Medical professionalism that is grounded in the autonomy of professionals’ decision-making, and public participation of patients in health governance are essential prerequisites for effective healthcare provision.
However, in non-democratic societies the agency of both healthcare workers and their clients is not encouraged – their understandings of what constitutes valid biomedical knowledge and good care are subjugated to bureaucratic vision, and their participation in health governance is formally restricted. But this does not mean that the agency of healthcare actors cease to exist in such socio-political circumstances.
In this research project, I trace the ground-level efforts of Russian healthcare practitioners and patients who are coping with institutional inefficiencies and introducing organisational innovations in country’s medical services. The research contributes to the academic debate on health-related institutional agency by exploring conditions and strategies of such agency under authoritarian regime. The project also contributes to the prolific literature on post-socialist welfare by studying how the meaning-making activities and the institutional work of ground-level actors build into and advance institutional changes in post-socialist healthcare.
Funding source
TRANSFORM research platform (Tampere University)
