A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

Background Telehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability. Methods A demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach. Results Findings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects. Conclusion Overall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Understanding role conflict and role ambiguity of school principals in Nepal

In the context of developed countries, a lot of research has been done to uncover and identify the problems school leaders face in their work but little is known about the school leadership of underdeveloped countries. In a quest to discover contextual problems in terms of role conflict and role ambiguity of school leaders, this qualitative study tries to capture the experiences of principals in Nepal through in-depth interviews of six community school principals. The findings reveal that the major sources of role conflict and ambiguity for principals from Nepal are problematic power-sharing, low job autonomy, dual role conflict, limited professional development training, and lack of leadership knowledge. The study has several policy-level implications such as importance of hiring principals with proven leadership skills and increasing the leadership skills of current principals to ensure that they can tackle these challenges.

The Problem of State Violence

When violence occurs, the state has an obligation to respond to and reduce the impacts of it; yet often the state originates, or at least contributes to, the violence. This may occur in a variety of ways, including through the use of force by police, pretrial incarceration at local jails, long periods of incarceration in prisons, or abuse and neglect of people who are incarcerated. This essay explores the role of the state in responding to violence and how it should contribute to reducing violence in communities, as well as in its own operations. Finally, it explores what the future of collaboration between state actors and the community looks like and offers examples of successful power-sharing and co-producing of safety between the state and the public.

Trends of Power Devolution in South Asia: A Comparative Appraisal of Pakistan’s Local Government System under the Civil-Military Regimes

In the South Asian countries, the trends of power sharing, decentralization and power evolution have not only always remained a pertinent debate for the consolidation of democracy and good governance, but also static political systems due to their multiethnic realities, multilingual differences, multicultural diversification, and their authoritarian orientation in the respective countries. Historically, the transfer of power through the local system of government (LGS) was seen as an important tool to accelerate the transition to representative democracy on the subcontinent. However, it was largely aimed at creating a new political class that would support colonial rule and meet the political demands of the local population for power sharing within the boundaries of the colonial government structure. Due to their embedded interests, the colonial legacies in South Asian states offered non-representative state institutions such as the military enough space to influence the transformation process of democracy. The paper has two main objectives: (1) to explore the concepts of power devolution and their associative nomenclature; (2) to analysis of the political and administrative dimensions of decentralization to underpin the structure of decentralization in South Asia in general and Pakistan in particular. The results of the study are that the lack of the weakest local government system in the South Asian region in general, and in Pakistan in particular, is due to the colonial legacy of an ongoing controlled political mindset in the form of bureaucracy, frequent military coups, a lack of political will to develop a welfare state in Pakistan. It uses the qualitative research methods of phenomenology and correlation, which sheds light on the meaning of relative terms often used to explain delegation of authority for political and administrative purposes.