Regulating Markets: The Real Costs of Poly-Centric Administration under the National Health Insurance Scheme (1912–46)

Using a transaction cost perspective, this article explores the administrative costs involved in quasi-market systems of public service delivery. Employing the historical example of the interwar National Health Insurance scheme, it revives Beveridge's early criticisms of the duplication and expense incurred by the utilization of approved societies for benefit administration purposes. To this we should add the costs incurred by central audit and actuarial evaluation, the main mechanisms through which the societies were centrally regulated. The article concludes that, thanks to regulatory requirements, this poly-centric system of public administration was more expensive than a state-run equivalent – and that this message has significance for recent reforms. In the course of the analysis, the narrowness of a 'pure' transaction cost perspective is demonstrated and common assumptions concerning distinctions between 'the state and the market' in administrative structures are drawn into question. The division of public administration into these two typologies is arguably based on a false dichotomy.     

Reviews

AIDS in Africa: The Social and Policy Impact edited by Norman Miller and Richard C. Rockwell Edwin Mellen Press, Lewiston (New York) and Queenston (Ontario), 1988. xxxi plus 336 pp. including map, tables, figures, notes, appendices and selected bibliographies. $110,00.

The Politics of Africa's Economic Stagnation by Richard Sandbrook Cambridge University Press, Cambridge, 1985. xiii plus 180 pp. including map, tables, notes and index. R.25,50 paperback.

Imperialism and Dependency: Obstacles to African Development by Daniel A. Offiong Howard University Press, Washington, DC, 1982. 304 pp. including tables, bibliography and index. $6,95 paperback.

Early Field Recordings: A Catalogue of Cylinder Collections at the Indiana University Archives of Traditional Music edited by Anthony Seeger and Louise S. Spear Indiana University Press, Bloomington, 1987. xviii plus 198 pp. $22,50.

Western Sahara: The Roots of a Desert War by Tony Hodges Lawrence Hill and Co., Westport (Connecticut), 1983. xii plus 388 pp. including maps, illustrations, tables, notes, appendix, bibliography and index. £6,95 paperback.

Somalia: Nation in Search of a State by David D. Laitin and Said S. Samatar Westview Press, Boulder (Colorado), and Gower, London, 1987. xvii plus 198 pp. including maps, illustrations, figures, tables, notes and index. $28,00.

Superpower Diplomacy in the Horn of Africa by Samuel M. Makinda Croom Helm, London and Sydney, 1987. 242 pp. including notes, appendices, select bibliography and index. £22,50.

Industrialization in West Africa by J.O.C. Onyemelukwe Croom Helm, London, 1984. v plus 226 pp. including tables, figures, bibliography and index. £17,95.

Modern Kongo Prophets: Religion in a Plural Society by Wyatt MacGaffey Indiana University Press, Bloomington, 1983. xiii plus 285 pp. including tables, figures, illustrations, notes, references and index. $12,00 paperback.

Naissance du Mozambique: Résistance et Révoltes Anticoloniales, 1854–1918 (Two Volumes) by René Pélissier Editions Pélissier, Orgeval (France), 1984. 833 pp. including maps, tables, notes, bibliography and index. $45,00 paperback.

The Political Economy of Namibia: An Annotated, Critical Bibliography by Tore LinnÉ Eriksen with Richard Moorsom Scandinavian Institute of African Studies, Uppsala, 1985. 423 pp. including map and authors’ index. SEK 110.

The Bureaucratic Struggle for Control of US Foreign Aid: Diplomacy versus Development in Southern Africa by Caleb Rossiter Bowker Publishing Co., Epping (England), and Westview Press, Boulder (Colorado), 1985. xiii plus 250 pp. including figures, tables, notes, bibliography and index. $25,50 paperback.

The Politics of Economic Power in Southern Africa by Ronald T. Libby Princeton University Press, Princeton (New Jersey), 1987. xxiii plus 361 pp. including maps, tables, bibliography and index. $45,00. $14,50 paperback.

South Africa in Crisis edited by Jesmond Blumenfeld Croom Helm, London, 1987. x plus 207 pp. including tables, notes and index. £19,95.

Pass Controls and the Urban African Proletariat in South Africa By Doug Hindson Ravan Press, Johannesburg, 1987. xii plus 121 pp. including notes, bibliography and index. R 14,00 paperback.

Hidden Struggles in Rural South Africa: Politics and Popular Movements in the Transkei and Eastern Cape, 1890–1930 by William Beinart and Colin Bundy Ravan Press, Johannesburg, 1987. xxvi plus 326 pp. including illustrations, maps, notes and index. R24,00 paperback.     

Noncoercive sexual contact with similarly aged individuals: what is the impact?

A community sample of 610 adults were grouped into those who reported no sexual abuse experience, others who reported noncoercive sexual contact with an individual that was at most 4 years older, and those who reported more severe sexual abuse. The first two groups did not differ from each other on current social support, trauma-specific symptomatology, and somatic complaints whereas the more severe sexual abuse group reported more problems on these dimensions. Further analyses suggested that of the two variables, coercion was more closely associated with problematic outcome than was the existence of an age difference.     

Realistic rehabilitation

Rehabilitation involves re-establishing livelihood security among the poorest households in order to reduce vulnerability to future disasters, re-start the local economy in a sustainable fashion, and avoid dependency. This article discusses experiences of post-war rehabilitation in Mozambique and suggests that, although many households rapidly re-started crop production, they remain vulnerable because they have not been able to rebuild reserves. The author cautions against over-rapid withdrawal from relief programmes, and suggests that distributing cash and allowing households to buy what they need most is sometimes more appropriate than distributing food, seeds, tools, and selected household goods.     

An experimental study of the effect of structured videotape feedback on adolescent group psychotherapy process

Group psychotherapy with disturbed undersocialized adolescents requires modification of traditional group psychotherapy methods. The effectiveness of a structured, brief video-tape feedback and discussion on group psychotherapy process with this population was studied by an analysis of detailed ratings of each statement, or process unit; in randomly selected videotapes from a control and experimental group during a nine-month period. Significant differences in level of intimacy of verbal content and in frequency of feedback about behavior in content indicate that this technique is effective in facilitating group psychotherapy goals.Received Ed.D. from University of Kentucky. Research interests are group psychotherapy process and methodology.Received M.A. from North Carolina State University. Research interest is adolescent group psychotherapy.Received Ph.D. from North Carolina State University. Research interest is adolescent group psychotherapy.Received M.A. from University of North Carolina. Research interest is group psychotherapy process.Received Ph.D. from Purdue University. Research interets include analysis of small group processes.     

Food insecurity and ART adherence in Swaziland: the case for coordinated faith-based and multi-sectoral action

ABSTRACT

Faith-based organisations (FBOs) have long been involved in HIV and AIDS impact mitigation and humanitarian relief, but most are not equipped to intervene in the structural drivers of food insecurity and attendant health inequities. Acknowledging limitations is as paramount a task for organisational effectiveness as maximising strengths. This article reports findings from a study of HIV-positive care supporters who volunteer with a church-run home-based care organisation in Swaziland. The article seeks to assess the impact of chronic food insecurity on antiretroviral adherence practices and how these individuals manage daily food shortages. Findings highlight the limited capacities of FBOs in highly vulnerable settings and the imperative for international and governmental coordination.     

CUSTODY FOR CHILDREN AGE 5 AND YOUNGER

The empirical literature concerning the developmental consequences of postdivorce custody arrangements for children age 5 and younger is summarized with a focus on implications for practitioners and researchers. A developmental-ecological model is used to organize the review. Key variables include socioeconomic resources, mother-child relationship, father-child relationship, mothers' and fathers' adjustment, cooperation and conflict within the parental alliance, the extended family network, and the day care environment.     

AIDS, security and the military in Africa: A sober appraisal

This article examines four accepted wisdoms about HIV/AIDS andAfrican armies and in each case concludes that substantial revisionis necessary in the light of emerging evidence. First, it appearsthat military populations do not necessarily have a higher prevalenceof HIV than civilian populations. HIV levels in armies dependon many factors including the demographics of the army, itspattern of deployment, the nature and stage of the epidemicin the country concerned, and the measures taken to controlthe disease by the military authorities. Second, although theepidemic has the potential to undermine the functioning of nationalmilitaries, and may have done so in isolated instances, armiesin general are well placed to withstand the threat. Third, evidencethat war contributes to the spread of the virus is meagre andsuggests that we should be concerned primarily with specificrisks that conflict may entail including population mobilityand changing sexual networks. Lastly, the hypothesis that AIDShas the potential to disrupt national, regional, and internationalsecurity remains speculative. ^1. Roger Yeager, Craig Hendrix, and Stuart Kingma, ‘Internationalmilitary Human Immunodeficiency Virus/Acquired Immunodeficiencysyndrome policies and programs: strengths and limitations incurrent practice’, Military Medicine 165, 2 (2000), pp.87–92. ^2. S. Kingma, ‘AIDS prevention in military populations: learningthe lessons of history’, International AIDS Society Newsletter,4, March 1996, pp. 9–11. ^3. UNAIDS, ‘AIDS and the military: UNAIDS point of view’,UNAIDS Best Practice Collection, May 1998 (http://www.unaids.org/html/pub/publications/irc-pub05/militarypv_en_pdf.pdf,9 January, 2005). ^4. A.E. Pettifor, H.V. Rees, A. Steffenson, L. Hlongwa-Madikizela,C. MacPhail, K. Vermaak, and I. Kleinschmidt, HIV and SexualBehaviour Among Young South Africans: A national survey of 15–24year olds (Reproductive Health Research Unit, University ofWitwatersrand, Johannesburg, 2004). ^5. According to a South African AIDS Law Project press releaseof 23 October 2003, ‘the SANDF has however excluded andcontinues to exclude job applicants with HIV from employmentin the SANDF’ (http://www.alp.org.za/modules.php?op=modload&name=News&file=article&sid=229,16 April, 2005). ^6. Yigeremu Abebe, Ab Schaap, Girmatchew Mamo, Asheber Negussie,Birke Darimo, Dawit Wolday, and Eduard J. Sanders, ‘HIVprevalence in 72,000 urban and rural army recruits, Ethiopia’,AIDS 17, 12 (2003), pp. 1835–40. ^7. Taddesse Berhe, Hagos Gemechu, and Alex de Waal, ‘Warand HIV prevalence: evidence from Tigray, Ethiopia’, AfricanSecurity Review 14, 3 (2005), pp. 107–14. ^8. Olive Shisana, Leickness Simbayi, and E. Dorkenoo, ‘SouthAfrica’s first national population-based HIV/AIDS behaviouralrisks, sero-status and media impact survey (SABSSM) researchproject’ (Third Quarterly Progress Report, Household Survey2002, Human Sciences Research Council, Pretoria, 2002). ^9. UNAIDS, ‘AIDS and the military’, UNAIDS TechnicalUpdate, 1998 (http://www.worldbank.org/wbi/aidsleadership/dls_AIDS_military_may14.pdf,July 21, 2004); ‘Military populations’ AIDS Briefs(http://www.heard.org.za/publications/AidsBriefs/sec/military.pdf,December 22, 2005). ^10. Tsadkan Gebre Tensae, ‘HIV/AIDS in the Ethiopian military:perceptions, strategies and impacts’ (unpublished paper,2002). ^11. A. Adefalolu, ‘HIV/AIDS as an occupational hazard to soldiers– ECOMOG experience’ (Paper presented at the 3rdAll Africa Congress of Armed Forces and Police Medical Services,Pretoria, 1999), pp. 4–11. ^12. M. Fleshman, ‘AIDS prevention in the ranks – UNtarget peacekeepers, combatants in war against the disease’,African Recovery 15, 1–2 (2004), pp. 9–10. ^13. The same was true in Thailand, where the army responded in advanceof the government. ^14. ‘HIV/AIDS and Uniformed Services: Analysing the Evidence’.Expert Meeting, Cape Town, December 6–7, 2004 called byUNAIDS and attended by Alan Whiteside. ^15. Edward Hooper, Slim (Bodley Head, London, 1990); Edward Hooper,The River: A journey to the source of HIV and AIDS (Penguin,London, 2000), pp. 42–9. ^16. Robert Shell, ‘The silent revolution: HIV/AIDS and militarybases in Sub-Saharan Africa’ in Consolidating Democracy,Seminar Report Series (Konrad Adenauer Foundation, East London,2000), pp. 29–41. ^17. Reinhard Kaiser, Paul Spiegel, Peter Salama, William Brady,Elizabeth Bell, Kyle Bond, and Marie Downer, ‘HIV/AIDSseroprevalence and behavioral risk factor survey in Sierra Leone,April 2002’ (Center for Disease Control and Prevention,Atlanta, GA, 2002). ^18. C. Mulanga, S. Bazepeo, J. Mwamba, C. Butel, J.-W. Tshimpaka,M. Kashi, F. Lepira, M. Carael, M. Peeters, and E. Delaporte,‘Political and socio-economic instability: how does itaffect HIV? A case study in the Democratic Republic of Congo’,AIDS 18, 5 (2004), pp. 832–4. ^19. Taddesse Berhe, Hagos Gemechu, and Alex de Waal, ‘Warand HIV prevalence: evidence from Tigray, Ethiopia’, AfricanSecurity Review 14, 3 (2005), pp. 107–14. ^20. Tim Allen, ‘AIDS, security and democratic governance’,The Hague, 2–4 May 2005. Presentation at expert seminar. ^21. Paul Spiegel, ‘HIV/AIDS among conflict-affected and displacedpopulations: dispelling myths and taking action’, Disasters28, 4 (2004), pp. 322–39. ^22. African Rights, Rwanda: Broken bodies, torn spirits; livingwith genocide, rape and HIV/AIDS (African Rights, Kigali, 2004);V. Randell, ‘Sexual violence and genocide against Tutsiwomen. Propaganda and sexual violence in the Rwandan genocide:an argument for intersectionality in international law’,Columbia Human Rights Law Review 33, 3 (2002), pp. 733–55. ^23. Kaiser et al., ‘HIV/AIDS seroprevalence’. ^24. P. Fourie and M. Schönteich, ‘Africa’s newsecurity threat: HIV/AIDS and human security in southern Africa’,African Security Review 10, 4 (2001), pp. 29–44; M. Schönteich,‘AIDS and age: SA’s crime time bomb’, AIDSAnalysis Africa 10, 2 (1999), pp. 1–4. ^25. Rachel Bray, ‘Predicting the social consequences of orphanhoodin South Africa’ (Working Paper No. 29, Centre for SocialScience Research, University of Cape Town, 2003).