While engaging disadvantaged groups in participatory processes as co-producers of knowledge empowers them to transform their situation (22); our experiences demonstrate that DST empowered participants to express their priority health concerns as well as their powerlessness to address the complex challenges. Community members felt powerless because structural challenges pertaining to WASH were aggravated by urbanization, overpopulation, and poverty; and therefore, require long term multi sectoral approaches. Unequal power relations between communities and service providers in priority setting for health research/interventions may also have led to mobilization of bias where priority problems affecting communities were not considered for interventions.
In academic studies, the main argument of this strand of the literature is that individual endowments in terms of time, money, and civic skills significantly influence the likelihood of political engagement (Verba, Scholzman and Brady 1995). As a result, rising economic disparities translate into uneven participation in political activities and so unequal involvement in the decision-making process. Inequality and rising disparities may also reduce trust in political institutions and promote a sense of powerlessness, which in turn may contribute to the acceptance of the status quo. In turn, economic inequalities are reinforced by other intersecting inequalities. As Kabeer writes, 'social, economic and spatial inequalities in turn contribute to political exclusion: such groups are generally denied voice and influence in collective decisions that affect their lives' (2010: 6). 2b1af7f3a8