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Accepted Contribution:

Towards "structural competency" in the context of social injustice: Challenges of psychosocial healthcare teams in Chile  
Sofia Bowen (Universidad Católica de Chile)

Contribution short abstract:

Reflecting on the complex challenges encountered by cancer healthcare professionals in Chile adopting the 'psychosocial' framework, this intervention explores implementing 'structural competency' within a context of limited resources, health inequality, and historical social injustice.

Contribution long abstract:

This intervention addresses the intricate decision-making, ethical, regulatory, and political challenges faced by healthcare professionals in Chile, with a particular emphasis on cancer care, while also extending its scope beyond this domain, adopting the 'psychosocial' framework endorsed by the World Health Organization. Chilean policymakers introduced this framework to address enduring health inequalities and social insecurity, caused by the implementation of neoliberal policies, by recognizing the psychological and social elements of health and disease. Although the policies recognize the social complexity of illness, which in theory includes structural issues, on the ground they mainly translate towards attention to psychological and cultural approach that emphasizes patients' lack of awareness or (‘erroneous’) cultural beliefs about illnesses and treatments, as well as the patient's responsibility for emotional recovery and adaptation. The key questions being explored include how psychosocial teams negotiate different ideologies, epistemes (ways of knowing), and legal frameworks during implementation. How do these practitioners and teams navigate ethical dilemmas as they recognise themselves as gatekeepers not only of healthcare services but also of rights and the acknowledgement of historical, political, and socioeconomic factors contributing to patients' suffering? Ultimately, the intervention aims to reflect on the challenges of implementing a "structural competency" approach in practice within a context of limited resources and historical and ongoing social injustice. This involves considering the broader societal and systemic factors that contribute to the "cancer epidemic" and general health inequalities, and exploring how healthcare practitioners can address these challenges in their day-to-day work.

Roundtable RT059
(Un)doing the anthropology of health care crisis: Structural Competency and health care professionals [Medical Anthropology Europe (MAE)]
  Session 1