Grassroots leadership in the Network of Healthy Communities in Rio de Janeiro, Brazil: a gender perspective

Abstract

Based on ethnographic research conducted with the Network of Healthy Communities in Rio de Janeiro, Brazil, this article examines how grassroots leaders have sought networks and partnerships as a strategy to amplify and strengthen their work, particularly through the exchange of information. It provides a gender analysis of activists’ work, leadership styles, motivations, mobilisation strategies, and difficulties. The study concludes that the politicisation of motherhood is critical for women's emergence as leaders, as well as for creating the necessary conditions for work in communities dominated by drug lords. Rather than reinforcing traditional gender conceptions, activism revises gender relations and identities. Health policies should include grassroots leaders, and invest in their potential for community health promotion, so that family and community medicine programmes can benefit from working with activists and using their strategies.

Acknowledgements

The author wishes to thank the Brazil's National Research Council for funding the research.

Notes

1. Community activism in Brazil has to be understood in the context of a progressive process of redemocratisation in the early 1980s, after nearly two decades of military dictatorship. A landmark in this process was the 1988 Constitution, which is far-reaching in guaranteeing citizens’ individual and collective rights. The Constitution decentralised power, and promoted significant social benefits. Brazil has become a stronger democracy and the notion of cidadania (citizenship) has gone mainstream.

2. In the Ottawa Charter the World Health Organization (WHO 1986:1) defines health promotion as: ‘the process of enabling individuals and communities to increase control over the determinants of health and thereby improve their health…The fundamental conditions and resources for health are: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity’. Five action areas for health promotion were identified: building healthy public policy; creating supportive environments; strengthening community action; developing personal skills through information and education skills; and re-orientating health-care services toward prevention of illness and promotion of health. The concept of health promotion is distinctive because it promotes a shift of approach from a curative approach to ill-health, to a model which stresses the social issues which determine health.

3. The concept of healthy cities/communities was proposed in 1985 by Leonard Duhl at the ‘Beyond Health Care Conference’ in Toronto, Canada. It was taken up by the World Health Organization, which launched a Healthy Cities initiative in 34 European cities in 1988. It has become an international movement devoted to grassroots social change seeking to promote health by building healthy cities and communities worldwide.

Additional information

Notes on contributors

Cecilia de Mello e Souza

Cecilia de Mello e Souza is a Professor at the EICOS Program (Interdisciplinary Community and Social Ecology Studies) at the Federal University of Rio de Janeiro. She is a social psychologist and anthropologist with a Ph.d from the University of California, Berkeley