The role of advocacy work in delivering primary healthcare to marginal communities

This study explores the critical role of advocacy work in delivering primary healthcare (PHC) to marginalized communities, confronting challenges stemming from economic and social inequities and institutional voids. Through a longitudinal ethnographic study of SEWA Rural, an NGO in northwest India, the research delves into the innovative clinical practices, organizational processes, and outreach activities developed since 1980 to provide PHC in areas lacking basic infrastructure and services. Utilizing various ethnographic methods over seven years, the study examines the dynamics of advocacy work, including the engagement with diverse stakeholders and the mobilization of non-state resources. SEWA Rural's advocacy approaches are scrutinized for their ability to transform attitudes, beliefs, and practices to foster inclusive PHC delivery. Preliminary findings highlight the evolution of knowledge and resourcing practices through advocacy, indicating a structurational dynamic that sustains inclusive PHC delivery and promotes social impact and community engagement.