The everyday political economy of health: Community health workers and the response to the 2015 Zika outbreak in Brazil

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How is neoliberalism implicated in concrete health vulnerabilities? How do macro-level political economy, policy and institutions translate into everyday experiences? Drawing on Marxist, feminist and International Political Economy critiques of everyday life, the article advances an everyday political economy of health focused on four key components: power, agency, intersectionality and the mutual implication of the global and the local. These components enable a nuanced investigation of concrete experiences of health and disease, and of the local implementation of health policies in the context of neoliberalism. The framework is applied to the case of the 2015 public health response to Zika in Brazil, and specifically to the role of community health workers, close-to-community healthcare providers tasked with bridging the health system and vulnerable groups. The everyday practice of these workers, and their working conditions overwhelmingly characterized by precarity and low pay, reveal the presence of global neoliberal dynamics pertaining to the reconfiguration of the Brazilian state as healthcare provider in a context of encroaching austerity, privatization and narrowly-defined cost-efficiency. These dynamics impacted detrimentally upon the effectiveness of the Zika response.

Original languageEnglish
Pages (from-to)146-166
Number of pages21
Issue number1
Early online date27 Jun 2019
Publication statusPublished - 2 Jan 2020

Bibliographical note

©2019 The Author.


  • Brazil
  • Everyday political economy
  • Zika
  • community health workers
  • global health
  • neoliberalism

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