Jump-Starting Collaboration: The ABCD Initiative and the Provision of Child Development Services through Medicaid and Collaborators

Many policy problems require governmental leaders to forge vast networks beyond their own hierarchical institutions. This essay explores the challenges of implementation in a networked institutional setting and incentives to induce coordination between agencies and promote quality implementation. It describes the national evaluation of the Assuring Better Child Health and Development program, a state-based program intended to increase and enhance the delivery of child development services for low-income children through the health care sector, using Medicaid as its primary vehicle. Using qualitative evaluation methods, the authors found that all states implemented programs that addressed their stated goals and made changes in Medicaid policies, regulations, or reimbursement mechanisms. The program catalyzed interagency cooperation and coordination. The authors conclude that even a modest level of external support and technical assistance can stimulate significant programmatic change and interorganizational linkages within public agencies to enhance provision of child development services.     

International measurement of food security: Enhancing alignment between evidence and assistance programs

A definition of food security used in developing countries by United Nations Agencies, The United States Agency for International Development (USAID) and other international development agencies establish four dimensions of food security: access, availability, utilization, and stability. This definition provides a framework for a multidimensional, rigorous measure of food security across developing countries and enables an analysis of the magnitude and severity of food insecurity across time and space. This framework also permits an analysis of the drivers of food insecurity that foster appropriate, cost‐effective food assistance programs. In the developed world, food security is often defined more narrowly, resulting in a less rigorous measurement of food security. Food security experts in developed countries can exploit the framework applied in the developing world to improve the measurement of food insecurity, as well as evidence‐based food assistance programs that are informed by its measurement.     

Lived citizenship as the locus of political agency in participatory policy

Participatory policies seeking to foster active citizenship continue to be dominated by a territorial imagination. Yet, the world where people identify and perform as citizens is spatially multifarious. This article engages with the tension between territorially grounded perceptions and relational modes of practicing political agency. Studying empirically the Finnish child and youth policies, we address jointly the participatory obligations that municipalities strive to fulfill, and the spatial attachments that children and young people establish in their lived worlds. To this end, we introduce the concept of lived citizenship as an interface where the territorially-bound public administration and the plurality of spatial attachments characteristic to transnational living may meet. We conclude by proposing a re-grounding of lived citizenship in both topological and topographical terms as an improvement in theoretical understanding of mundane political agency and as a step towards more proficient participatory policies.     

Stewardship of health security: The challenges of applying the One Health approach

Experience with the control of epidemics, notably the 2004 outbreaks of avian influenza, has demonstrated that a “One Health approach,” that recognizes that human, animal, and environmental health are interdependent, is the most effective way of dealing with threats from emerging infectious diseases (EID). However, introducing and applying a One Health approach is challenging for many countries. One of the key challenges relates to stewardship. The evolution of the strategies and policies used to introduce and adopt the One Health approach in the detection and response to EID over the period 2005 to 2017 is described at global level and in country case studies of Thailand and Indonesia. Both countries experienced significant outbreaks of H5N1 avian influenza from 2004 and have sought to adopt the One Health approach in their response strategies. The challenges for stewardship of health systems in introducing a One Health approach are described, and key lessons identified in regard to national level agency coordination, engagement of the broader civil society outside government, and developing a reliable, credible, and impartial decision‐making process. The concept of stewardship provides valuable insights for policymakers on how to incorporate a One Health approach into their EID response systems.     

Dealing with sectoral corruption in Bangladesh: Developing citizen involvement

Bangladesh has had a troubled political history since gaining independence in 1971 and is also beleaguered by poverty and natural environmental disasters. In particular however, corruption is blighting its prospects for economic growth, undermining the rule of law and damaging the legitimacy of the political process. This article adopts a sectoral approach to the study of corruption by examining people's experiences of using health and education services in Bangladesh through a large scale quantitative survey. It also presents case study research which assesses the impact of anti‐corruption work by Transparency International Bangladesh (TIB) in the areas of health and education. The article concludes that: the poorest in Bangladesh are most penalised by corruption; there are significant benefits for health and education service users resulting from TIB's interventions and there is a need for committed political leadership if ongoing efforts to tackle corruption are to be effective and sustainable. Copyright © 2009 John Wiley & Sons, Ltd.     

Development Programs in Bangladesh: Hardware versus Software

Development programs in Bangladesh have been affected in the past by unequal emphasis on infrastructure and people-building. Some programs emphasize the hardware of development, which provides physical facilities that are supposed to make life more comfortable for rural citizens. The hardware must be supplemented by software, which will enable rural inhabitants to make optimum utilization of physical facilities. This important aspect has been neglected in the past, although some programs made halfhearted attempts to provide education and health-care training to the rural poor. The recent proliferation of non-governmental organizations (NGOs) in Bangladesh has been beneficial in the sense that the software component of development is receiving more attention, and programs are now being designed with the assumption that the software of development is the most crucial element for success.     

International Organizations ICTs Policies: E‐Democracy and E‐Government for Political Development

New technologies provide new channels of access to political information and participation in decision‐making processes. This assumption is clearly important in the action plans and policies of International Organizations (World Bank, Organisation for Economic Co‐operation and Development, United Nations), which have assumed a leadership role in the reform of political institutions. Starting from an analysis of the reasons that have brought the state and processes of institution building back into focus, this paper will reconstruct the International Organizations' vision of the transformative potential of new information technologies and their activity in this field. Particular attention will be devoted to e‐democracy and e‐government as policies to build democracy in developing countries.     

Beyond the categories: human service managers view the new federal aid

Social agency chief executives in six program areas--welfare, health, mental health, community action, model cities, and community mental health centers--were surveyed to determine their reaction to the recent revenue sharing/block grant efforts to decentralize the federal aid system. Despite their strong belief that social initiatives and values were advanced principally by federal action, and that excessive reliance on state and local officials could severely jeopardize social programs with weak constituencies, agency executives also recognized major weaknesses in traditional categorical grant policy and, to varying degrees, supported revenue sharing and block grant alternatives. Those agencies largely dependent on federal support for their survival--model cities, community action programs, and community mental health centers--tended to support the new aid efforts only reluctantly. Those agencies more fully integrated into the regular policy-making arrangements of local government--health, welfare, and mental health agencies--were considerably more positive in their endorsement of greater decentralization.     

Quality of care assessment: policy relevant issues

This paper reviews the quality assessment literature, presents a study which compares five different methods of assessing quality of care, and proposes policy recommendations. Results are: (1) Most quality assessment issues are a century old. (2) The results of assessment of quality of care are dependent on the method used; therefore, more methodologic research is needed. (3) The use of lists of criteria, concerning what a physician does, to assess quality of care could result in decreased efficiency in the health system by requiring the performance of ineffective procedures. (4) It is not certain that examination of the level of care rendered will increase the health level of the population; therefore, any national program which assesses quality of care must be prospectively evaluated. (5) A quality assessment system must be concerned with both the population who received services at the institution, and the population who did not but for whom the institution is responsible.From the Carnegie-Commonwealth Clinical Scholar Program of the Johns Hopkins University.Supported in part by grants 5R01HS00110 and 5T01HS00112 from the National Center for Health Services Research and Development and by the Carnegie Corporation and Commonwealth Fund. Dr. Brook was a Carnegie-Commonwealth Clinical Scholar and is now a Commissioned Officer in the U.S. Public Health Service stationed at the National Center for Health Services Research and Development. This paper does not represent the official position of this agency.     

Overview of the Office of Research, Statistics, and International Policy functions

Research and statistics have been an integral part of social security program development and administration since the program's beginning. The Office of Research, Statistics, and International Policy (ORSIP) is responsible for developing and disseminating information on the effects of programs operated by the Social Security Administration (SSA) and the interactions among these programs, other tax and transfer programs, and economic, social, and demographic forces. This mission is carried out by collecting and tabulating statistics and by conducting policy research and legislative impact analyses. ORSIP also provides technical assistance to other SSA components. In this overview, each of those functions is outlined and major initiatives to carry out the office's primary objectives for fiscal year 1986 are described.     

Federalism and suitable housing for the frail elderly: A comparison of policies in Canada and the United States

Abstract

The frail elderly have special multidimensional housing needs beyond affordability, including shelter that is more adaptive to reduced function and offers supportive services. Suitable housing for this population comprises three policy areas—housing, health care, and social services. In a federal system, development and implementation of policies in these areas involves participation of several levels of government and the nongovernmental sector. This paper uses federalism as a conceptual framework to examine and compare these policy areas in Canada and the United States.

In both countries, general national housing policies—relying heavily on the nongovernmental sector and characterized by joint federal‐provincial programs in Canada and by important local government roles and age‐specific programs in the United States‐have benefited the elderly. The effects of such policies on the frail elderly, however, have been less positive because of the general lack of essential human services and, to a lesser degree, health care that enables them to live outside institutions. This is especially true in the United States, where health care policy is fragmented and is dominated by a private insurance system, partial federal financing of health insurance for the elderly, and tense federal‐state relations in financing health care for the poor. Although Canadian policies and programs operate autonomously and more uniformly within a national health plan, neither country has a universal, comprehensive long‐term care system. Geographically diverse patterns of social services, funded by grants to states and provinces and the nonprofit sector, are common to both countries. However, the United States has inadequately funded age‐specific programs and has relied on a growing commercial service provision. Housing outcomes for frail elders are moving in the right direction in both countries; however, Canada seems to be better positioned, largely because of its health care system. As increased decentralization continues to characterize the three policy areas that affect suitable housing for frail elders, the United States can learn from Canada's negotiated federalism approach to more uniform solutions to merging housing and long‐term care.     

Does Family‐Friendly Policy Matter? Testing Its Impact on Turnover and Performance

This study investigates the relative effects of four types of family‐friendly policies—child care subsidies, paid leave for family care, telework, and alternative work schedules—on turnover rates and effectiveness in federal agencies. Contemporary social exchange theory predicts that an agency’s average level of satisfaction with a specific family‐friendly policy is negatively associated with turnover in the agency but positively associated with overall performance. This analysis differs from common expectations. Only child care subsidies show a positive, significant influence on reducing turnover. Child care subsidies and alternative work schedules reflect positive and significant influences on agency effectiveness. Ironically, an agency’s average satisfaction with telework arrangements proves to be a significant but negative effect on performance.     

Can child care assistance in welfare and employment programs support the employment of low‐income families?

Policymakers have long recognized child care as a key ingredient in low‐income parents' employability. We examine the effects of expansions in child care policies that were bundled with a mix of employment‐related policies and implemented as part of several random assignment studies on families' child care access and cost. Almost all of these welfare and employment programs increased employment and led to concomitant increases in the use of child care, especially paid child care. Only the programs that also expanded access or affordability of child care consistently increased the use of child care subsidies and reduced out‐of‐pocket costs to parents, allowing parents to purchase center‐based care. With one exception, such programs had small effects on employment‐related child care problems, suggesting that broader and more generous targeting of child care assistance may be important for achieving the goal of enhancing the stability of employment among low‐income families. © 2004 by the Association for Public Policy Analysis and Management.     

Abstracts section

The theme of poverty eradication is now again at the top of the development policy agenda. In November 2000 the UK Department for International Development (DfID) published an important White Paper on International Development with the title Eliminating world poverty: a challenge for the 21st century. The World Bank World Development Report for 2000/2001 also takes poverty as its theme with the title Attacking poverty. It is interesting to note that the World Bank has bracketed the decade of the 1990s with the 1990 World Development Report simply entitled Poverty. After many conflicting theories of economic development, the basic problem of poverty in developing countries is now being addressed in a much more holistic way, as is exemplified in the following articles. It should be noted that two of these act as introductory articles to a special issue of a journal on this topic. The article by Lustig and Stern introduces the December 2000 issue of Finance and Development whose overall title is ‘How we can help the poor’ and the article by Baulch and Hoddinott introduces the August 2000 issue of the Journal of Development Studies entitled ‘Economic mobility and poverty dynamics in developing countries’. These special issues contain articles on poverty in addition to the ones abstracted here. Copyright © 2001 John Wiley & Sons, Ltd.     

THIRD WORLD URBANIZATION AND AMERICAN FOREIGN AID POLICY: DEVELOPMENT ASSISTANCE IN THE 1990s

Over the next decade, the demographic and economic characteristics of countries to which the United States government provides technical and financial assistance for economic development will change substantially. Rapid urban population growth, the expanding role of cities and towns in national economies, continued migration of population from rural to urban areas, explosive growth in the size of the labor force, and shifts in the occupations of the labor force from agriculture to manufacturing and ser- vices will require a reorientation of American development assistance. Yet, program objectives and budget allocations of the U.S. foreign aid program fail to reflect these changes in the characteristics of its clientele. The US. Agency for International Development lacks an overt strategy for coping with urbanization in developing nations. Without an urban strategy, the American foreign aid program is likely to incur increasing opportunity costs and fail to address critical problems arising from fundamental shifts in the economic and social structure of developing countries.     

Rethinking economic openness and macro control in developing countries

The Chinese economy is at a critical point in both state-owned enterprises (SOEs) reform and WTO accession. Both events challenge the stability of Chinese economy. After the hit of Southeast Asian economic crisis, policies toward economic openness and macro control need be considered carefully. This paper provides a review of economic opening policies adopted in developing countries and a review of causes and consequences of the Southeast Asian economic crisis. Lessons for Chinese economy are summarized. A major conclusion of the paper is that although the Southeast Asian type of economic crisis due to the high foreign debt ratio may not happen in China, the internal debt and smoothness of transformation of the economic system to meet the demand of an open economy may be the major challenge. I thank Dr. Xiaobo Hu for his suggestion in restructuring the paper in early stage. Thanks also go to the two anonymous reviewers for their valuable comments. The remaining errors are mine. Early vision of the paper was presented at the Conference of Social Science Development for 21^st Century in China in June 1998 in Beijing. He received his Ph.D in Economics from Ohio State University in 1993. His research interests are in economic development in rural China, international trade policies in Asia, and urban economics. His recent articles are published in journals such asEconomic Development and Cultural Change, Quarterly Review of Economics and Finance, China Economic Review, andASEAN Economic Bulletin.     

The practice and effect of development planning in Bangladesh

Development planning in Bangladesh has not been conspicuously successful. Neverthless it is essential for the nation to continue to plan its economy. Bangladesh's plans must be explored within the context of the economic and sociopolitical constraints that are placed upon the plan and its implementation. The First Five Year Plan (FFYP) was prepared within the framework of a socialist economy but not implemented accordingly. The attitude of the government was a major factor in the eventual distortion of this plan. The mobilization of national resources and their allocation, land reforms, subsidy measures, and industrial policies pursued by the government appeared to protect group interests rather than following recommendations of the plan. A bitter triangular relationship emerged among the politicians, the bureaucrats and the planners. This can explain why the implementation of the plan fell short of what was minimally expected. Subsequent plans, unlike the FFYP which placed high priority on social sectors, have been formulated in favour of the more productive sectors of agriculture and manufacturing. The outcome has been a modest increase in economic growth, but inequality and poverty have tended to perpetuate themselves. To achieve growth with social equality, planning in Bangladesh appears to need strong public commitment and bureaucratic support, the absence of which may prove to make national development planning ineffective, if not counterproductive.     

Healthy Country, Healthy People: Policy Implications of Links between Indigenous Human Health and Environmental Condition in Tropical Australia

Investment in programs that help Indigenous people undertake work maintaining the environmental health of their country has benefits for the environment as well as the physical, mental and cultural health of the Indigenous people involved. For health these findings have direct implications for some national health policies, service provision to homelands, health promotion and Indigenous health research. There are also direct implications for environmental investment in northern Australia and the design and regulation of markets in resource entitlements. Indirectly the findings should be important for economic, employment and education policies as well as those promoting social harmony. Given the range of benefits there is a strong argument for cross-agency investment in working on country by Indigenous people.     

STUDYING FEDERALISM: PERSPECTIVES AND PROSPECTS

Governing Federations: Constitution, Politics Resources , edited by MICHAEL WOOD, CHRISXIPHER WILLIAMS, CAMPBELL SHARMAN (Sydney: Hale & Iremonger in association with the Royal Australian Institute of Public Administration, 1989, 281 pp).
Federalism in Canada t Australia: Historical Perspectives 192088 , edited by BRUCE W. HODGINS, JOHN J. EDDY, SHELAGH D. GRANT, JAMES STRUTHERS (Peterborough: Frost Centre for Canadian Heritage and Development Studies, Trent University, 1989, 511 PP).
Australian Federalism , edited by BRIAN GALLIGAN (Melbourne: Longman Cheshire, 1989, 278 pp).     

Scaling‐up participation at USAID

Since the 1970s many non‐governmental development organisations have moved away from top‐down modes of operation toward participatory practices that hand over decision‐making power to the poor. The bilateral development agencies of the industrialised states have been slower to follow suit, but in the 1980s and 1990s a number of such agencies also initiated participatory‐oriented reforms. Development scholars have paid little attention to reforms of the larger organisations. In this article, we analyse the efforts of the United States Agency for International Development to embrace participation in the 1990s. Internal reformers managed to change some agency procedures but had only limited success in institutionalising participatory practices. Forces internal to the agency, including rigid rules and employee incentive structures, hampered reform efforts. Also, while some developments external to the agency facilitated participation, many others, including legislative interference and shifting national policy priorities, hindered change toward participation. The case reveals how complex webs of accountability relationships make participatory‐oriented transformation a cumbersome process in large development organisations. Change towards participation can succeed, but only if reformers acknowledge and consider existing institutional constraints. Copyright © 2004 John Wiley & Sons, Ltd.