Strengthening citizen-led accountability initiatives is a critical rights-based strategy for improving health services for indigenous and other marginalized populations. As these initiatives have gained prominence in health and other sectors, there is great interest in how they operate and what makes them effective. Scholarly focus is shifting from measuring the efficacy of their tools and tactics to deepening understand-ing of the context-sensitive pathways through which change occurs. This paper examines how citizen-led initiatives’ actions to strengthen grassroots networks, monitor health services and engage with authorities interact with local sociopolitical conditions and contribute to accountability achievements for indigenous populations in rural Guatemala. We used qualitative comparative analysis to first systematize and score structured qualitative monitoring data gathered in 29 municipal-level initiatives, and then analyze patterns in the presence of different forms of citizen action, contextual conditions and accountability out-comes across cases. Our study identifies pathways of collective action through which citizen-led initiatives bolster their power to engage and negotiate with authorities and bring about solutions to some of the health system deficiencies that they face. While constructive engagement is widely advocated as the most effective approach to interaction with authorities, our study indicates that success depends on wider processes of community mobilization. To overcome the power asymmetries that marginalized groups face when engaging with authorities, iterative processes of network building and participatory monitoring as well as persistence in their demands are critical. These processes further provide an enabling environment for moving beyond the local and projecting indigenous voices to engage with authorities at higher governance levels. Initiatives also applied adversarial legal action as an alternative engagement strategy that contributed to bolster citizen power. Our findings indicate the potential of collective power generated by the actions of citizen-led initiatives to enable marginalized populations to hold authorities accountable for health system failures.
The resource was published in the World Development Journal, Vol. 113, January 2019, pages 392-401.
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Last updated January 30, 2013.
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Last updated: April 26, 2024
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The current list of third party service providers we use include:
| COOKIE NAME | PROVIDER | CATEGORY | DESCRIPTION |
|---|---|---|---|
| wp_lang | grassrootsjusticenetwork.org | necessary | |
| wordpress_test_cookie | grassrootsjusticenetwork.org | necessary | Cookie set by WordPress to check if the cookies are enabled on the browser to provide appropriate user experience to the users |
| _gat | grassrootsjusticenetwork.org | analytics | Used to monitor number of Google Analytics server requests when using Google Tag Manager |
| lidc | linkedin.com | advertisement | Used by the social networking service, LinkedIn, for tracking the use of embedded services. |
| __hssrc | grassrootsjusticenetwork.org | analytics | Used to determine if a session is a new session |
| li_sugr | linkedin.com | analytics | Used to make a probabilistic match of a user's identity outside the Designated Countries |
| UserMatchHistory | linkedin.com | advertisement | These cookies are set by LinkedIn for advertising purposes, including: tracking visitors so that more relevant ads can be presented, allowing users to use the 'Apply with LinkedIn' or the 'Sign-in with LinkedIn' functions, collecting information about how visitors use the site, etc. |
| YSC | youtube.com | functionality | Registers a unique ID to keep statistics of what videos from YouTube the user has seen. |
| _ga | grassrootsjusticenetwork.org | analytics | ID used to identify users |
| bcookie | linkedin.com | advertisement | Used by LinkedIn to track the use of embedded services. |
| _ga_W3R156NSLL | grassrootsjusticenetwork.org | analytics | Used to persist session state |
| IDE | doubleclick.net | advertisement | This cookie is used for targeting, analyzing and optimisation of ad campaigns in DoubleClick/Google Marketing Suite |
| __hs_do_not_track | grassrootsjusticenetwork.org | necessary | Prevents the tracking code from sending any information to HubSpot |
| __cf_bm | grassrootsjusticenetwork.org | necessary | Cloud flare's bot products identify and mitigate automated traffic to protect your site from bad bots. Cloudflare places the __cf_bm cookie on End User devices that access Customer sites that are protected by Bot Management or Bot Fight Mode. The __cf_bm cookie is necessary for the proper functioning of these bot solutions. |
| _gid | grassrootsjusticenetwork.org | analytics | ID used to identify users for 24 hours after last activity |
| hubspotutk | grassrootsjusticenetwork.org | analytics | Contains visitor's identity |
| __hstc | grassrootsjusticenetwork.org | analytics | Analytics tracking cookie |
| __cf_bm | vimeo.com | necessary | Cloud flare's bot products identify and mitigate automated traffic to protect your site from bad bots. Cloudflare places the __cf_bm cookie on End User devices that access Customer sites that are protected by Bot Management or Bot Fight Mode. The __cf_bm cookie is necessary for the proper functioning of these bot solutions. |
| _gcl_au | grassrootsjusticenetwork.org | advertisement | Used by Google AdSense for experimenting with advertisement efficiency across websites using their services. |
| bscookie | linkedin.com | advertisement | Used by LinkedIn to track the use of embedded services. |
| VISITOR_INFO1_LIVE | youtube.com | advertisement | Tries to estimate the users' bandwidth on pages with integrated YouTube videos. |
| AnalyticsSyncHistory | linkedin.com | functionality | Used to store information about the time a sync with the lms_analytics cookie took place for users in the Designated Countries |
| __hssc | grassrootsjusticenetwork.org | analytics | Analytics session cookie |
| vuid | vimeo.com | analytics | This first party cookie created by Vimeo is used to assign a Vimeo Analytics unique id. |
| __hs_cookie_cat_pref | grassrootsjusticenetwork.org | necessary | The HubSpot Cookie Banner's consent preferences cookie. |
| ar_debug | google-analytics.com | ||
| VISITOR_PRIVACY_METADATA | youtube.com | ||
| NID | google.com | necessary | This cookies is used to collect website statistics and track conversion rates and Google ad personalisation |
| cf_clearance | vimeo.com | ||
| __cf_bm | hsforms.com | necessary | Cloud flare's bot products identify and mitigate automated traffic to protect your site from bad bots. Cloudflare places the __cf_bm cookie on End User devices that access Customer sites that are protected by Bot Management or Bot Fight Mode. The __cf_bm cookie is necessary for the proper functioning of these bot solutions. |
| JSESSIONID | nr-data.net | functionality | JSESSIONID is a platform session cookie and is used by sites with JavaServer Pages (JSP). The cookie is used to maintain an anonymous user session by the server. |
| _cfuvid | vimeo.com | necessary | This cookie is used to apply rate limits to traffic. It allows the Cloudflare WAF to distinguish individual users who share the same IP address. |
Personal information you submit via your member account, other than information provided or content posted by you to public areas of the Site as described below, is deleted from Namati’s records following the deletion of your account. However, such information may continue to be retained by third-party service providers to which it has been disclosed for one of the reasons listed above. Any financial records will be kept in accordance with Namati’s data retention policy.
Your Information is stored on Digital Ocean servers in New York, USA. When you provide personal information to us, we request your consent to transfer that personal information to the USA. The USA does not have an adequacy decision from the European Commission, which means that the Commission has not determined that the laws of the USA provide adequate protection for personal information. Although the laws of the USA do not provide legal protection that is equivalent to the EU GDPR, we safeguard your personal information by treating it in accordance with this Policy. We take appropriate steps to protect your privacy and implement reasonable security measures to protect your personal information in storage. We use secure transmission methods to collect personal data through our website. We also enter into contracts with our data processors that require them to treat personal information in a manner that is consistent with this Policy.
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The Forum uses data about your posts and other activity to make automated decisions about whether your posts are spam.
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From time to time, we may email users of the Site information regarding important developments affecting Namati. We may also email users on occasion regarding the Site. Such emails may be sent to users of the Site if they have given their consent previously or if they have requested information from us or acquired goods or services from us in the past and have not opted out of receiving marketing communications. You can ask us to stop sending you marketing messages at any time by (i) logging into the website and checking or unchecking relevant boxes to adjust your marketing preferences; or (ii) by following the opt-out links on any marketing message sent to you; or (iii) by contacting us at any time.You may choose to unsubscribe from future emails by using the unsubscribe link included in all mass email correspondence from Namati.
If a user elects to use our referral service to inform a friend about the Site and Forum, we request the name and email address of the friend. Namati will automatically send the friend a one-time email inviting the friend to visit the Site. Namati stores this information for the sole purpose of sending this one-time email, and, while a third-party mail service provider may retain the information in its database, no additional emails will be sent by Namati without further action by the friend.
The Site and the Forum may contain links to websites owned and operated by other parties. We are not responsible for and have no control over the privacy policies of those sites. We encourage you to review the privacy policies and terms of use of those sites prior to providing them with any information.
Namati uses cookies. Cookies are small pieces of information that a website transfers to your computer’s hard drive for record-keeping purposes and may have unique identifiers and transmit information about you and how you use the Site. Such information may include your search preferences, your browser type and the date and time of use. If you choose, you can disable some (but not all) Cookies in your device or browser settings, but doing so may affect your ability to use the Site.
Namati does permit several non-advertising third parties to set third-party cookies in order to enhance Site functionality. These third parties may include, but are not limited to: Facebook, Google, and Vimeo. For more information on the cookies that these third parties set, users are encouraged to consult the privacy policies and terms of use of these third parties.
Namati is concerned about the privacy protection of children who access the Internet and this website is not intended for children and we do not knowingly collect data relating to children. Accordingly, the Site and Forum are not intended for use by anyone under the age of 16, and we do not knowingly collect information from anyone under 16 years of age without the consent of a parent or guardian.
We reserve the right to disclose any information to comply with any law, regulation, decree, judgment, order, subpoena or any other governmental order (“Order”) without any obligation to contest or verify the accuracy of such Order.
This Policy will be governed by and construed in accordance with the laws of the State of New York, without regard to any principles of conflicts of law. You agree that any action at law or in equity that arises out of or relates to any use of the Site may be filed:
The section titles in this Policy are for convenience only and have no legal or contractual effect. The Site, the Forum, and any third-party services they use, may be subject to additional terms and conditions regarding privacy and use of information. Your use of the Site and the Forum is subject to those terms and conditions, which are incorporated into this Policy by reference. In the event of an inconsistency between this Policy and any additional posted conditions, the provisions of the additional conditions shall control.
We may need to change the Policy from time to time in order to address new issues and to reflect changes on the Site or in the law. We reserve the right to revise or make any changes to the Policy, and your continued use of the Site subsequent to any changes to this Policy will mean that you agree to and accept such changes. You can tell if the Policy has been updated by checking the last revised date posted on the top of this page. Historic versions can be obtained by contacting us at privacy@namati.org
You can access, remove, update or correct your information in your Site profile (https://grassrootsjusticenetwork.org/connect/member/YOUR USERNAME HERE/?edit=1) and your Forum profile (https://connect.grassrootsjustice.network/u/YOUR USERNAME HERE/preferences/account).
You can also access, remove, update or correct your information, and raise any questions or concerns regarding the Site or the Policy, by emailing privacy@namati.org, or mailing:
Namati Data Protection Officer 1616 P Street NW, Suite 101 Washington, DC 20036, USA
It is important that the personal data we hold about you is accurate and current. Please keep us informed if your personal data changes during your relationship with us.
You have the right to:
Request access to your personal data (commonly known as a “data subject access request”). This enables you to receive a copy of the personal data we hold about you and to check that we are lawfully processing it.
Request correction of the personal data that we hold about you. This enables you to have any incomplete or inaccurate data we hold about you corrected, though we may need to verify the accuracy of the new data you provide to us.
Request erasure of your personal data. This enables you to ask us to delete or remove personal data where there is no good reason for us continuing to process it. You also have the right to ask us to delete or remove your personal data where you have successfully exercised your right to object to processing (see below), where we may have processed your information unlawfully or where we are required to erase your personal data to comply with local law. Note, however, that we may not always be able to comply with your request of erasure for specific legal reasons which will be notified to you, if applicable, at the time of your request.
Object to processing of your personal data where we are relying on a legitimate interest (or those of a third party) and there is something about your particular situation which makes you want to object to processing on this ground as you feel it has an impact on your fundamental rights and freedoms. You also have the right to object where we are processing your personal data for direct marketing purposes. In some cases, we may demonstrate that we have compelling legitimate grounds to process your information which override your rights and freedoms.
Request restriction of processing of your personal data. This enables you to ask us to suspend the processing of your personal data in the following scenarios:
Request the transfer of your personal data to you or to a third party. We will provide to you, or a third party you have chosen, your personal data in a structured, commonly used, machine-readable format. Note that this right only applies to automated information which you initially provided consent for us to use or where we used the information to perform a contract with you.
Withdraw consent at any time where we are relying on consent to process your personal data. However, this will not affect the lawfulness of any processing carried out before you withdraw your consent. If you withdraw your consent, we may not be able to provide certain products or services to you. We will advise you if this is the case at the time you withdraw your consent.
You will not have to pay a fee to access your personal data (or to exercise any of the other rights). However, we may charge a reasonable fee if your request is clearly unfounded, repetitive or excessive. Alternatively, we could refuse to comply with your request in these circumstances.
We may need to request specific information from you to help us confirm your identity and ensure your right to access your personal data (or to exercise any of your other rights). This is a security measure to ensure that personal data is not disclosed to any person who has no right to receive it. We may also contact you to ask you for further information in relation to your request to speed up our response.
We try to respond to all legitimate requests within one month. Occasionally it could take us longer than a month if your request is particularly complex or you have made a number of requests. In this case, we will notify you and keep you updated.
If you live in an EEA Member State, all of which have adopted the EU GDPR and national , you have a right to lodge a complaint with your relevant supervisory authority about this policy and its application. The European Commission has a list of EU national data protection authorities here:
http://ec.europa.eu/justice/article-29/structure/dataprotectionauthorities/index_en.htm
If you live in the United Kingdom, you have a right to lodge a complaint with your relevant supervisory authority, the ICO, about this policy and its application:
https://ico.org.uk/make-a-complaint/