Lost in the web of decentralized governance? Entrepreneurial public servants, mosquitos, and health adaptation

• In Event: 21067 - Organizational Responses to Regulatory Changes

Abstract

Building “climate-resilient” health systems that can manage climate change’s effects on infectious diseases and other health outcomes will pose substantial challenges, especially in low- and middle-income countries struggling to respond to emerging epidemics. Public health experts will be key actors in transforming current programs and designing adaptive strategies that integrate public health and climate change goals. Past research has shown that public health experts understand the threat climate change poses to health, but material barriers impede them from taking action. While this explanation is correct, it is not complete. Drawing from organizational sociology and the environmental sociology literature on the climate value-action gap– when values do not correlate with actions, this study examines the mismatch between public health experts’ views on climate change and their actions by looking at how aspects of the organizational culture and the institutions they belong shape their response. In particular, I pay attention to the institutional design and logic of the polycentric governance of dengue disease. I use the case of Peru, one of the countries most affected by the rise of dengue, a climate-sensitive disease, due to changes in environmental conditions and extreme weather events. Using data from 37 in-depth interviews, government documents, and reports from intergovernmental organizations and financial institutions, I show the decentralization process ­–a tool of neoliberal reform– that tends to be taken for granted, not only had material effects. It reinforced specific ways of organizing work (e.g., decentralized sectoralism) and values (e.g., entrepreneurialism) that shape their views of the health sector's role in addressing the climate crisis.

Author

• Maria Isabel Espinoza, Michigan State University