Cooperativismo y Desarrollo, September-December 2024; 12(3), e711
Translated from the original in Spanish

 

Original article

Strategy for the gender approach in terms of cooperative enterprise management

 

Estrategia para el enfoque de género en función de la gestión de las empresas cooperativas

 

Estratégia para uma abordagem baseada em gênero para a gestão de empresas cooperativas

 

Katiuska Correa Fernández1 0009-0001-2001-9871 chumano@pri.eicma.cu
Odalys Labrador Machín2 0009-0004-2402-790X odalys@upr.edu.cu
Jineht Pérez Martínez2 0000-0002-8160-0475 jperezm@upr.edu.cu
Claudia María González Slovasevich2 0000-0001-5853-429X claudia.slovasevich95@gmail.com

1 Ministry of Agriculture Informatics and Communications Company (UEB EICMA Pinar del Río). Pinar del Río, Cuba.
2 University of Pinar del Río "Hermanos Saíz Montes de Oca". Pinar del Río, Cuba.

 

Received: 26/12/2023
Accepted: 2/10/2024


ABSTRACT

Cooperative enterprises, as actors of local development, play a decisive role in the economic and social transformation of the territories, from the production of goods, provision of services and satisfaction of social needs. Work has been done to dignify the role of women, gender equity and appropriate treatment for the participation of young people, but it is urgent to adopt a more realistic approach to the management processes in which both are involved. The management process of cooperative enterprises in Cuba does not contemplate in its materialization the gender approach in terms of their integral development. The objective of this research is to design a strategy for the gender approach in the management of cooperative enterprises in the municipality of Pinar del Río, as part of their integral development. The research is based on the dialectical-materialist method, which allows guiding the exploration of new regularities, conceptions and principles of operation as a function of the research. Associated with this, the procedures of analysis and synthesis and the documentary analysis technique were used. The main result offered lies in the foundation of actions and regularities that contribute to the Strategy with a gender approach in the management of the cooperative sector as an important tool for cooperative business management.

Keywords: cooperatives; local development; gender equality; generational replacement.


RESUMEN

Las empresas cooperativas, como actores del desarrollo local, juegan un papel decisivo en la transformación económica y social que realizan los territorios, desde la producción de bienes, prestación de servicios y la satisfacción de las necesidades sociales. Se ha trabajado en función de dignificar el papel de la mujer, la equidad de género y el tratamiento adecuado para con la participación de los jóvenes, pero urge adoptar un enfoque más próximo a la realidad, en cuanto a los procesos de gestión en los que ambos intervienen. El proceso de gestión de las empresas cooperativas en Cuba no contempla en su materialización el enfoque de género en función de su desarrollo integral. La presente investigación tiene como objetivo: Diseñar una estrategia para el enfoque de género en función de la gestión de las empresas cooperativas en el municipio de Pinar del Río, como parte de su desarrollo integral. Para realizar la investigación, se parte del método dialéctico-materialista, que permite orientar la exploración de nuevas regularidades, concepciones y principios de funcionamiento en función de la investigación. Asociado a esto se utilizaron los procedimientos de análisis y síntesis y la técnica de análisis documental. El principal resultado que se ofrece radica en la fundamentación de las acciones y regularidades que tributan a la Estrategia con enfoque de género en la gestión del sector cooperativo como herramienta importante para la gestión empresarial cooperativa.

Palabras clave: cooperativas; desarrollo local; igualdad de género; relevo generacional.


RESUMO

As empresas cooperativas, como atores do desenvolvimento local, desempenham um papel decisivo na transformação econômica e social dos territórios, a partir da produção de bens, da prestação de serviços e da satisfação das necessidades sociais. Tem-se trabalhado para dignificar o papel da mulher, a igualdade de gênero e o tratamento adequado da participação dos jovens, mas é urgente adotar um enfoque mais realista nos processos de gestão em que ambos estão envolvidos. O processo de gestão das empresas cooperativas em Cuba não leva em conta o enfoque de gênero em termos de seu desenvolvimento integral. O objetivo desta pesquisa é elaborar uma estratégia para a abordagem de gênero na gestão de empresas cooperativas no município de Pinar del Río, como parte de seu desenvolvimento integral. A pesquisa se baseia no método dialético-materialista, que permite a exploração de novas regularidades, concepções e princípios operacionais em função da pesquisa. Associado a isso, foram utilizados os procedimentos de análise e síntese e a técnica de análise documental. O principal resultado oferecido está na comprovação de ações e regularidades que contribuem para a estratégia com enfoque de gênero na gestão do setor cooperativista como uma importante ferramenta de gestão do negócio cooperativo.

Palavras-chave: cooperativas; desenvolvimento local; igualdade de gênero; renovação geracional.


 

INTRODUCTION

Internationally, gender bias is attracting a great deal of interest. Through marches, protests and viral campaigns on social media, women around the world are demanding the end to sexual harassment, femicide and inequality. Empowering women and girls is crucial to achieving the Sustainable Development Goals (SDGs) by 2030.

Arcas Lario et al. (2022) underline the contribution of agricultural cooperatives to the SDGs, their economic importance and their positive effects on other socioeconomic activities. The aforementioned authors highlight the social role of agri-food cooperatives because of the number of members they integrate and the number of workers they employ, because: (a) in addition to their members, they also bring benefits to farmers and the population of the area in which they are established, (b) they generate social cohesion, as they do not relocate, create employment and contribute to the training of their members and workers, and (c) they have a high commitment to the community, as extolled by one of their cooperative principles, in terms of the environmental dimension, agrifood cooperatives help farmers to adapt to the changes proposed by sustainable agriculture.

Gender equality and the empowerment of women and girls are central to the achievement of the SDGs. Transversely through the whole agenda, it is postulated that development will only be sustainable if it favors all people equally. This is specified in SDG 5 and target 5.5, which states: "Ensure women's full and effective participation and equal opportunities for leadership at all decision-making levels in political, economic and public life" (Stegagnini, 2023). The above is only possible, if progress is made in the co-responsible conciliation and equality of women and men in the labor and business spheres,

In the case of Cuba, the process of economic, legislative and public policy transformations that has developed in recent years has focused, on the one hand, on the implementation of the National Economic and Social Development Plan until 2030 (MEP, 2021) in which the 2030 Agenda is assumed as a national priority, aligning the 17 Millennium Development Goals to its strategic axes (Cuba, 2019), on the other hand, the improvement of the Cuban legislative system, in relation to the forms of management of the economy as a result of the approval of the Constitution of the Republic of Cuba in 2019, has energized the development processes in the territories and, within them, cooperative ownership.

In this context, the Cuban State and its representative organizations, within their lines of action, aim to measure and evaluate the real contribution of cooperatives to the fulfillment of the SDGs, in line with the open pronouncement of the International Cooperative Alliance for cooperatives to collect information on their contributions to the fulfillment of the 2030 Agenda. All these positions place the Cuban cooperative sector before the challenge of evaluating its contribution to the fulfillment of the SDGs.

However, according to Páez Cuba and Rodríguez Torres (2023), there has been an insufficient approach to gender mainstreaming in social studies and in the comprehensive design of public policies that comprehensively cover all sectors of the economy, cooperatives appear as promoters of the SDGs in terms of equity and maintains that in the context of the development of the Cuban cooperative movement, they perform a diversity of economic activities, but discriminatory social roles and stereotypes towards women still persist.

On the other hand, in the preliminary review of the literature and experiences in the management of cooperative enterprises, it was found that in our country there are no studies applied to cooperative enterprises from the management point of view, whose result converges in a strategy where gender mainstreaming is integrated, an aspect of vital importance to achieve the efficiency expected from them, that is, the management process of cooperative enterprises in Cuba does not consider in its materialization the gender approach in terms of their integral development.

Based on the above, within the framework of cooperative development, a problem arises: How to achieve gender mainstreaming in the cooperative management process? This question leads to the general objective of the present research, which consists of the following: To design a strategy for gender mainstreaming in the management of cooperative enterprises as part of their integral development.

 

MATERIALS AND METHODS

In order to highlight the developmental character present in gender equity mainstreaming, the dialectical-materialist method is used as a starting point. This method allows guiding the search for new regularities, conceptions and operating principles of the cooperative management process, in order to mainstream the gender perspective, which means making visible and considering the inequalities between genders, the existing power relations between them and intervening to modify them.

Different methods, procedures, techniques and tools were used in the work to collect, process and analyze the information, highlighting the analysis and synthesis to study the international and national experience in gender equity, through the synthesis the theoretical-methodological elements in relation to gender equity are systematized. Documentary analysis was used to evaluate the bibliography related to the problem and its verification at the national level, as well as in the analysis of some components of the proposed strategy.

Relevant were the results of the interview and structured survey applied to cooperative managers and members, respectively, to determine the deficiencies and causes in the treatment of gender equality in these cooperatives.

 

RESULTS AND DISCUSSION

Theoretical references on gender mainstreaming

The term mainstreaming was first defined in the session on Mainstreaming the gender perspective into all policies and programs of the United Nations System of the United Nations Economic and Social Council, adopted in 1997. It was defined as the process of assessing the implications for women and men of any planned activity, including laws, policies or programs, in all sectors and at all levels. It is a strategy designed to make women's as well as men's concerns and experiences an integral element in the design, implementation, monitoring and evaluation of policies and programs in all political, economic and social spheres, so that women and men benefit equally and inequality is not perpetuated. The ultimate goal is to achieve gender equality.

Gender analysis makes it possible to see that gender inequalities are not natural, but the product of a social construction and, therefore, are historical and political; they involve power relations and resistance to injustice and inequity in access to rights and opportunities. Addressing "gender" as a relational category between people implies considering that inequalities respond to a form of exercising power based on society's accepted belief in male superiority. This belief generates multiple forms of discrimination based on the different valuation assigned to each human being according to his or her sex.

From the foregoing, it is necessary to differentiate that while the sex of individuals is the set of hormonal, chromosomal, physiological or anatomical characteristics that, among others, make up an assignment at birth that designates them as male or female, gender is a classification that refers to socially, culturally and historically constructed attributes that are embodied in practices, roles, capacities and social expectations identified in a differential manner according to that sex assigned at birth, and in the notions of masculinity and femininity in force in the patriarchal system, culturally and historically constructed attributes that are embodied in practices, roles, capacities and social expectations identified in a differential manner according to the sex assigned at birth, and in the notions of masculinity and femininity in force in the patriarchal system present in different societies over time (Ministry of Productive Development, 2021).

In this regard, the National Economic and Social Development Plan until 2030, in its six strategic axes, mainstream the gender approach, the reduction of inequalities, economic growth and zero hunger, basically integrating the three dimensions of sustainable development (economic, social and environmental). The contents of the 17 SDGs are implicit in each of the six strategic axes, with the Human development, equity and social justice axis being the one that integrates the most SDGs within its specific objectives, which evidences the multidimensional nature of our development model (MEP, 2021, p. 43).

The conditions for the sustainability of the agricultural sector associated with socio-political transformations in the cooperative sphere consider, Díaz Machado et al. (2021), that it can be understood as a scientific awareness that the self-perception of individual and family producers, with emphasis on young people, as managers of an agrarian culture and as guarantors of its reproduction, is a key condition for the achievement and preservation of agrarian development.

Regarding the challenge of gender equity in cooperatives, Arévalo Zurita et al. (2022) point out that the gender approach from a company can be considered a certain will to be "fashionable", in this sense UN Women and the Economic Commission for Latin America and the Caribbean (2022) state that it is related to values linked to ethical components, expectations of social responsibility, possibilities of access from the relations articulated between men and women in the labor context, which define the space and the condition associated to the position of women in the economic and social framework, as well as in the labor market in particular. Hence, gender equity is considered a strategy that creates wealth for companies (Braunstein et al., 2020; Minasyan et al., 2019).

Next, it is important to emphasize the difference between gender and the gender equity approach, because when we refer to the term gender, it was understood as the set of socially constructed roles, psychosocial characteristics, interpersonal relationships, attitudes, behaviors, set of values, relative power and influence, which are assigned to both sexes by society in general. However, biological sex is composed of specific genetic and anatomical characteristics, while gender is associated with acquired and learned identity, which varies significantly intra- and interculturally.

Gender is a social and cultural construction that is structured on the basis of a series of practices, representations, symbols, norms and values that societies build on the basis of sexual differences, which Espina Prieto and Echevarría León (2020) consider a dimension constructed from the roles that were historically assigned and are assigned in the different spaces of action, defining unequal characteristics and identities in both sexes.

According to Alemán Salcedo et al. (2020), gender equity applied to cooperativism would make it possible to particularize equitable approaches, problematizing the need for inter-cooperation, direct cooperative social responsibility, training and the configuration of equality plans in this sector. Thus, cooperatives would become not only a source of employment, but also of women's social empowerment, which should be based on a cross-cutting perspective (Páez Cuba & Torres Rodríguez, 2023).

In the field of agricultural development, according to Conti and Sánchez Iudicello (2023), gender approaches focus on the analysis of situations of inequality almost exclusively in the context of territories. However, one quality of these approaches is that innovation strategies in terms of gender generally favor approaches aimed at making gender inequalities visible from a perspective that understands them as just one more aspect to be considered. In this order, a conception of the gender agenda has been privileged more as an external theoretical approach, characterized by its applicability to a territory/people, than as an issue or matrix for review within institutions and their practices, which are considered gender-neutral. This implies that such approaches consider gender issues as a variable or attribute of the territories in which they intervene.

The aforementioned authors argue that this makes invisible the influence of the perspectives and subjectivities of both technical personnel and institutional cultures in the construction of gender in rural areas and, even more so, its incidence in the daily life of institutional spaces.

The International Cooperative Alliance, an organization that since 1895 has brought together and promoted the cooperative movement in the world, has established a set of principles that constitute a universal rule for the development of the sector. The conformation of these postulates has evolved since its emergence until today, through the main congresses of the institution (Mirabal González, 2019). These principles, such as voluntary and open membership, economic participation of members, social responsibility and inter-cooperation, among others, should respond to the needs of the sector, taking advantage of the potential they offer to the territory.

In line with this, international experiences highlight the importance of some of the socioeconomic performance aspects of cooperatives, such as: comprehensive management, legal framework, institutional environment, access to financing, comprehensive assistance or accompaniment, cooperative education, viable and consistent strategies and plans, as well as intercooperation and its projection towards the community (Mirabal González, 2019).

In relation to cooperatives, the documents addressed refer indistinctly to equality, equity or mainstreaming approach. Along these lines, Páez Cuba and Torres Rodríguez (2023) emphasize that the inclusion of the gender perspective in the cooperative sphere should be pursued to a greater extent, since, while women are hired in highly feminized and more precarious sectors, traditional roles with patriarchal roots are perpetuated, a situation that also affects the cooperative phenomenon, as it is an important part of the social fabric.

In this sense, values such as mutual aid, responsibility, democracy, equality, solidarity and, in particular, equity prevail in cooperative management, which is essential for the valuation of gender equity, as are the cooperative principles. Hence the importance and relevance that, at the present time in Cuba, the gender approach and the generational change in cooperative management are promoted, in terms of its integral development, to dynamize the rural area from the intervention and the protagonism of its partners, favoring the collaborative endogenous development, from the integration of young people in the organizations to guarantee the generational change and gender equality.

The National Program for the Advancement of Women conceived as: Agenda of the Cuban State for the Advancement of Women, with the participation of the Federation of Cuban Women, promotes the advancement of women and equal rights, opportunities and possibilities, endorsed in the Constitution of the Republic of Cuba, as well as delves into the objective and subjective factors that, as expressions of discrimination, persist in Cuban society and hinder greater results in the economic, political, social and family, in order to eliminate them; it incorporates the gender issue throughout the system of formation and training of cadres. However, there are still barriers that hinder the implementation of the gender mainstreaming approach in the management process of cooperatives and in agricultural development in general.

Diagnosis of women's participation in cooperatives

In order to carry out this work, a diagnosis is made on the situation of women's participation and integration in the Cuban cooperative sector. For this purpose, several instruments were applied in order to determine the regularities on the situation of the gender perspective and the treatment of gender equality in cooperative enterprises. The elaboration of the Cause-Effect Diagram (Ishikawa), represented in figure 1, made it possible to reveal some deficiencies present in the sector's entities.

Figure 1. Ishikawa diagram
Source: Own elaboration

As a result of the technique applied, the deficiencies in such treatment were identified, starting from the general causes; the most significant causes that reveal this statement are the following:

  1. Low level of knowledge of the board of directors and members about the concept of gender equality in the management process of cooperatives.
  2. Lack of attention from the company and advice from the National Association of Small Farmers on gender-related issues.
  3. They do not have instruments and methods to promote gender equality in the cooperatives.
  4. Low percentage of women in cooperatives in relation to men.
  5. It is recognized that cooperatives can do more to promote gender equality issues in their management process.
  6. Most of those interviewed and surveyed, both from the Board of Directors and cooperative members, recognize the need for a strategy that covers gender equity in a cross-cutting manner.
  7. They consider that the family plays an important role in promoting gender equality and generational change.

In this sense, the aspects summarized as results of the diagnosis corroborate the need for a strategy with a gender focus that, in turn, ensures generational replacement in pursuit of integral cooperative management.

Strategy with a gender approach in cooperative enterprises

Delgado Merchán and Zambrano Loor (2023) agree that a strategy represents an adaptive procedure or set of procedures by which action is sequentially organized to achieve the desired purpose or goal; it is a broad, open, flexible, interactive and, above all, adaptive concept, applicable to the implementation of training, research, innovation and creativity stimulation models.

The presentation of the proposed strategy begins with an explanation of its structural components, which is composed of 4 stages and 10 steps, for which the objectives and description of each stage are determined, as well as the objectives, description and techniques of each step.

Stage I: Preliminary preparation

Objective: To prepare participants for the strategic planning process with a gender perspective in agricultural cooperatives, observing compliance with the established premises.

Description: This stage is characterized by creating the conditions for the execution of the exercise, based on active participation, economic and logistical assurance of the activities foreseen in this stage, as well as the organization of time as an important resource.

Step 1: Selection of the actors involved in the process.

Objective: Determine the actors with the greatest influence and responsibility in the strategic planning process with a gender perspective in agricultural cooperatives.

Description: In this step, the work team that participates in the strategic planning process with a gender perspective for agricultural cooperatives will be formed. They should be made up of those local stakeholders that are essential for the development of the locality. Other institutions may be incorporated depending on the issues to be dealt with and to give the group an integral character for a better solution to the strategic problems derived from the subsequent appraisal. The functions to be carried out are socialized with the team members. The characteristics and work rules of the group members will be identified based on the analysis and discussion of the participants' proposal.

Techniques: group work, brainstorming, interviews.

Step 2: Sensitization and training.

Objective: To sensitize stakeholders on the need for a gender mainstreaming strategy for agricultural cooperatives.

Description: The stages and steps of the strategy will be explained to the team members. Seminars, conferences and workshops will be held, as needed, on the main elements related to the gender mainstreaming strategy, as well as on other aspects of the management process identified in the previous stage. In addition, the training needs of actors involved in gender mainstreaming issues will be identified and addressed as the process progresses.

Techniques: surveys, interviews, group discussion.

Step 3: Verification of compliance with the premises.

Objective: Verify compliance with the premises of the strategy.

Description: The implementation of the strategy requires the fulfillment of the premises described above. Compliance with these premises will allow the creation of favorable conditions for the development of the proposed strategy. If any of them are not fulfilled, it is necessary to return to the sensitization step and carry out the pertinent actions to achieve the commitment and involvement of the stakeholders in the cooperative's strategic planning. The president of the board of directors is responsible for assessing compliance with these premises.

Techniques: observation.

Stage II: Strategic analysis

Objective: Identify the main problems and strengths of cooperatives in terms of gender equality in the development of their management, as well as the barriers and opportunities shown by the environment.

Description: In this diagnostic stage, the strengths, weaknesses, threats and opportunities of the cooperatives in terms of gender equality issues will be identified.

Step 4: Strategic diagnosis on gender equity.

Objective: Determine weaknesses, threats, strengths and opportunities.

Description: The main weaknesses, threats, strengths and opportunities will be identified and listed; in terms of gender equality, they will be reduced to 10, which will remain by consensus after having discussed the priorities.

Technique: group work, brainstorming, list reduction.

Stage III: Planning

Objective: At this stage, the planning process will begin with knowledge of the different actors and their relationships, and the levels of subordination to which each one of them responds. The mission and vision will be stated.

Step 5: Mission and vision statement.

Objective: To formulate the mission and vision of the cooperative sector in accordance with its potential.

Description: The group analyzes the cooperative's mission proposals according to the conception of gender equality. For this purpose, the scope of action is taken into account in correspondence with the particularities of the cooperative in terms of potentialities and needs.

The vision statement takes into account the importance of looking to the future in order to strengthen cooperativism as one of the fundamental actors of the Cuban socialist economic model. It allows thinking strategically and prospectively, being proactive and directing efforts to achieve it. In the definition of the vision, reflections are made on the importance of having a strategic vision with a gender approach, an analysis is made of each of the ideas presented by the team members, in addition, an analysis is made mainly of human resources. Criteria are exchanged and unified.

Techniques: Team work, group discussion, brainstorming.

Step 6: Definition of strategic lines.

Objective: Define the strategic lines that will contribute to the mainstreaming of the gender approach in cooperatives.

Description: In this step, an exercise is carried out to find alternatives to take advantage of opportunities, enhance strengths, defend against threats and reduce weaknesses identified in the diagnosis using the Impact Methodology with crosses, value scale. As a result of the exercise, the problem situation of the cooperative in terms of gender equality and the quadrant (Offensive (I), Defensive (II), Adaptive (III) and Survival (IV)) in which it finds itself will be exposed.

Techniques: group work, consensus building and documentary analysis.

Step 7: Design of expected results and corresponding actions for each strategic line.

Objective: To design the expected results and actions, in accordance with the defined strategic lines.

Description: In this stage, the expected results of each strategic line and the corresponding actions are designed.

Techniques: team work, group discussion, documentary analysis.

Stage IV: Implementation, monitoring and evaluation

In this phase, the strategy implementation process will begin. With the necessary requirements, there will be a monitoring process that will determine the main achievements and problems in the implementation that will allow a better functioning of the strategy.

Step 8: Implementation of the gender mainstreaming strategy in agricultural cooperatives.

Objective: To implement the strategy in the cooperatives based on the actions to be executed in each strategic line assumed.

Description: In this step, it is begun the implementation of the strategy with a gender approach, a process that must be participatory, conscious, critical, creative, transparent, innovative, in correspondence with the socio-economic essence of cooperatives. Techniques: group work, group discussion.

Step 9: Monitoring and evaluation.

Objective: Monitor the main actions and evaluate their impact on cooperativism.

Description: This stage is essential because it constitutes the basis for the necessary transformations within the implementation process. The work system to be followed for monitoring the implementation of the strategy and its execution schedule is defined. A working group is created to undertake the planned monitoring and evaluation actions, as well as a set of result indicators to evaluate the impact of the cooperative's gender-focused strategy.

Techniques: group work, group discussion, documentary analysis.

Regardless of the indicators proposed, the following can be assessed:

Step 10: Feedback.

Objective: To provide feedback on the gender mainstreaming process in the cooperatives based on the sustainability of the proposed strategic actions.

Description: In this step, depending on the results of the impact evaluation of the gender mainstreaming strategy, the strategic lines can be redefined.

This last step connects the implementation, monitoring and evaluation stage with the planning stage.

Techniques: Team work, group discussion, Ishikawa diagram.

The validation of the proposed strategy was developed in the Rafael Morales Agricultural Production Cooperative in the municipality of Pinar del Río, belonging to the Tobacco Collection and Processing Company of Pinar del Río. It is implemented transversally to the rest of the management processes and constitutes an appreciable tool that allows the gradual incorporation of gender mainstreaming in the cooperative management process, consistent with its essence and socioeconomic nature.

In summary, the theoretical and conceptual analysis of gender mainstreaming in the management of cooperative enterprises reveals contradictions and inadequacies in the conceptual framework, which limits a theoretical-practical vision and its link with the particularities of the cooperative sector. In the cooperatives studied, steps have been taken to facilitate the incorporation of women as working members and in positions of responsibility, but there is still a long way to go and important challenges to be faced, it is noted that the proposed strategy demonstrated its usefulness and viability for the improvement of cooperative management, particularly in terms of raising awareness of the importance of gender equity, making visible the significant contribution of women to the achievement and mainstreaming of gender equality in the cooperative sector.

 

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Conflict of interest

Authors declare that they have no conflicts of interest.

 

Authors' contribution

Odalys Labrador Machín carried out the theoretical-methodological conception of the management process of social responsibility and corporate social responsibility and made the final revision of the article.

Katiuska Correa Fernández elaborated the draft and carried out the data collection, analysis and interpretation.

Jineht Pérez Martínez worked on the theoretical-methodological conception and carried out data collection, analysis and interpretation.

Claudia María González Slovasevich contributed to the empirical diagnosis.

All the authors reviewed the writing of the manuscript and approve the version finally submitted.

 


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