Sarah Akhtar


Organization: Bolivia Hydrocarbon Regulatory Assistance Project; Yunus Centre
Location: La Paz, Santa Cruz, Bolivia, and Dhaka, Bangladesh
Year: 2010

MRP/Thesis abstract:

‘Rickshaw’nomics and ‘Morales’ization: Perspectives on Rural Healthcare in Bangladesh and Bolivia

Recent buzzwords in development such as participation and empowerment perhaps warrant rethinking the way women are incorporated into decision-making governance processes. Here, the perspectives of social actors in both Bangladesh and Bolivia’s disparate medical settings are addressed. The work presented here captures two perspectives – that of the top-down narrative presented by health officials that promote the particular form of governance adopted in each country, and the bottom-up narrative of the women who utilize the services created. With reference to a private governance system of healthcare delivery – Grameen Kalyan in Bangladesh, and a public system in Bolivia – the MAS government, the relationship between the form of governance and women’s satisfaction with healthcare services is examined. By contrasting the views of rural women with official discourses the research presented here argues that there is a discrepancy between the two views. It seems to be the case that the more involved women are, and the more they can relate to the form of governance and participate in the decision making process, the more satisfied they are with the health-care system. The argument and findings here show that despite the disconnect between the two perspectives, the more women are permitted to feel that they are participating in the governance system of healthcare delivery services, the more beneficial, useful, and satisfactory they find their health services to be.