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An evaluation of primary-level healthcare undertaken in Tanzania 1989-91 found that district health managers felt powerless to address health care performance weaknesses, although the district is the unit to which government management functions have been decentralized. In order to understand the managers views, this article analyses the pattern of decentralization within the health system from their perspective. It reviews the hislorical development of government structures and the theory and practice of decentralization within Tanzania. The matrix of accountability for health care has become very confusing, with multiple and cross-cutting flows of authority within and between levels of the system. District health managers have limited authority to take management action, such as managing resources, in ways that would begin to address problems of inefficiency and poor quality of care within primary care. District health management also suffers from weak resource allocation and financial management piocedures. The main obstacles preventing more effective management are: resource constraints; conflicts between the demands for central control and local discretion; limited institutional capacity; and political and cultural influences over the implementation of decentralization. Evaluation of past experience suggests that future policy influencing the organizational structure of government health services must be developed cautiously, recognizing the critical importance of complementary action to develop both institutional capacity and political and economic support for the health system. 相似文献
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A dual processing model of sexual harassment judgments predicted that the behavior of a complainant in a prior case would influence evaluations in an unrelated subsequent case. In the first of two experimental scenarios depicting social-sexual conduct at work, the female complainant's conduct was manipulated to be aggressive, submissive, ambiguous, or neutral. Half of the participants were asked to reflect upon the first scenario after reading it and before answering responsibility questions. The other half simply reviewed the scenario and answered the questions. When the complainant acted aggressively, her behavior in the first scenario caused men who reflected on the fact pattern to find less evidence of harassment. Most interestingly, an aggressive complainant observed in the first scenario caused participants (especially women) to rate lower the likelihood that a neutral complainant in a second independent case was the victim of gender discrimination. Across cases, men found less evidence of harassment than did women. 相似文献
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This paper presents two examples that indicate the breadth of the impact of regulation on innovation. That some of the impacts in those examples were not intended by the regulators is taken as evidence that a better understanding of the impact of regulation is needed. The examples can be understood within theoretical frameworks that place innovation at the centre of social and economic activity within an integrated system. It is argued that understanding that system is essential to the better appreciation of the innovation process and relevant policy. 相似文献
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Crime rates have dropped substantially in the United States, but incarceration rates have remained high. The standard explanation for the lasting trend in incarceration is that the policy choices from the 1980s and 1990s were part of a secular increase in punitiveness that has kept rates of incarceration high. Our study highlights a heretofore overlooked perspective: that the crime–punishment wave in the 1980s and 1990s created cohort differences in incarceration over the life course that changed the level of incarceration even decades after the wave. With individual-level longitudinal sentencing data from 1972 to 2016 in North Carolina, we show that cohort effects—the lingering impacts of having reached young adulthood at particular times in the history of crime and punishment—are at least as large (and likely much larger) than annual variation in incarceration rates attributable to period-specific events and proclivities. The birth cohorts that reach prime age of crime during the 1980s and 1990s crime–punishment wave have elevated rates of incarceration throughout their observed life course. The key mechanism for their elevated incarceration rates decades after the crime–punishment wave is the accumulation of extended criminal history under a sentencing structure that systematically escalates punishment for those with priors. 相似文献
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Lucy Welsh 《Feminist Legal Studies》2017,25(1):123-129
On 17 May 2016 Lucy Welsh interviewed Annelise Riles about her work on the relationship between law and time as part of Welsh’s involvement with the AHRC Regulating Time network. Annelise Riles is the Jack G. Clarke Professor of Law in Far East Legal Studies and Professor of Anthropology at Cornell, and is Director of the Clarke Program in East Asian Law and Culture. Her work examines the transnational dimensions of laws, markets and culture across the fields of comparative law, conflict of laws, the anthropology of law, public international law and international financial regulation. Most recently Professor Riles has been examining the nature and meaning of the settlement made on the so-called Comfort Women, and what impact that has for locating events in the past. The Comfort Women were Korean women who were essentially captured and forced to work as sexual slaves for the Japanese army during World War Two. In 2015, Japanese and South Korean ministers agreed a settlement (comprising an apology and financial payment to provide for the women) in what they regarded as an irreversible and final settlement of the issue. Welsh and Riles exchange over their mutual interests in time and routinisation in this interview as they discuss what the story of the Comfort Women has to tell us. 相似文献
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Lucy William 《The Modern law review》2004,67(4):709-713
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