Formatting patient knowledge and channelling participation: how patient organisations work under authoritarianism

Abstract

Patient experiential knowledge is important for the quality and responsiveness of healthcare systems. However, it is not rare for patients to struggle to have their knowledge recognised as credible and valuable. This study explores how patient organisations work to adjust patient knowledge to formats recognisable and acceptable by healthcare governance decision-makers. Using the case of patient organisations in Russia, we show that such formatting involves changes in language, practices, and materiality that contribute to channelling patient participation into specific routes and forms while marginalising others. Channelling of patient participation, then, rather than being a result of direct coercion, emerges as a distributed process continuously co-produced by a multitude of actors, such as state administration, patient organisations themselves, patient surveys, consultative spaces, and normative acts.