Activismo sanitario en Croacia. Volver a la salud popular en Croacia - Generación de nuevas formas de agencia colectiva / Back to People's Health in Croatia – Generating new forms of collective agency

Snježana Ivčić, Aleksandar Džakula, Damir Martinović, Valerija Žapčić

Resumen


Este documento se refiere a las nuevas formas de agencia colectiva en el ámbito de la asistencia sanitaria en Croacia desde 2015 hasta 2018. Estas nuevas formas se desarrollaron en medio de la creciente privatización y mercantilización del cuidado a la salud y la disminución simultánea de la accesibilidad a la misma.

La privatización se ha producido de forma lenta, pero continua, en los últimos 29 años. Las organizaciones tradicionales de la sociedad civil en el ámbito de la sanidad solían caracterizarse por ejercer en un conjunto limitado de actividades, por estructuras verticales, y a menudo se centraban en una sola enfermedad y en la colaboración con la industria farmacéutica. Estas prácticas daban resultados limitados, por lo que surgieron formas de activismo mejoradas.

En esta investigación, ilustramos su desarrollo utilizando el ejemplo de tres estudios de caso de agencia colectiva. El primer estudio de caso examina el análisis de políticas y el grupo activista creado por la Organización para la Iniciativa y la Democratización de los Trabajadores (OWID); el segundo se centra en el grupo informal de estudiantes de medicina llamado U3, formado en la Escuela de Salud Pública Andrija Štampar con el objetivo de desarrollar el pensamiento crítico; y el tercer estudio de caso considera la Asociación Karika, iniciada como un intento de repensar la asistencia sanitaria en la comunidad.

Los principales métodos de investigación empleados fueron el análisis y seguimiento de procesos y la comparación de datos de investigación con el fin de evidenciar las diferencias entre las formas tradicionales y las nuevas de activismo sanitario, además de las fuentes de información secundarias como la literatura científica y profesional. Los resultados muestran que las nuevas formas de agencia colectiva en el ámbito sanitario incluyen a varios grupos de ciudadanos no necesariamente relacionados con una enfermedad específica, que tienen una estructura horizontal y que se enfocan sobre el sistema sanitario en general. En conclusión, representan el inicio de un cambio paradigmático en el activismo desde el enfoque en una sola enfermedad hacia una atención sanitaria integral que tiene el potencial de hacer frente a la creciente cuestión de la comercialización, la mercantilización y la desigualdad en los sistemas sanitarios actuales.

Palabras clave: Croacia, salud pública, atención sanitaria integral, agencia colectiva, activismo

Abstract

This paper concerns new forms of collective agency in the area of healthcare in Croatia from 2015 until 2018. These new forms developed in the midst of the growing privatization and commodification of health care and the simultaneous decrease in the accessibility to healthcare.

Privatization has taken place slowly, but continuously over the last 29 years. The traditional civil society organizations in the field of healthcare used to be characterized by a narrow set of activities, with vertical structures, and were frequently focused on a single-disease approach and collaboration with the pharmaceutical industry. Such practices produced limited results; hence improved forms of activism emerged.

In this research, we illustrate their development using the example of three case studies of collective agency. The first case study is looking at the policy analysis and the activist group started by the Organization for Workers' Initiative and Democratization (OWID); the second one focuses on the informal group of medical students called U3 formed at the Andrija Štampar School of Public Health with the aim of developing critical thinking; and the third case study considers the Karika Association, started as an attempt to rethink healthcare in the community.

The main research methods employed included process tracing analysis and research data comparison aimed at showing the differences between the traditional and the new forms of healthcare activism, in addition to the secondary sources of information such as scientific and professional literature. The results show that the new forms of collective agency in the healthcare area include various groups of citizens not necessarily connected with a specific disease, that they have a horizontal structure and are focused on the healthcare system in general. In conclusion, they represent the beginning of a paradigmatic shift in activism from a single-disease approach towards comprehensive health care that has the potential to deal with the growing issue of commercialization, commodification and inequalities in today's healthcare systems

Key words: Croatia, public health, comprehensive health care, collective agency, activi

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