Step 1 Select a dimension of ex/inclusion Open
Multidimensional
Relational
Intersecting risks and drivers
Dynamic
Multi-layered and contextual
ParticipatoryExclusion is relational as both a process and an outcome. As a process, exclusion is about the rupture between individuals, groups and societies. As an outcome, it is about the end result of this rupture when the excluded cannot enjoy shared opportunities and are in a position of relative deprivation as compared to the rest of the society. In other words, both the process of exclusion and its result are about differentiated and unequal relations between the excluded and mainstream society.
Many adopt this approach in their policy actions. The World Health Organization, for example, has used it since 2008 to inform the work of its Commission on Social Determinants of Health. The body developed a policy analysis framework that examines exclusionary processes in four dimensions – social, economic, political and cultural – as drivers of health inequalities. The approach proved useful by shedding light on how and why the excluded have differential access to the resources required to protect their health, and by, subsequently, revealing ways to redress the situation.
The diagnosis and tackling of this relationality is amongst the major policy merits of ex/inclusion. Four markers can assist inclusive policy work in this regard.
Step 2 Select an Inclusive Policy Marker Open
Addressing deficits in both the supply of services and the demand for them are (equally) critical in inclusive interventions. Two key points will assist policy reflections in this regard.
Step 3 Select a Policy Design Consideration
The task of inclusive policies is both to provide a public services network available, accessible and affordable by all, and to boost recourse to it. Provision of services is, generally, a well-entrenched part of conventional approaches and policy instruments. The issue of uptake is as important but, in the context of long-term exclusion, more challenging. The fact that certain services and opportunities are available does not necessarily imply that those who have been excluded for a long time will automatically accept and use them. The costs of services are often blamed for inhibiting uptake. The concern is valid but other factors are not to be ignored. Persistent inequality and exclusion may lead those affected to mistrust mainstream society. It may also result in various forms of self-reliance, which should not be by default equated with self-segregation and self-exclusion, by the marginalized populations and their possible rejection of the available services. The excluded individuals may be equally affected by the feeling of shame (whether felt or anticipated), an internal sense of inadequacy and stigma associated with the status of disadvantage and that of a welfare recipient. These nuanced analyses of the causes that impact uptake deserve particular consideration in the context of inclusive policy design and service delivery.
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