Mr I Nyoman Sutarsa1
1Medical School, The Australian National University, Australia
Like any social institution, health systems place actors and people at the centre and are shaped by power dynamics that underlie societal interactions. Recognising how individuals, groups, organisations, and networks derive their power is critical to unpack how and why power flows in particular directions as well as how it might be used to promote equity-oriented health systems. Different expressions of power interact one another to shape political priorities and policy trajectories. Drawing from a 10-months place-based research in Bali Province, this paper presents the emergence of epistemic communities, interlinked and organised networks of local NGOs and academia, as key actors in the practice of health system strengthening. The paper raises the concern that these partnerships on one hand improve local research capacity and program implementation, but on the other hand are also an effective instrument for power acquisition to deploy control over the local research agenda, health systems programming and interventions. This paper examines how political capital can be enhanced through social networks, expertise and economic resources to navigate the direction of power flows. It argues that political capital as a dimension of power exertion is visible through collective actions to influence health systems and service delivery.
Mr I Nyoman Sutarsa is a Ph.D. scholar at the ANU Medical School examining health systems strengthening interventions in Indonesia.