Doctoral Dissertation Research: Reproducing the State: Women Community Health Volunteers

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How do women community health volunteers succeed in delivering maternal and child health services? Moreover, what does their success tell us about the micro-level workings of state power and its capacities to shape the lives of marginalized groups? This research studies the significance of street-level bureaucracy, i.e. frontline workers, in negotiating state power, and the inter-relationship of intimate labor with inequities of gender, class, and ethnicity. Findings will show how community health workers negotiate, and often overcome, social and symbolic boundaries in their communities. This has implications for global health. Community health worker programs are critical for the effective delivery of health services in low- and middle-income countries, especially for marginalized populations. By emphasizing the experiences of these workers in negotiating the dynamics of their communities, this research will generate policy recommendations about how to better support community health workers in their role. This research will study a) the reasons why women continue to work as community health volunteers; b) the meaning that this work has for them, beyond their formal tasks; and c) how caste affects their experiences with their community on the one hand, and with the health system on the other. The project will conduct a relational ethnography of Dalit, formerly untouchable, and dominant caste community health volunteers in the two districts of Muktsar and Shaheed Bhagat Singh (SBS) Nagar in Punjab, India. The North Indian state of Punjab presents a privileged case in terms of overall prosperity and social mobility for Dalits relative to the rest of India. Within Punjab, Muktsar and SBS Nagar are two districts that have similar percentages of Dalits in the population, but differ on key indices of economic mobility, such as literacy. The community health volunteers are pre-dominantly lower caste, working class women. The project expects that while gender and caste act to subsidize the state, the state also provides opportunities for these women to mitigate their marginalization by according them status and access otherwise unavailable to them. Comparing Muktsar and SBS Nagar will allow for a nuanced understanding of caste not as static social identity, but rather as reproduced dynamically in the context of the local political economy.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.