scholarly journals The “Sustainability Doctrine” in Donor-Driven Maternal Health Programs in Tanzania

2022 ◽  
pp. 73-91
Author(s):  
Meredith G. Marten
Keyword(s):  
Health System ◽  
Health Systems ◽  
Newborn Care ◽  
Health System Strengthening ◽  
Respectful Maternity Care ◽  
Health Issues ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Sustainable Health

AbstractStrengthening health systems to provide equitable, sustainable health care has been identified as essential for improving maternal and reproductive health. Many donors and non-governmental organizations (NGOs) have contributed to undermining health system strengthening, however, through adhering to what Swidler and Watkins call the “sustainability doctrine,” policies that prioritize time-limited, targeted interventions best suited for short-term funding streams, rather than the long-term needs of local populations. This chapter presents ethnographic data from semi-structured and key informant interviews with 16 policymakers and NGO directors in Dar es Salaam, Tanzania from 2011 to 2012. I illustrate how sustainability doctrine policies were put into practice, and how they have persisted, despite their shortcomings, using examples of donor-prioritized maternal healthcare initiatives in Tanzania rolled-out several years apart: prevention of mother-to-child transmission of HIV (PMTCT) and basic emergency obstetric and newborn care (BEmONC) programs in the late 2000s, and more recent efforts to implement respectful maternity care (RMC) programs. I focus on several issues informants identified as crippling efforts to build strong health systems, particularly the internal brain drain of healthcare workers from the public sector to higher-paying NGO jobs, and the prioritization of types of programs donors believed could be sustained after the funding period ended, specifically trainings and workshops. I describe how despite these issues, international organizations still design and implement less effective programs that often fail to account for local circumstances in their efforts to solve some of the more intractable health issues facing Tanzania today, in particular, the country’s stagnating maternal mortality rate. In this chapter, I argue that practices promoted and implemented under the guise of “sustainability” in policy papers and reports generated by donors paradoxically contribute to health system precarity in Tanzania.

Bridges to sustainable health systems: public-private interaction for market access

2020 ◽  
Vol 35 (12) ◽  
pp. 1929-1939
Author(s):  
Simone Guercini ◽  
Matilde Milanesi ◽  
Andrea Runfola
Keyword(s):  
Health System ◽  
Health Systems ◽  
Market Access ◽  
Content Type ◽  
Industrial Marketing ◽  
The Public ◽  
Recent Debate ◽  
Public Actor ◽  
Sustainable Health

Purpose This paper aims to investigate the market access (MA) of ethical drugs, the underlying public-private interaction (PPI) between pharmaceutical companies and public actors, and the implications for the sustainability of the health system. Design/methodology/approach A qualitative interpretivist approach was selected. Interviews were carried out as the primary method of data collection: 27 interviews were conducted with 13 key informants from the pharmaceutical industry. Findings The perspective of MA evolves from formal negotiation with the public actor at various levels to PPI, which should include aspects of interactions with other actors in the network. Conceptualization in these terms is fundamental because it allows an understanding of the implications in terms of the sustainability of the health system. Originality/value The paper discusses MA by highlighting the shift from a “market access as formal negotiation” perspective to a “public-private interaction for market access” perspective, in which the focus is on the content of the interaction and the representation of the network of relevant actors for MA. It contributes to the debate on the sustainability of health systems by suggesting the adoption of a medium-to-long-term approach to economic and social sustainability based on PPI; it adopts an industrial marketing approach and contributes to the recent debate on PPI.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

scholarly journals Opening a Path towards Sustainable Corporate Behaviour: Public Participation in Criminal Environmental Proceedings

2021 ◽  
Vol 13 (14) ◽  
pp. 7886
Author(s):  
Pavel Kotlán ◽  
Alena Kozlová ◽  
Zuzana Machová
Keyword(s):  
Public Participation ◽  
Criminal Liability ◽  
Active Role ◽  
Legal Framework ◽  
The European Union ◽  
Criminal Proceedings ◽  
Human Rights Protection ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations

Establishing criminal liability for environmental offences remains daunting, particularly with regard to the ‘no plaintiff—no judge’ element as a result of which the public seems to be ultimately deprived of the possibility to participate in criminal environmental proceedings. While there is arguably a lack of specific instruments at the European Union (EU) level which would prescribe such legal obligation on the part of the State, there has been a shift in understanding the role of the public and its participation in criminal liability cases, namely under the auspices of the so-called effective investigation and the concept of rights of victims in general. Using the example of the Czech Republic as a point of reference, this article aims to assess the relevant legal developments at both EU and Czech levels to illustrate why the non-governmental organizations (NGOs), essentially acting as public agents, should be granted an active role in environmental criminal proceedings. After examining the applicable legal framework and case law development, the article concludes that effective investigation indeed stands as a valid legal basis for human rights protection which incorporates an entitlement to public participation. Despite that, this pro-active shift is far from being applied in practice, implying that the legislation remains silent where it should be the loudest, and causing unsustainable behaviour of companies.

scholarly journals Resilience Testing of Health Systems: How Can It Be Done?

2021 ◽  
Vol 18 (9) ◽  
pp. 4742
Author(s):  
Heather L. Rogers ◽  
Pedro Pita Barros ◽  
Jan De Maeseneer ◽  
Lasse Lehtonen ◽  
Christos Lionis ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Phase 1 ◽  
Action Planning ◽  
Health System Strengthening ◽  
System Transformation ◽  
Traffic Light ◽  
Phase 0 ◽  
Five Phases ◽  
Quantitative Indicators

The resilience of health systems has received considerable attention as of late, yet little is known about what a resilience test might look like. We develop a resilience test concept and methodology. We describe key components of a toolkit and a 5-phased approach to implementation of resilience testing that can be adapted to individual health systems. We develop a methodology for a test that is balanced in terms of standardization and system-specific characteristics/needs. We specify how to work with diverse stakeholders from the health ecosystem via participatory processes to assess and identify recommendations for health system strengthening. The proposed resilience test toolkit consists of “what if” adverse scenarios, a menu of health system performance elements and indicators based on an input-output-outcomes framework, a discussion guide for each adverse scenario, and a traffic light scorecard template. The five phases of implementation include Phase 0, a preparatory phase to adapt the toolkit materials; Phase 1: facilitated discussion groups with stakeholders regarding the adverse scenarios; Phase 2: supplemental data collection of relevant quantitative indicators; Phase 3: summarization of results; Phase 4: action planning and health system transformation. The toolkit and 5-phased approach can support countries to test resilience of health systems, and provides a concrete roadmap to its implementation.

The regulation of health care in Scandinavia: professionals, the public interest and trust

2018 ◽  
pp. 61-76
Author(s):  
Karsten Vrangbæk
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Health Insurance ◽  
Health System ◽  
Health Systems ◽  
Public Interest ◽  
State Level ◽  
Professional Regulation ◽  
The Public ◽  
Voluntary Health Insurance

Scandinavian health systems have traditionally been portrayed as relatively similar examples of decentralised, public integrated health systems. However, recent decades have seen significant public policy developments in the region that should lead us to modify our understanding. Several dimensions are important for understanding such developments. First, several of the countries have undergone structural reforms creating larger governance units and strengthening the state level capacity to regulate professionals and steer developments at the regional and municipal levels. Secondly, the three Nordic countries studied experienced an increase in the purchase of voluntary health insurance and the use of private providers. This introduces several issues for the equality of users and the efficiency of the system. This paper will investigate such trends and address the question: Is the Nordic health system model changing, and what are the consequences for trust, professional regulation and the public interest?

scholarly journals Media frames and public perceptions of global poverty in the UK: Is there a link?

2019 ◽  
Vol 44 (1) ◽  
pp. 59-79 ◽  
Author(s):  
Mirjam Vossen ◽  
Lau Schulpen
Keyword(s):  
Developing Countries ◽  
Public Perceptions ◽  
Global Poverty ◽  
Media Frames ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
The Media ◽  
The Uk ◽  
The Relationship

Abstract This study investigates the relationship between media frames and public perceptions of global poverty. Building on a frame analysis, the paper reconstructs prevailing poverty narratives in British news articles and non-governmental organizations’ (NGO’s) advertisements between 2011 and 2013. Following this, these narratives are compared with the narratives that emerge from public opinion studies. The findings suggest that there is a strong connection between media frames and public knowledge and perceptions of global poverty. Both the media and the public define poverty in developing countries’ terms of destitute victims, lack of development and bad governance. Both suggest that the causes of poverty are internal to developing countries and imply that there has been little progress in reducing global poverty.

scholarly journals PUBLIC SECTOR INSTITUTIONS OF FOREIGN POLICY EXPERTISE IN UKRAINE:AN ANALYTICAL OVERVIEW

2020 ◽  
Vol 16 (3) ◽  
pp. 340-359
Author(s):  
Oleg Onopko ◽  
Keyword(s):  
Foreign Policy ◽  
Public Sector ◽  
Structural Damage ◽  
Domestic Politics ◽  
Think Tanks ◽  
National Academy Of Sciences ◽  
The Public ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Political Mythology

An important condition for the effective protection and implementation by Russia of its national interests in Ukraine is an understanding of the circle of actors that influence the development of Ukrainian foreign policy. Among them, there are expert institutions that provide analytical and scientific support for foreign policy decisions made by the highest bodies of state power. For- eign policy expertise in Ukraine is a grey area for Russian political science. The article opens a series of publications whose purpose is to solve this problem. It systematizes information about Ukrainian institutes of foreign policy expertise, those whose activities are directly or indirectly financed by the state. It was revealed that during the presidency of Viktor Yanukovych (2010– 2014), the public sector suffered significant structural damage, and its consequences have not yet been overcome. Today, Ukrainian public institutions of foreign policy expertise include: the National Institute for Strategic Studies, the Institute of World History of the National Academy of Sciences of Ukraine and university think tanks. The author considers these organizations through the prism of constructivism and institutionalism — as political structures (institutions) whose activities affect the context of Ukrainian foreign policy and the behavior of its actors. It has been established that their main scientific and applied research interests are related to problems of national, regional and international security, Russian domestic politics, problems of information, as well as military and political confrontation with Russia. All these issues are considered by institutions exclusively through the prism of Euro-Atlanticism and anti-Russian political mythology. Since at least 2014, they have been transmitting ideas hostile to Russia to the Ukrainian political and academic elite. In the same vein, the political socialization of students is carried out, in which university think tanks actively work in close collaboration with state and non-governmental organizations of NATO member countries. Today, the public sector of foreign policy expertise in Ukraine is not in the best condition, but it invariably retains its analytical and scientific potential, as well as its tough anti-Russian position.

scholarly journals The Public Policy Implementation on the Merchants Relocation in Tebing Tinggi City, North Sumatera Indonesia

2020 ◽  
Vol 9 (1) ◽  
pp. e158911782
Author(s):  
Zainal Abidin Harahap ◽  
Badaruddin Badaruddin ◽  
Heri Kusmanto
Keyword(s):  
Public Policy ◽  
Policy Implementation ◽  
Conflicts Of Interest ◽  
Descriptive Analysis ◽  
The Public ◽  
Internal Conflicts ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Public Policy Implementation ◽  
In The Beginning

This research described the public policy implementation Mayor's Regulation of Tebing Tinggi City Number: 501/195 of 2018 through model of Van Meter and Van Horn concerning to the Relocation Merchants in Pasar Kain and Pasar Induk Market Tebing Tinggi. This research method applied the qualitative approach and descriptive analysis. To gain data and information some informant included the Head of the Trade Office, Merchants, Members of Legislative and the local non-governmental organizations were selected. According to the research and discussion, there were results of the implementation of the Pasar Kain merchant relocation policy. It show that the standards and policy objectives were adequate of clear and realistic to be implemented. The utilization of available resources was not used optimally, communication between organizations was adequate. In the beginning there are many miscommunications between merchants and the relocation team, the characteristics of the implementing organization were consistent despite the many conflicts of interest and internal conflicts among the social, economic and political environment.  In the initially, there were many social conflicts, the involvement of political elites and decrease income of merchants after being relocated. The attitude of the implementers was also quite consistent in supporting the policy. The implementation of the Pasar merchant relocation policy has not been optimal because the stalls have not been completely occupied.

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