In the first video, we asked the question, "Is participation always a good thing?" This is a question that many participatory researchers struggle with on a daily basis. You have learned about some of the positive impacts that participatory approaches might bring: transformational learning in individuals and communities, building social and organizational capacity in a community, individual and collective empowerment to make decisions, tackling inequalities in health, the creation of new forms of local knowledge and evidence, and even policy change. However, there are also critics of both particular types of participatory approaches, and of participation as an approach in general. In this video, you'll become familiar with common critiques and start to develop the tools to critically appraise participatory approaches yourself. You'll have the chance to consider and discuss where participation is and is not appropriate. As public health researchers and practitioners, you'll then be able to consider, has a particular participatory approach been successful, how might we measure the success. Is a participatory approach the right one for me to take in my context? So what are some of the criticisms commonly leveled at participatory approaches to public health? In Cooke and Kothari's, Participation: The New Tyranny, they set out some particular critiques of participation in international development, which could also be applied to public health. They argue that participation often comes in place of power, people took part in projects but were not given power and responsibility over decision-making. In fact, by simplifying what power constitutes, it merely enables a reassertion of power and social control. Cooke and Kothari aren't alone, other authors have also been critical of the way that participation has developed in recent times. Some studies have demonstrated possible negative byproducts of participation. For example, it has being found that sometimes it has increased mistrust between a community, soured relationships with those excluded from the network, diverted claims away from state institutions, and transferred blame onto the community, and delegitimized participatory politics, both for participants and non-participants, subsequently constricting the democratic imagination. Other critics have lamented the travel of participation from radical social movements inside elite institutions, and it is those institutions still control the agenda. Power is not being redistributed. Moreover, it promotes consensus over conflict, which is not always a good thing. Participation can help to facilitate a non-conflicted partnership between marginalized groups and powerful actors such as a state, governmental organizations, policymakers, leaving established power relations unchallenged. It then just becomes a means to justify, legitimate and perpetuate the current order. It's been claimed as such, participation has lost its original meaning, disconnected from wider movements for social transformations. While these are critiques of the general trends towards participation, others have been critical of particular approaches. For example, participatory programs applied by actors in the global north to communities in the global south, face accusation of new forms of colonialism. Poor facilitation is another common charge leveled against participatory approaches. The international collaboration for participatory health research, argued that poor facilitation can contribute to the entrenchment of the very dominating authority they're seeking to study and influence. They argue it should not be seen as another off-the-shelf method like any other technical research method, and we should always remain critical. Others have asked, what happens at the end of the project. Does the participation stop and the funding dries up and all the practitioners go home, can participation be built sustainable. Throughout this course, you've learned about the benefits that participatory approaches can bring to public health, but with these clear challenges and limitations, we need to think from the outset about whether participatory approaches are appropriate in our context. We need to always be reflexive in order that we build participatory approaches that are meaningful and empowering and not exploitative. In this video, you've heard about the scholarly debate surrounding the critique of participatory approaches and some of the prominent criticisms that must be considered. In the next video, you'll learn about the ladder of participation, a useful tool for you to assess participatory approaches. But before you begin to think about frameworks for assessing participation, sometimes it is helpful for us to pause, reflect, and ask if participatory approaches are the right ones to take it to. Now you will take part in one activity to encourage you to think about contexts in which a participatory approach is appropriate or not, think about strategies that may or may not help to mitigate some of the identified dangers of participation.
