: a case study of two Healthy City partnerships. doi
  4. (2006). Challenging the stigma of sex work in India: Material context and symbolic change. doi
  5. (1996). Community participation in HIV prevention: Problems and prospects for community-based strategies among female sex workers in Madras. doi
  6. (2004). Dhanda, dharma and disease: Traditional sex work and HIV/AIDS in rural India. doi
  7. (2003). Dialogicality and social representations: The dynamics of mind. Cambridge:
  8. (2001). Grassroots participation, peer education and HIV prevention by sex workers in South Africa. doi
  9. (2004). HIV prevention among sex workers in India. doi
  10. (2005). HIV prevention and sex workers: an international lesson in empowerment. doi
  11. (2005). HIV prevention programmes for female sex workers in Andhra Pradesh, India: Outputs, cost and efficiency. doi
  12. (1999). Learning to change: Seven years' stint of STD/HIV intervention programme at Sonagachi.
  13. (2003). Letting them die': Why HIV/AIDS prevention programmes fail. doi
  14. (1999). Measuring the impact of a behaviour change intervention for commercial sex workers and their potential clients in Malawi. doi
  15. (2002). Modelling HIV/AIDS epidemics in Botswana and India: impact of interventions to prevent transmission.
  16. (2003). Narrating survival and change in Guatemala and South Africa: The politics of representation and a liberatory community psychology.
  17. (1995). Participation and power. In doi
  18. (2001). Participation as spiritual duty; Empowerment as secular subjection. In
  19. (2001). Participation: The new tyranny. doi
  20. (2004). Participatory research in constrained settings: Sharing challenges from Cambodia. doi
  21. (2001). People's knowledge', participation and patronage: Operations and representations in rural development.
  22. (2002). Programmed to fail? Development projects and the politics of participation. doi
  23. (1983). Rural development: Putting the last first. doi
  24. (2004). Searching for justice for body and self in a coercive environment: Sex work in Kerala, doi
  25. (2004). Social development of commercial sex workers in India: An essential step in HIV/AIDS prevention. AIDS Patient Care and STDs, doi
  26. (2004). The 'transformative' unfolding of 'tyrannical' participation. In
  27. (1996). The concept of “we”: A community social psychology myth? doi
  28. (2002). The construction of community participation: Village family planning groups and the Indonesian state. doi
  29. (1989). The return to community. doi
  30. (2004). The Sonagachi Project: A sustainable community intervention program. doi
  31. (1997). The World Bank Participation Sourcebook. doi
  32. (2001). Truck drivers, middlemen and commercial sex workers: AIDS and the mediation of sex in south west Uganda. doi

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