The decentralization of health care in developing countries: organizational options

The complex ways in which decentralization is practised in the field of government health services are examined. Organizationally, decentralization means a choice between different types of public institution, which vary in terms of: the areas over which they have jurisdiction, the functions delegated to local institutions; and the way decision-makers are recruited, so producing institutions. There is little agreement about the optimum size of areas, either in terms of population or territory. Areas cannot be delimited without consideration being given to the powers to be exercised at each level. The specification of functions always assumes certain things about who will exercise the delegated powers. The two issues cannot be separated. Five structures of decentralization are distinguished, each of which could in principle be created at regional, district and village/community level: the multi-purpose local authority, the single-purpose council, the hybrid council, the single purpose executive agency, the management board, field administration, health teams, and interdepartmental committees. Whatever the institutions used for decentralization, the choice of structures and the ensuing process of decision-making will be highly charged politically. © 1997 John Wiley & Sons, Ltd.     

THE RELATIONSHIP BETWEEN CHILDHOOD MALTREATMENT AND ADOLESCENT INVOLVEMENT IN DELINQUENCY*

Recent research suggests a link between childhood maltreatment and later involvement in delinquency. This study examines this issue using official and self-report data from the Rochester Youth Development Study. The analysis addresses three central issues: the magnitude of the relationship between early child maltreatment and later delinquency, official and self-reported; the possibility of spuriousness in this relationship; and the impact of more extensive measurement of maltreatment on later delinquency. A significant relationship between child maltreatment and self-reported and official delinquency is found and this relationship, especially for more serious forms of delinquency, remains when controlling for other factors. The results also suggest that more extensive maltreatment is related to higher rates of delinquency. Implications and suggestions for further research are discussed.     

Nudge Nudge, Think Think: Two Strategies for Changing Civic Behaviour

This paper reviews two contrasting approaches governments use to engage the citizen to promote better public policy outcomes: nudging citizens using the insights of behavioural economics, as summarised by Thaler and Sunstein (2009) or giving citizens the space to think through and debate solutions, as indicated by proponents of deliberative democracy. The paper summarises each approach, giving examples; then it compares and contrast them, illustrating their relative strengths and weaknesses. The paper concludes by suggesting that the approaches share some common features and policy-makers could useful draw upon both.     

DO NEIGHBORHOODS GENERATE FEAR OF CRIME? AN EMPIRICAL TEST USING THE BRITISH CRIME SURVEY*

For a long time, criminologists have contended that neighborhoods are important determinants of how individuals perceive their risk of criminal victimization. Yet, despite the theoretical importance and policy relevance of these claims, the empirical evidence base is surprisingly thin and inconsistent. Drawing on data from a national probability sample of individuals, linked to independent measures of neighborhood demographic characteristics, visual signs of physical disorder, and reported crime, we test four hypotheses about the mechanisms through which neighborhoods influence fear of crime. Our large sample size, analytical approach, and the independence of our empirical measures enable us to overcome some of the limitations that have hampered much previous research into this question. We find that neighborhood structural characteristics, visual signs of disorder, and recorded crime all have direct and independent effects on individual‐level fear of crime. Additionally, we demonstrate that individual differences in fear of crime are strongly moderated by neighborhood socioeconomic characteristics; between‐group differences in expressed fear of crime are both exacerbated and ameliorated by the characteristics of the areas in which people live.     

Special Elections to the U.S. House of Representatives: A General Election Barometer?

Vacancies in the U.S. House of Representatives are filled using special elections. These elections occur off the usual American electoral cycle, and their results are routinely portrayed by the American mass media as indications of what to expect in the next general election. We examined the predictive power of special elections results with respect to the general election outcomes for the U.S. House of Representatives from 1900 to 2008. We found that special elections that yield a change in partisan control do have predictive power regarding general election results.