Relational Navigation and the Social Organization of Health Action: A Comparative Systems Mapping of Guyana, Suriname, and Eswatini

Health behaviour research typically explains health action in terms of individual beliefs, structural access, and institutional trust. While these factors are important, they overlook the social processes through which people coordinate health response in everyday life. Using nationally representative UNICEF MICS6 survey data from Guyana, Suriname, and Eswatini, freely available through the MICS portal, this study introduces the concept of relational navigation. Shaped by historically structured systems of social organization that define who can act, who must be consulted, and how legitimacy is established, relational navigation refers to the socially embedded process by which individuals transform health needs into health action. Guyana, Suriname, and Eswatini are three post-colonial countries that can be treated as relatively pure ideal types of predominant relational legacies. Guyana reflects ethnic segmentation rooted in plantation society, Suriname reflects colonial stratification and plural social classification, and Eswatini reflects hierarchical kinship and chieftaincy systems. Together, these cases represent distinct forms of socially mediated coordination under conditions of inequality. The study will combine data from the women, men, children under five, and household survey files to examine health outcomes alongside relational and contextual variables, resulting in three harmonized country datasets with approximately 1,070 cases in Guyana, 1,380 in Suriname, and 840 in Eswatini. Analysis will employ causal loop diagrams (CLDs) to model systems of relationships, including social pathways, authority chains, trust circuits, and feedback structures characterized by reinforcement and balance. By comparing patterns across the three countries using the same variables, the study aims to establish proof of concept for relational navigation as a theoretically meaningful and empirically observable mechanism in existing survey data.