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

妇女社区保健志愿者如何成功地提供妇幼保健服务？此外，他们的成功告诉我们，国家权力在微观层面的运作及其塑造边缘化群体生活的能力是什么？本研究探讨了基层官僚（即一线工人）在国家权力谈判中的意义，以及亲密劳动与性别、阶级和种族不平等的相互关系。调查结果将显示社区卫生工作者如何协商并经常克服其社区中的社会和象征性界限。这对全球健康有影响。社区卫生工作者规划对于中低收入国家有效提供卫生服务至关重要，特别是对边缘化人群而言。通过强调这些工作人员在协商其社区动态方面的经验，这项研究将产生关于如何更好地支持社区卫生工作人员发挥作用的政策建议。本研究将研究a)妇女继续担任社区卫生志愿者的原因；B)这份工作对他们的意义，超越了他们的正式任务；c)种姓如何一方面影响他们与社区的体验，另一方面影响他们与卫生系统的体验。该项目将对印度旁遮普省Muktsar和Shaheed Bhagat Singh (SBS) Nagar两个地区的达利特人（以前是贱民）和占主导地位的种姓社区卫生志愿者进行相关人种志研究。相对于印度其他地区，印度北部的旁遮普邦在总体繁荣和社会流动性方面为达利特人提供了一个特殊的案例。在旁遮普，Muktsar和SBS Nagar是两个达利特人口比例相似的地区，但在经济流动性的关键指标上存在差异，比如识字率。社区卫生志愿者主要是低种姓的工人阶级妇女。该项目预计，在性别和种姓法案补贴国家的同时，国家也为这些妇女提供机会，通过提高她们的地位和获得她们原本无法获得的权利来减轻她们的边缘化。比较Muktsar和SBS Nagar将允许对种姓的细微理解，而不是静态的社会身份，而是在当地政治经济背景下动态复制的。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

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.