“We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa

dc.contributor.authorKelly, Gabrielle
dc.date.accessioned2016-08-29T13:02:46Z
dc.date.available2016-08-29T13:02:46Z
dc.date.issued2016-07
dc.description.abstractProblems in fairly allocating welfare and health resources or targeting social programmes are very often located in the spaces where citizens interact directly with state workers. This study draws on observations of doctor-patient encounters in disability assessments for the South African disability grant (DG), to examine how doctor-patient interactions shape social welfare allocation. I show that interactions between doctors and patients are sites of negotiation and contestation over rights to social assistance. Claimants’ understanding of disability differed from biomedical conceptions of disability. Doctors carrying out DG assessments faced both direct and indirect pressure from claimants, who aimed to influence their decisions through narratives of suffering and performances of disability. Frustrated by communication barriers, as well as the perceived unfairness and arbitrary nature of assessments, some claimants used verbal or physical abuse as a form of protest against the system. In order to defend themselves from these pressures and maintain authority in these interactions, doctors employed coping strategies that distanced and objectified claimants, minimising opportunities for patients to bully them or affect their judgment. These strategies strained already tense doctor-patient relationships and made the DG system illegible to the public. This demonstrates the importance of considering trust, power dynamics and the exercise of agency by both patients and providers in understanding policy implementation.en_ZA
dc.identifier.apacitationKelly, G. (2016). <i>“We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa</i> University of Cape Town ,Faculty of Humanities ,Centre for Social Science Research(CSSR). Retrieved from http://hdl.handle.net/11427/21585en_ZA
dc.identifier.chicagocitationKelly, Gabrielle <i>“We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa.</i> University of Cape Town ,Faculty of Humanities ,Centre for Social Science Research(CSSR), 2016. http://hdl.handle.net/11427/21585en_ZA
dc.identifier.citationKelly, G. (2016). “We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa. CSSR Working Paper No. 383. Centre for Social Science Research, University of Cape Town.en_ZA
dc.identifier.isbn978-1-77011-370-1en_ZA
dc.identifier.ris TY - Working Paper AU - Kelly, Gabrielle AB - Problems in fairly allocating welfare and health resources or targeting social programmes are very often located in the spaces where citizens interact directly with state workers. This study draws on observations of doctor-patient encounters in disability assessments for the South African disability grant (DG), to examine how doctor-patient interactions shape social welfare allocation. I show that interactions between doctors and patients are sites of negotiation and contestation over rights to social assistance. Claimants’ understanding of disability differed from biomedical conceptions of disability. Doctors carrying out DG assessments faced both direct and indirect pressure from claimants, who aimed to influence their decisions through narratives of suffering and performances of disability. Frustrated by communication barriers, as well as the perceived unfairness and arbitrary nature of assessments, some claimants used verbal or physical abuse as a form of protest against the system. In order to defend themselves from these pressures and maintain authority in these interactions, doctors employed coping strategies that distanced and objectified claimants, minimising opportunities for patients to bully them or affect their judgment. These strategies strained already tense doctor-patient relationships and made the DG system illegible to the public. This demonstrates the importance of considering trust, power dynamics and the exercise of agency by both patients and providers in understanding policy implementation. DA - 2016-07 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 978-1-77011-370-1 T1 - “We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa TI - “We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa UR - http://hdl.handle.net/11427/21585 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21585
dc.identifier.vancouvercitationKelly G. “We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africa. 2016 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/21585en_ZA
dc.languageengen_ZA
dc.publisher.departmentCentre for Social Science Research(CSSR)en_ZA
dc.publisher.facultyFaculty of Humanitiesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en_ZA
dc.title“We want another doctor!” Citizen agency and contested notions of disability in social assistance applications in South Africaen_ZA
dc.typeWorking Paperen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceWorking paperen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Kelly_Working Paper 383_2016.pdf
Size:
853.09 KB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.72 KB
Format:
Item-specific license agreed upon to submission
Description:
Collections