What could be achieved with greater public hospital autonomy? Comparison of public and PNFP hospitals in Uganda

The policy of hospital autonomy has been discussed for some time in Uganda. There is little evidence from Uganda or elsewhere that increased autonomy will improve hospital performance. This article compares the performance of three private not‐for‐profit (PNFP) and public hospital pairs to address this question. PNFP and public hospitals have similar management structures but PNFP hospitals had better trained managers and a church affiliated chair in the hospital management committee. Both types have problems with personnel management but these appear more pronounced in public hospitals. Drug supply management appears better in PNFP hospitals. Overall, workloads are similar, but analysis of patterns of utilisation and prices across services suggest that patient choice of facilities is influenced by relative price levels, and that willingness to pay is higher for PNFP services. PNFP hospitals are more successful at generating revenue. There are no clear differences in efficiency between PNFP and public hospitals but there is some evidence of higher quality levels in PNFP hospitals. PNFP hospitals' performance is plausibly related to three areas of managerial autonomy. First, better management of drug supply is facilitated by their freedom to purchase drugs from the open market. Second, greater success with personnel management is plausibly related to their greater autonomy over staffing. Third, higher levels of cost recovery are enabled by their freedom to set fees. However, differences in accountability and competence of hospital management, and population willingness to pay for services may also help to explain differences. Further, the use of PNFP financing strategy by public hospitals has implications for universal access to hospital services. Although there appear to be potential advantages from greater public hospital autonomy, the Ugandan government should ensure it has developed strategies to enhance public hospital management and to protect access to public hospitals before advancing further with hospital autonomy policy. Copyright © 2002 John Wiley & Sons, Ltd.     

A Participant Evaluation of the U.S. Navy Parent Support Program

This study reports on the results of a program evaluation of the U.S. Navy New Parent Support Program (NPSP). NPSP is comprised of two components: center-based parenting classes and home-based visits. Data are presented on: (a) satisfaction with program quality, (b) how well the program met its primary objectives (e.g., helps reduce parenting stress), (c) how well the NPSP met its Reasons for Being (RFBs; e.g., Helps service members concentrate on their job), and (d) program impact on mission-related outcomes (i.e., quality of life (QOL), readiness, and program impact on their decision to remain in the military). Results indicate that parents who take part in both the parenting classes and home-based visits report that the program exceeded their expectations, the program improved their perceptions of their parenting and coping skills, they perceived that the program demonstrated the Navy’s concern for Sailors and their families, and the program enhanced the family’s quality of life. Implications of study findings are discussed.

Remembering and Voting: Theory and Evidence from Amnesic Patients

One of the most prominent claims to emerge from the field of public opinion is that citizens can vote for candidates whose issue positions best reflect their own beliefs even when they cannot remember previously learned stances associated with the candidates. The current experiment provides a unique and powerful examination of this claim by determining whether individuals with profound amnesia, whose severe memory impairments prevent them from remembering specific issue information associated with any particular candidate, can vote for candidates whose issue positions come closest to their own political views. We report here that amnesic patients, despite not being able to remember any issue information, consistently voted for candidates with favored political positions. Thus, sound voting decisions do not require recall or recognition of previously learned associations between candidates and their issue positions. This result supports a multiple memory systems model of political decision making.     

Governing failure: development,aid and audit in Haiti

This paper analyses practices for monitoring, tracking and assessing the international aid and reconstruction efforts in Haiti in an attempt to ‘build back better’ from the devastation of the January 2010 earthquake. We suggest that aid and reconstruction efforts filter through an international network of development organisations. This network also acts as a governing auspice, overseeing the transformation of Haiti from a ‘failed state’ to a strong democratic state. The central governing mechanism in this reconstruction effort involves the embedding of the ideas and practices of audit within Haitian political and civic culture. We reveal how, in Haiti, this culture of audit monitors aid and reconstruction through biopolitical technologies such as benchmarks and performance indicators, and through the constitution of calculable and accountable entities. More than a means of implementing disaster recovery, audit culture is a technique of biopolitical governance that aims to transform Haiti's state, civic institutions and citizens into entities accountable to an international development agenda.     

Eyewitness Identifications by Older and Younger Adults: A Meta-Analysis and Discussion

The current meta-analysis compared younger and older adult eyewitness identification accuracy and includes analyses designed to determine what witness and event factors might moderate any differences found. Results showed that, regardless of lineup type and perpetrator age, older eyewitnesses are reliably worse at making correct lineup decisions than younger eyewitnesses whether they are identifying perpetrators or rejecting perpetrator-absent lineups. Discussion of possible causes for this difference in identification accuracy is drawn from cognitive and social psychology literatures, and possible implications for future research and public policy are put forth.     

Use of Autopsy to Determine Live or Stillbirth: New Approaches in Decision‐support Systems

Fetal deaths are important cases for forensic medicine, as well as for criminal and civil law. From a legal perspective, the determination of whether a deceased infant was stillborn is a difficult process. Such a determination is generally made during autopsy; however, no standardized procedures for this determination exist. Therefore, new facilitative approaches are needed. In this study, three new support systems based on 10 autopsy parameters were tested for their ability to correctly determine whether deceased infants were alive or stillborn. Performances were analyzed and compared with one another. The artificial neural networks and radial basis function network models had 90% accuracy (the highest among the models tested), 100% sensitivity, and 83.3% specificity. Thus, the models presented here provide additional insights for future studies concerning infant autopsies.     

Responding to academic dishonesty in universities: a restorative justice approach

The implementation of restorative approaches in schools has been commonly seen in elementary and high schools, yet the development of restorative approaches in post‐secondary institutions has not been fully explored. In respect to university education, a more restorative approach to student discipline can be a proactive educational response mediating the response of student discipline boards to instances of student wrongdoing. Existing practices are explored, and critiqued from a restorative justice perspective. The rationale behind moving to a restorative response is outlined, and the experiences of student discipline boards that currently employ restorative approaches are assessed to determine how effective this paradigm shift could be. How university responses to student misconduct might function if aspects of the academic environment were built on restorative values and principles is explored, in particular, through looking at the benefits accruing to the development of restorative practices in the classroom, in distance education and for students who experience language difficulties.     

The Impact of School Meals on School Participation: Evidence from Rural India

This article assesses the effect of transition from monthly distribution of free food grains to the daily provision of free cooked meals to school children on enrolments and attendance in a rural area of India. School panel data allow a difference-in-differences estimation strategy to address possible endogeneity of programme placement. The results suggest that programme transition had a significant impact on improving the daily participation rates of children in lower grades. The average monthly attendance rate of girls in grade one was more than 12 percentage points higher while there was a positive but insignificant effect on grade one boys' attendance rate. The impact on enrolment levels was insignificant.     

(En)gendered Security? The Complexities of Women's Inclusion in Peace Processes

As peacebuilding discourses increasingly stress the importance of including women, to what degree have security-related practices taken heed? It has been over 10 years since the United Nations Security Council passed Resolution 1325 on Women, Peace, and Security, yet it remains a “confused and confusing” tool for scholars and practitioners in assessing women's inclusion in peacebuilding. This article adds to our understanding on women and peacebuilding by engaging 1325 as an operationalizable concept and then applying it to peace agreements to understand how women's security is addressed as part of formal peace processes. Given previous difficulties in operationalizing 1325’s mandate, this article engages it as a three-level concept useful for studying the ways in which women are “brought into” security, called (en)gendered security. Using this concept of (en)gendered security, I assess intrastate peace agreements between 1991 and 2010 to elucidate where and how women are included in peace processes. This article illustrates the potential of a systematized and practical approach to security embodied in 1325 and a preliminary discussion of what accounts for better approaches to (en)gendered security during peacebuilding.     

Elite perceptions of land reform in early republican Turkey

This article focuses on the land reform attempts of the single‐party regime in Turkey of the mid‐1930s through the mid‐1940s, culminating in the reform Law of 1945. Why the Turkish ruling elite wanted a land reform is still not adequately understood, and there are a number of controversial and often contradictory interpretations. The thesis here is that despite mainstream approaches to the issue in Turkish historiography, the land reform attempts during the single‐party era should be seen as part of the Kemalist project of conservative modernisation. The article argues that a variety of concerns were important in shaping the Turkish elite's thinking on land reform, including an ideology of peasantism combined with a fear of rural unrest (from sharecroppers, agricultural laborers and landless and land‐poor peasants); a fear also of urbanisation, proletarianisation and socialist ideas; a desire to strengthen Republican nationalist ideology in the countryside as a basis of regime support (with a particular emphasis on the Kurdish issue). The conclusion presents an interpretation of the Turkish land reform that connects the long‐and short‐term causes of the land reform Law of 1945.