Running head: CRITICAL ANALYSIS OF PROJECT PIAXTLA 1

Critical Analysis of Project Piaxtla

Name

Institution Affiliation
CRITICAL ANALYSIS OF PROJECT PIAXTLA 2

Outline

Introduction ..................................................................................................................................... 3

Participatory Planning Approach .................................................................................................... 4

Participatory Planning Methods .................................................................................................. 4

Using Land Struggles to Assess Participatory Health Projects ...................................................... 6

Participatory Planning Method in Practice ................................................................................. 7

Project Piaxtla Participation in the Context of Global Health: NAFTA. ........................................ 9

Conclusion .................................................................................................................................... 11
CRITICAL ANALYSIS OF PROJECT PIAXTLA 3

Critical Analysis of Project Piaxtla

Introduction

The Primary Health Care (PHC) policy was the result of the World Health Organization

(WHO) affiliate state meeting held at Alma Ata in 1978. The member states to the WHO

developed a framework to enhance the healthcare of the citizen by eliminating the inequalities in

the health facilities (De Vos et al. 2009, p.121). Resultantly, the main agenda of the Declaration

of Alma-Ata was primary health care. The main items highlighted in the convention entail

involvement in the organization, control, and planning of primary health in addition to

community and personal self-relief (De Vos et al. 2009, p.122). The result of the agreement

recognized three significant participatory strategies: the community development approach; the

medical approach and the health service approach. The declaration highlighted the need for

economic and social advancement in the healthcare which formed the conventional basis for the

provision of health care services (De Vos et al. 2009, p.122). Particularly, the guidelines of

equity and social justice modeled the practice of healthcare as the propelling element behind

health improvements. The guidelines also emphasized on the effect of technology suitability and

sustainability in primary health care (Bhatia & Rifkin 2010, p.1). Currently, the principles

outlined in the declaration of Alma Ata have become evident in most primary health

interventions in various countries around the world. On such instance the Project Piaxtla, a

primary health care program based in Western Mexico, which significantly highlights the

guidelines of the Alma Ata declaration (Werner & Sanders 1997, p.141). The research will

utilize the participatory planning approach to examine Project Piaxtla in the context overtime

changes in needs assessment, the program stakeholders, the issues of inequality and how the

actions are in line with the framework of participatory planning.

CRITICAL ANALYSIS OF PROJECT PIAXTLA 4

Participatory Planning Approach

Participatory planning is a collaborative planning process. Participatory planning has

developed as an alternative to institutionalized forms of planning that rely on public agencies to

develop the framing of problems and solutions. It is a more time-intensive process that focuses

on educating participants in the vocabulary at hand and then works with participants to develop

visions or ideas for the changes they want to see. Specifically, this approach is rooted in the idea

that local knowledge is valuable and participatory processes have the potential to address issues

like exclusion and discrimination. It is also more focused on the process than on the product,

although in some cases the product is an important aspect of the project. Gosling and Edwards

(2003, p.194) believe that the approach involves a technique of reversing the power relation

between the members of the community and the external agencies. The basis of the approach is a

systematic development plan founded on the highlighted problems and the suggestion for solving

such issues. Practically, the planning and designing of the development intervention is the

responsibility of the community members rather than the external parties. According to Green

(1993, p.240), the existing inefficiencies of the external entities necessitates the conveyance of

the development agenda to the community members who are the recipient of the service.

Specifically, the inefficiencies of the external agencies entail the time constraints, overemphasis

on the alternatives, inadequate stakeholder participation and limited parties involved in the

project participation which the external parties are accountable for development (Hubbard 2001,

p.25).

Participatory Planning Methods

Within the participatory planning approach, there are various techniques, some of which,

like charrettes, visioning, and community mapping, are commonly used by community groups
CRITICAL ANALYSIS OF PROJECT PIAXTLA 5

trying to engage stakeholders. A charrette is a collaborative design event that fosters community

ownership of a project by including stakeholders before the start of design and maintaining

inclusion in the process throughout the evolution of the plan or design (Lennertz, Lutzenhiser,

Cox Blair, Wood, & Wilbur, 2013). Generally, charrettes are intended to be intense processes,

lasting only a couple of days, where ideas are taken from scratch and built out into drawings and

plans. The charrette is held up a valuable participatory design process because its very nature as

community-based process should translate into popular support of the resulting plans Visioning

is a process where participants are asked to think about how they would like their community to

be, identify ways to work toward the vision and turn the vision into images and words.

Community mapping is when participants observe and collect neighborhood information through

fieldwork. They can then use this information to identify assets and gaps within a geographic

area and use this data to strategize next steps. Storytelling and theater/role-playing is also under

the participatory planning umbrella. The first allows participants to share their history and

identity, while the latter allows participants to imagine new points of view and reflect on their

own (Innes & Booher, 2010). All of these techniques build on the principle of collaborative

learning that is central to participatory planning.

Many times organizations engaging participants in participatory processes will use a

combination of techniques, whereas others will focus solely on one technique. Generally, the

first principle of participatory planning approaches it that projects are encounter natural variation

since they occur in an unregulated setting. The second principle is that participatory planning

depends on searching for diversity. Specifically, this principles seeks to assess any disparities,

anomalies, and contradictions. The third hypothesis insists on the significance of self-awareness

in participatory planning since it enables the organizers to assess their behavior and accept errors
CRITICAL ANALYSIS OF PROJECT PIAXTLA 6

(Chambers 1992, p.15). fourth, the method relies on the assumption of maximizing tradeoffs and

offsetting biases which entail understanding issues affecting the poor as well as the marginalized

such as the children and women (Chambers 1992, p.14). Vlassoff and Moren (2002, p.1713)

point out that most communities have victimized women by providing them lesser role compared

to men. Instead, social, economic and political factors should determine the needs of both

women and men equally. Consequently, an assessment of gender is essential before

implementing the participatory planning approach. Eventually, the concepts of sharing and

facilitating information are significant to the functioning of the participatory planning approach.

In fact, these concepts outline the need to support learning among the rural community members

and enhance information exchange between the facilitator and the community members.

Using Land Struggles to Assess Participatory Health Projects

Prior to the Mexican Revolution, the poor people encountered challenges of unequal

distribution of land. In fact, the feudal land regulation of the Porfirio Diaz was the significant

cause of Mexican Revolution since Diaz supported the fair apportionment of land to the elite at

the expense of the native people. The farmers had ineffective means to maintain themselves

since the significant part of the plantation belonged to the rich who had the best of farmlands.

Resultantly, the landless sought to support themselves through farming on the barren lands on

the hillsides utilizing crude techniques or working as sharecroppers. Regardless, survival through

such means was difficult. Therefore, the Mexican Revolution was a significant era for

transforming the health of the citizens and the defending their rights. Specifically, the casual

laborers and the health team of the Piaxtla project were able to retrain the benefits of their twenty

years struggle for better health and equal distribution of land through the Mexican Revolution

(Werner & Sander, 1997, p.149).

CRITICAL ANALYSIS OF PROJECT PIAXTLA 7

The peasants succeeded in challenging the unequal distribution of land which resulted in

poor health care as well as inadequate food through skills that they attained from Piaxtla. Based

on their constitutional knowledge, the landless started to encroach and cultivate some of the land

plantations that belonged to the elite. The called for eligible land titles form the government

following equal subdivision of land. Afterward, the peasant relied on representative when the

government did not consider their legal titles of land ownership. The long-term lobbying by the

landless resulted in a law that forced the state government to provide the farmers with legal

documentation (Werner & Sanders, 1997, p.145). Besides, Salina de Gotari period as the

president resulted to the reintroduction of the land reforms as well as the ejido system which

were somehow not active when Mexico was preparing to join the American Free Trade

Agreement (NAFTA). In fact, Salina de Gotari introduced a diktat which enables the former

ejidos members to vote either for the retention of the ejidal structure or disband it. Despite the

existence of propaganda from the extant government to propel people to append the ejidos, the

poor farmers resolved for its extension (Rath, 2009, p. 161).

Participatory Planning Method in Practice

Prior to the initialization of the Project Piaxtla, the farmworkers receive food loans from

the elite people. Conversely, the reimbursement of such food advances was intense to the extent

that the peasant had limited resources to use after repaying the debts. For example, the credit

system indicated that the peasants would reimburse one bag with six bags of maize.

Consequently, the establishment of the Piaxtla projected enabled the farmworkers to design a

cooperative maize bank to refute the unethical debt system. Besides, the loans from the corn

banks lower rates of interested when compared to former credit system and it redirected the

income to increase the pool of fund. Finally, five more villages integrated into the community
CRITICAL ANALYSIS OF PROJECT PIAXTLA 8

controlled loan initiative which resulted in more availability of capital. Through extension, the

initiative improved the nutrition and the health of the farmworkers by advancing their financial

status. Furthermore, the program helped the peasant to develop managing, accounting, and

planning techniques through coordination and accountability. Besides, the peasants improved

their confidence as well as their living condition (Werner & Sanders 1997, p.114).

Many women in Ajoya started understanding and attaining their societal powers as well

as roles. Specifically, they resolved to combat the increasing menace of drunkenness among

men. Since children and women appeared to victims of alcoholism since their exposed to

interpersonal and domestic abuse in the region. With men using funds meant for food to buy

alcohol, alcoholism appeared to have a negative impact on health and nutrition of the women as

well as children. Interestingly, business owner saw the gap to open alcohol cantinas so as attract

the developing market niche. However, the health workers from the Piaxtla Project merged with

women and children to oppose the development of alcohol business in the area. Specifically, they

achieved this by designing a theatrical presentation that dramatized the effect of alcohol abuse on

the families. Even though some of the health workers were detained, the effectiveness of this

approached was illustrated through the closing of most native inns (Werner & Sanders 1997,

p.145). During the initialization stage of the project, the designers of the project observed a

recurrence of problem that they sought to solve. Resultantly, they included preventive

approaches such as water systems and drainage systems into the main objective of the project

(Edwards et al. 2011, p.10). They resolved to safeguard the essential needs and rights of the

natives through safe as well as convenient water source. In fact, this approach resulted in a more

shift of socio-political dimension of the Piaxtla project. Among the strategic approach was to
CRITICAL ANALYSIS OF PROJECT PIAXTLA 9

facilitate a protest to enable the local gain control of the water sources which the elite had

privatized initially (Warner & Sanders, 1997, p.143).

Project Piaxtla Participation in the Context of Global Health: NAFTA.

North America Free Trade Agreement (NAFTA) was a 1990s neoliberal agreement

among the United States, Mexico, and Canada to amend the World Bank as well as the

International Monetary Fund’s guidelines (Werner & Sanders 1997, p.147). the establishment of

NAFTA resulted in a high decrease of poverty and food levels in Mexico as depicted in the

following figures. It is through this accord that the Mexican government introduced the

Oportunidades initiative aimed at alleviating the level of poverty in the nation. The program also

sought to improve the nutrient level as well as healthcare standards among the marginalized

communities through financial aids as part of the general poverty elimination approach. The

State of Puebla which is the biggest area for Piaxtla Municipality is among the six main

beneficiaries of the program (Villareal, 2010, p.6).

Year %(people) poverty magnitude % (people) food poverty

1992 29.7 21.4
1994 30.0 21.2
1996 46.9 37.4
1998 41.7 33.3
2000 31.8 24.1
2002 26.9 20.0
2004 24.7 17.4
2006 20.7 13.8
2008 25.1 18.2
Table 1: level of poverty in Mexico (Coneval, 2017)
CRITICAL ANALYSIS OF PROJECT PIAXTLA 10

90

80

70

60

50
Capabilities
40 Poverty
30 Food Poverty

20

10

0
1992 1994 1996 1998 2000 2002 2004 2006 2008

Figure 1: level of poverty in Mexico

Even though the NAFTA accord resulted to significant improvement of financial and

social dimensions in Mexico, it was different from ejidos communal land guidelines.

Specifically, the ejidos communal land system opposed the trade relations between Mexico and

the United States since the entities from the United States could not buy extensive lands to plant

winter crops in Mexico. Consequently, the approach the Mexican government applied during the

development of NAFTA used the excuse to cancel the ejidos communal land system and other

property system that laid in the way of the formation of the NAFTA accord. Besides, the

endorsement of NAFTA had a significant implication on peasants as well as the architects of the

Piaxtla project. Particularly, there was a significant risk of losing the health benefits and the

productive lands that they had attained during their tussle with the state government. Resultantly,

Zapatista National Liberation Army (EZLN) resolved to an uprising in Chiapas which erupted

the same day of the launching of the NAFTA in 1st January 1994. The uprising was massive that
CRITICAL ANALYSIS OF PROJECT PIAXTLA 11

it raised concern to the ruling party about social justice. Therefore, the Chiapas revolution helped

the farmworkers to retain their lands and other benefits. Despite the successful uploading of the

injustices outlined in the NAFTA accord, it execution had other adverse effect on the community

and the international health. The agreement resulted to plummeting real earning in Mexico

propelling the citizens to endure exorbitant taxes, high fees for health care services, and reduces

quality of social services. Besides, at the global platform, the agreement limited the access to

basic rights such as nutrition and health. For example, the guidelines enacted by global financial

organizations such as the IMF had indirect impact to the native people due to expensive services.

Conclusion

The study has demonstrated that Piaxtla project was a population focused program.

Clearly, population-centered initiatives cover various section because they involve stakeholders

beyond the context of health care. The multispectral aspect of the project helped the natives to

have access to the equal distribution of land which resulted to improved nutrition and health.

Besides, the program empowered the marginalized people in the community such as women and

children where women were empowered to fight alcoholism. However, external entities such as

the NAFTA accord had a negative impact on the Piaxtla project by limiting the peasants’ right to

land as well as limiting access to health care. Although the native tried to protest against the

internal problems facing the program, the NAFTA guidelines were beyond their realm since it

had a wide effect that impeded the development of the Piaxtla project. Such instance portrays the

intertwining elements hindering the process of sustainable development. As such, it challenging

for such community-based programs to attain a maximum outcome.

CRITICAL ANALYSIS OF PROJECT PIAXTLA 12

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