Planning approach

Running head: CRITICAL ANALYSIS OF PROJECT PIAXTLA 1
Critical Analysis of Project Piaxtla
Name
Institution Affiliation

CRITICAL ANALYSIS OF PROJECT PIAXTLA 2
Outline
Introduction..................................................................................................................................... 3
Participatory Planning Approach.................................................................................................... 4
Participatory Planning Methods.................................................................................................. 4
Using Land Struggles to Assess Participatory Health Projects ...................................................... 6
Participatory Planning Method in Practice ................................................................................. 7
Project Piaxtla Participation in the Context of Global Health: NAFTA......................................... 9
Conclusion .................................................................................................................................... 11

Critical Analysis of Project Piaxtla
Introduction
The Primary Health Care (PHC) policy was the result of the World Health Organization
(WHO) affiliate state meeting held at Alma Ata in 1978. The member states to the WHO
developed a framework to enhance the healthcare of the citizen by eliminating the inequalities in
the health facilities (De Vos et al. 2009, p.121). Resultantly, the main agenda of the Declaration
of Alma-Ata was primary health care. The main items highlighted in the convention entail
involvement in the organization, control, and planning of primary health in addition to
community and personal self-relief (De Vos et al. 2009, p.122). The result of the agreement
recognized three significant participatory strategies: the community development approach; the
medical approach and the health service approach. The declaration highlighted the need for
economic and social advancement in the healthcare which formed the conventional basis for the
provision of health care services (De Vos et al. 2009, p.122). Particularly, the guidelines of
equity and social justice modeled the practice of healthcare as the propelling element behind
health improvements. The guidelines also emphasized on the effect of technology suitability and
sustainability in primary health care (Bhatia & Rifkin 2010, p.1). Currently, the principles
outlined in the declaration of Alma Ata have become evident in most primary health
interventions in various countries around the world. On such instance the Project Piaxtla, a
primary health care program based in Western Mexico, which significantly highlights the
guidelines of the Alma Ata declaration (Werner & Sanders 1997, p.141). The research will
utilize the participatory planning approach to examine Project Piaxtla in the context overtime
changes in needs assessment, the program stakeholders, the issues of inequality and how the
actions are in line with the framework of participatory planning.

Participatory Planning Approach
Participatory planning is a collaborative planning process. Participatory planning has
developed as an alternative to institutionalized forms of planning that rely on public agencies to
develop the framing of problems and solutions. It is a more time-intensive process that focuses
on educating participants in the vocabulary at hand and then works with participants to develop
visions or ideas for the changes they want to see. Specifically, this approach is rooted in the idea
that local knowledge is valuable and participatory processes have the potential to address issues
like exclusion and discrimination. It is also more focused on the process than on the product,
although in some cases the product is an important aspect of the project. Gosling and Edwards
(2003, p.194) believe that the approach involves a technique of reversing the power relation
between the members of the community and the external agencies. The basis of the approach is a
systematic development plan founded on the highlighted problems and the suggestion for solving
such issues. Practically, the planning and designing of the development intervention is the
responsibility of the community members rather than the external parties. According to Green
(1993, p.240), the existing inefficiencies of the external entities necessitates the conveyance of
the development agenda to the community members who are the recipient of the service.
Specifically, the inefficiencies of the external agencies entail the time constraints, overemphasis
on the alternatives, inadequate stakeholder participation and limited parties involved in the
project participation which the external parties are accountable for development (Hubbard 2001,
p.25).
Participatory Planning Methods
Within the participatory planning approach, there are various techniques, some of which,
like charrettes, visioning, and community mapping, are commonly used by community groups

trying to engage stakeholders. A charrette is a collaborative design event that fosters community
ownership of a project by including stakeholders before the start of design and maintaining
inclusion in the process throughout the evolution of the plan or design (Lennertz, Lutzenhiser,
Cox Blair, Wood, & Wilbur, 2013). Generally, charrettes are intended to be intense processes,
lasting only a couple of days, where ideas are taken from scratch and built out into drawings and
plans. The charrette is held up a valuable participatory design process because its very nature as
community-based process should translate into popular support of the resulting plans Visioning
is a process where participants are asked to think about how they would like their community to
be, identify ways to work toward the vision and turn the vision into images and words.
Community mapping is when participants observe and collect neighborhood information through
fieldwork. They can then use this information to identify assets and gaps within a geographic
area and use this data to strategize next steps. Storytelling and theater/role-playing is also under
the participatory planning umbrella. The first allows participants to share their history and
identity, while the latter allows participants to imagine new points of view and reflect on their
own (Innes & Booher, 2010). All of these techniques build on the principle of collaborative
learning that is central to participatory planning.
Many times organizations engaging participants in participatory processes will use a
combination of techniques, whereas others will focus solely on one technique. Generally, the
first principle of participatory planning approaches it that projects are encounter natural variation
since they occur in an unregulated setting. The second principle is that participatory planning
depends on searching for diversity. Specifically, this principles seeks to assess any disparities,
anomalies, and contradictions. The third hypothesis insists on the significance of self-awareness
in participatory planning since it enables the organizers to assess their behavior and accept errors

(Chambers 1992, p.15). fourth, the method relies on the assumption of maximizing tradeoffs and
offsetting biases which entail understanding issues affecting the poor as well as the marginalized
such as the children and women (Chambers 1992, p.14). Vlassoff and Moren (2002, p.1713)
point out that most communities have victimized women by providing them lesser role compared
to men. Instead, social, economic and political factors should determine the needs of both
women and men equally. Consequently, an assessment of gender is essential before
implementing the participatory planning approach. Eventually, the concepts of sharing and
facilitating information are significant to the functioning of the participatory planning approach.
In fact, these concepts outline the need to support learning among the rural community members
and enhance information exchange between the facilitator and the community members.
Using Land Struggles to Assess Participatory Health Projects
Prior to the Mexican Revolution, the poor people encountered challenges of unequal
distribution of land. In fact, the feudal land regulation of the Porfirio Diaz was the significant
cause of Mexican Revolution since Diaz supported the fair apportionment of land to the elite at
the expense of the native people. The farmers had ineffective means to maintain themselves
since the significant part of the plantation belonged to the rich who had the best of farmlands.
Resultantly, the landless sought to support themselves through farming on the barren lands on
the hillsides utilizing crude techniques or working as sharecroppers. Regardless, survival through
such means was difficult. Therefore, the Mexican Revolution was a significant era for
transforming the health of the citizens and the defending their rights. Specifically, the casual
laborers and the health team of the Piaxtla project were able to retrain the benefits of their twenty
years struggle for better health and equal distribution of land through the Mexican Revolution
(Werner & Sander, 1997, p.149).

The peasants succeeded in challenging the unequal distribution of land which resulted in
poor health care as well as inadequate food through skills that they attained from Piaxtla. Based
on their constitutional knowledge, the landless started to encroach and cultivate some of the land
plantations that belonged to the elite. The called for eligible land titles form the government
following equal subdivision of land. Afterward, the peasant relied on representative when the
government did not consider their legal titles of land ownership. The long-term lobbying by the
landless resulted in a law that forced the state government to provide the farmers with legal
documentation (Werner & Sanders, 1997, p.145). Besides, Salina de Gotari period as the
president resulted to the reintroduction of the land reforms as well as the ejido system which
were somehow not active when Mexico was preparing to join the American Free Trade
Agreement (NAFTA). In fact, Salina de Gotari introduced a diktat which enables the former
ejidos members to vote either for the retention of the ejidal structure or disband it. Despite the
existence of propaganda from the extant government to propel people to append the ejidos, the
poor farmers resolved for its extension (Rath, 2009, p. 161).
Participatory Planning Method in Practice
Prior to the initialization of the Project Piaxtla, the farmworkers receive food loans from
the elite people. Conversely, the reimbursement of such food advances was intense to the extent
that the peasant had limited resources to use after repaying the debts. For example, the credit
system indicated that the peasants would reimburse one bag with six bags of maize.
Consequently, the establishment of the Piaxtla projected enabled the farmworkers to design a
cooperative maize bank to refute the unethical debt system. Besides, the loans from the corn
banks lower rates of interested when compared to former credit system and it redirected the
income to increase the pool of fund. Finally, five more villages integrated into the community

controlled loan initiative which resulted in more availability of capital. Through extension, the
initiative improved the nutrition and the health of the farmworkers by advancing their financial
status. Furthermore, the program helped the peasant to develop managing, accounting, and
planning techniques through coordination and accountability. Besides, the peasants improved
their confidence as well as their living condition (Werner & Sanders 1997, p.114).
Many women in Ajoya started understanding and attaining their societal powers as well
as roles. Specifically, they resolved to combat the increasing menace of drunkenness among
men. Since children and women appeared to victims of alcoholism since their exposed to
interpersonal and domestic abuse in the region. With men using funds meant for food to buy
alcohol, alcoholism appeared to have a negative impact on health and nutrition of the women as
well as children. Interestingly, business owner saw the gap to open alcohol cantinas so as attract
the developing market niche. However, the health workers from the Piaxtla Project merged with
women and children to oppose the development of alcohol business in the area. Specifically, they
achieved this by designing a theatrical presentation that dramatized the effect of alcohol abuse on
the families. Even though some of the health workers were detained, the effectiveness of this
approached was illustrated through the closing of most native inns (Werner & Sanders 1997,
p.145). During the initialization stage of the project, the designers of the project observed a
recurrence of problem that they sought to solve. Resultantly, they included preventive
approaches such as water systems and drainage systems into the main objective of the project
(Edwards et al. 2011, p.10). They resolved to safeguard the essential needs and rights of the
natives through safe as well as convenient water source. In fact, this approach resulted in a more
shift of socio-political dimension of the Piaxtla project. Among the strategic approach was to

facilitate a protest to enable the local gain control of the water sources which the elite had
privatized initially (Warner & Sanders, 1997, p.143).
Project Piaxtla Participation in the Context of Global Health: NAFTA.
North America Free Trade Agreement (NAFTA) was a 1990s neoliberal agreement
among the United States, Mexico, and Canada to amend the World Bank as well as the
International Monetary Fund’s guidelines (Werner & Sanders 1997, p.147). the establishment of
NAFTA resulted in a high decrease of poverty and food levels in Mexico as depicted in the
following figures. It is through this accord that the Mexican government introduced the
Oportunidades initiative aimed at alleviating the level of poverty in the nation. The program also
sought to improve the nutrient level as well as healthcare standards among the marginalized
communities through financial aids as part of the general poverty elimination approach. The
State of Puebla which is the biggest area for Piaxtla Municipality is among the six main
beneficiaries of the program (Villareal, 2010, p.6).
Year %(people) poverty magnitude % (people) food poverty
1992 29.7 21.4
1994 30.0 21.2
1996 46.9 37.4
1998 41.7 33.3
2000 31.8 24.1
2002 26.9 20.0
2004 24.7 17.4
2006 20.7 13.8
2008 25.1 18.2
Table 1: level of poverty in Mexico (Coneval, 2017)

Figure 1: level of poverty in Mexico
Even though the NAFTA accord resulted to significant improvement of financial and
social dimensions in Mexico, it was different from ejidos communal land guidelines.
Specifically, the ejidos communal land system opposed the trade relations between Mexico and
the United States since the entities from the United States could not buy extensive lands to plant
winter crops in Mexico. Consequently, the approach the Mexican government applied during the
development of NAFTA used the excuse to cancel the ejidos communal land system and other
property system that laid in the way of the formation of the NAFTA accord. Besides, the
endorsement of NAFTA had a significant implication on peasants as well as the architects of the
Piaxtla project. Particularly, there was a significant risk of losing the health benefits and the
productive lands that they had attained during their tussle with the state government. Resultantly,
Zapatista National Liberation Army (EZLN) resolved to an uprising in Chiapas which erupted
the same day of the launching of the NAFTA in 1st January 1994. The uprising was massive that
0
10
20
30
40
50
60
70
80
90
1992 1994 1996 1998 2000 2002 2004 2006 2008
Capabilities
Poverty
Food Poverty

it raised concern to the ruling party about social justice. Therefore, the Chiapas revolution helped
the farmworkers to retain their lands and other benefits. Despite the successful uploading of the
injustices outlined in the NAFTA accord, it execution had other adverse effect on the community
and the international health. The agreement resulted to plummeting real earning in Mexico
propelling the citizens to endure exorbitant taxes, high fees for health care services, and reduces
quality of social services. Besides, at the global platform, the agreement limited the access to
basic rights such as nutrition and health. For example, the guidelines enacted by global financial
organizations such as the IMF had indirect impact to the native people due to expensive services.
Conclusion
The study has demonstrated that Piaxtla project was a population focused program.
Clearly, population-centered initiatives cover various section because they involve stakeholders
beyond the context of health care. The multispectral aspect of the project helped the natives to
have access to the equal distribution of land which resulted to improved nutrition and health.
Besides, the program empowered the marginalized people in the community such as women and
children where women were empowered to fight alcoholism. However, external entities such as
the NAFTA accord had a negative impact on the Piaxtla project by limiting the peasants’ right to
land as well as limiting access to health care. Although the native tried to protest against the
internal problems facing the program, the NAFTA guidelines were beyond their realm since it
had a wide effect that impeded the development of the Piaxtla project. Such instance portrays the
intertwining elements hindering the process of sustainable development. As such, it challenging
for such community-based programs to attain a maximum outcome.

References
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Villarreal, M.A (20100. NAFTA and the Mexican Economy. Congressional Research Service.
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