Understanding participation dilemmas in community mobilisation: can collective action theory help?

Abstract

Community mobilisation interventions have been used to promote health in many low-income and middle-income settings. They frequently involve collective action to address shared determinants of ill-health, which often requires high levels of participation to be effective. However, the non-excludable nature of benefits produced often generates participation dilemmas: community members have an individual interest in abstaining from collective action and free riding on others’ contributions, but no benefit is produced if nobody participates. For example, marches, rallies or other awareness-raising activities to change entrenched social norms affect the social environment shared by community members whether they participate or not. This creates a temptation to let other community members invest time and effort. Collective action theory provides a rich, principled framework for analysing such participation dilemmas. Over the past 50 years, political scientists, economists, sociologists and psychologists have proposed a plethora of incentive mechanisms to solve participation dilemmas: selective incentives, intrinsic benefits, social incentives, outsize stakes, intermediate goals, interdependency and critical mass theory. We discuss how such incentive mechanisms might be used by global health researchers to produce new questions about how community mobilisation works and conclude with theoretical predictions to be explored in future quantitative or qualitative research.

A theory of change for community interventions to prevent domestic violence against women and girls in Mumbai, India

“…In the first phase (July 2015 to November 2016), an external consultant (Fernandes) met with our teams for counselling and community mobilisation, police and hospital liaison, two clinical psychologists, and a lawyer to understand their experiences, challenges, and perceptions of outcomes. He interviewed seven clients of our crisis and counselling services, six police officers, and five healthcare providers, and conducted focus group discussions with eight members of a community women's group, 15 members of a men's group, 17 members of a youth group, and nine adolescents involved in an education program (report available as extended data (Osrin, 2019)).…”

“…Adverse effects were also documented (although flare-ups in communities might actually suggest that the program was having an effect). Actions are documented as extended data (Osrin, 2019).…”

“…We invited external activists, academics, and practitioners in Mumbai, our program base (April 2016), Delhi, where policy and advocacy expertise is concentrated (July 2016), and London, our collaborative academic base (July 2016). A summary of these meetings is available as extended data (Osrin, 2019). • A woman told a community organiser that her neighbour was being beaten and locked in the house by her partner.…”

“…Open Science Framework: A theory of change for community interventions to prevent domestic violence against women and girls in Mumbai, India. https://doi.org/10.17605/OSF.IO/47JMG (Osrin, 2019).…”

“…We have included more background on all of this in the Methods: "In order to understand what kinds of individual and collective action people might take, and therefore to align our expectations in the theory of change with potential reality, the action documentation exercise recorded community mobilisation team members' experiences of the kinds of action that community members had undertaken in the past. It yielded 76 actions, documented as extended data (Osrin, 2019). Adverse effects were also documented (although flare-ups in communities might actually suggest that the program was having an effect)."…”