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Intercultural Health in Ecuador: A Critical Evaluation of the Case For Affirmative Biopolitics

Netsch Lopez, Trisha S (2022) Intercultural Health in Ecuador: A Critical Evaluation of the Case For Affirmative Biopolitics. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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This research examines the prospect of affirmative biopolitics through Intercultural Health policies in Ecuador. Spurred by radical demands for decolonization by the indigenous uprising, Interculturality became a political platform for the recognition of indigenous groups and alternate forms of development such as Sumak Kawsay and Buen Vivir during the administration of President Correa. Part of expansive healthcare reforms, Intercultural Health policies attempted to recognize traditional indigenous medicines within the public universal healthcare system. Based on ethnographic research at a Ministry of Public Health clinic housing indigenous midwives and biomedical practitioners, I examine the biopolitical implications of enacting Interculturality through national healthcare policies.

I argue Intercultural Health policies provide a critical case study for a nuanced theory of affirmative biopolitics. Through detailed examination of policy in-action, I examine the complex negotiations behind adjusting biopolitical agendas to include diverse ways of life. Across multiple levels of policy design and implementation, I analyze the frictions between the hegemonic forces of biopolitical agendas such as the Buen Vivir objectives, and expanding the biolegitimacy of diverse ways of life through Interculturality. Despite attempts to incorporate traditional medicines, the push to achieve statistical health outcomes ultimately reinforced the dominance of biomedicine. At all levels, individuals questioned what forms of inclusion are truly legitimizing. However, instead of resisting biopolitical control outright, many sought more inclusive forms of biopower.

Building upon proposals for affirmative biopolitics, I propose an analytical framework for examining how biopolitical agendas can incorporate diverse ways of life. I argue that affirmative biopolitics are defined by a plurality of lifeways, networks of change, participatory governance, and political and structural adjustment. Through my analysis of Intercultural Health policies, I demonstrate how these components interact in complex ways to both support and undermine affirmative biopolitical goals. In doing so, I argue against theorizing biopower as predominantly neoliberal or as a monolithic agenda of the state. I demonstrate how Ecuadorian neo-socialist policies established a co-responsibility between citizens, communities, and the state. Likewise, activist and indigenous involvement in political structures creates challenges from within state institutions. Ultimately, biopolitical controls limit radical paradigms to incremental affirmative change.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Netsch Lopez, Trisha Stsn9@pitt.edutsn9
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairMusante, Kathleenkathleen.musante@pitt.edukathleen.musante
Committee CoChairAlter,
Committee MemberMatza,
Committee MemberTerry,
Committee MemberGuerra-Reyes,
Date: 6 June 2022
Date Type: Publication
Defense Date: 18 March 2022
Approval Date: 6 June 2022
Submission Date: 24 March 2022
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 341
Institution: University of Pittsburgh
Schools and Programs: Dietrich School of Arts and Sciences > Anthropology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Intercultural Health, Affirmative Biopolitics, Biopolitics, Buen Vivir, Cultural Competence, Humanized Birth, Intercultural Birth, Midwifery, Traditional Birth Attendants, TBAs, Community Health Workers, CHWs, MDGs, Correa, Ecuador
Date Deposited: 06 Jun 2022 15:56
Last Modified: 06 Jun 2022 15:56

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  • Intercultural Health in Ecuador: A Critical Evaluation of the Case For Affirmative Biopolitics. (deposited 06 Jun 2022 15:56) [Currently Displayed]


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