Community health organizing and the political economy of health care in Morelos, Mexico

This dissertation analyzes the emergence of a community-based alternative health care movement in Morelos, Mexico, and its local expressions among health groups in the mestizo town of Zarragoza. Influenced by self-help approaches, cultural revitalization efforts, and the global alternative medicine movement, health groups in this study run community clinics, natural pharmacies, and health promoter training programs in order to make the health care alternatives they offer accessible and affordable to community residents. This study explores the work of three health groups in Zarragoza and examines the practices they employ in their community clinics and the discourses that their participants advocate.;The study situates local health organizing efforts in the context of global and national health policies that influence paradigms governing formal health care distribution and health sector reforms in Mexico. Specifically, it explores the strategies of local health groups as a response to the government's inadequate efforts to provide "health for all" and to alleviate health care shortages in the face of socioeconomic challenges that many Mexicans experience. The study also examines health organizing as a response to perceived limitations of biomedicine as the population ages and the burden of chronic illnesses accelerates the deterioration of an underfunded public health system. As health care protection decreases under neoliberal state reforms, health groups advocate a new way of "doing" health care that emphasizes patient participation in illness prevention, health education, and the attainment of medical care outside of government health structures.;This dissertation merges critical and political economy approaches in medical anthropology with actor-oriented frameworks. By considering how the agendas of health groups reflect local and global trends, the study contributes to the medical anthropology literature by furthering our understanding of the global and syncretic nature of medical pluralism. This dissertation also contributes a case study to the scarce literature on social movements in health, offering new perspectives on how communities, most specifically women, are interacting with a myriad of global and national pressures to contribute solutions to local problems concerning health care. By detailing local perspectives and grounding the project in issues of political economy, this research offers new insights into local understandings of health care that may be overlooked in government health planning and the implementation of development programs.