Perceptions of the health system and public trust in government in low- and middle-income countries: evidence from the World Health Surveys

In low- and middle-income countries, health care systems are an important means by which individuals interact with their government. As such, aspects of health systems in these countries may be associated with public trust in government. Greater trust in government may in turn improve governance and government effectiveness. We identify health system and non-health system factors hypothesized to be associated with trust in government and fit several multilevel regression models to cross-national data from 51,300 respondents in thirty-eight low- and middle-income countries participating in the World Health Surveys. We find that health system performance factors are associated with trust in government while controlling for a range of non-health system covariates. Taken together, higher technical quality of health services, more responsive service delivery, fair treatment, better health outcomes, and financial risk protection accounted for a 13 percentage point increase in the probability of having trust in government. Health system performance and good governance may be more inter-related than previously thought. This finding is particularly important for low-income and fragile states, where health systems and governments tend to be weakest. Future research efforts should focus on determining the causal mechanisms that underlie the observed associations between health system performance and trust in government.     

Child abuse and neglect:A National Summary Of State Statutes

Effective court improvements must be based on comprehensive, baseline analysis of state child abuse and neglect statutes. This information will provide policy makers with improved tracking and evaluation opportunities as significant statutory changes are contemplated in pending federal initiatives and state court improvement activities. This article provides excerpts of a comprehensive national study undertaken to determine the level of uniformity or variance in statutes since the initiation of federal legislation attempting to improve state practice in the handling of child abuse and neglect cases. The state-by-state information is designed to provide diverse jurisdictions with an opportunity for comparative statutory analysis. The complete, 50 state Matrix of State Statutes Pertaining to Child Abuse, Neglect and Dependency is scheduled for publication later this year.     

The history of women in science: A women's studies course

Women have always done scientific work but have rarely received the recognition they deserved. As a result most of us learn, from elementary school on through university, that science is and always has been the province of men. Women are seldom mentioned in history of science courses and their contributions are often attributed to male scientists. This paper describes a lower division course in the history of women in science, offered jointly through the Women's Studies Program and the Biology Department at Portland State University. It includes a discussion of the topics and issues covered in the course and the types of questions raised about women scientists. Examples are given to illustrate historic trends and some of our experiences in the classroom are described. A representative bibliography provides an introduction to various aspects of the subject.     

Laboratory evidence of unsuspected parental consanguinity among cases of disputed paternity

A search was conducted to find evidence of possible incestuous unions between the biologic parents of children involved in 2500 paternity cases. Suspicion was raised when either (1) a mother and her child possessed identical HLA phenotypes, or (2) the child appeared to be possibly homozygous for one maternal haplotype (i.e., one of the child's HLA haplotypes was a blank). These mother-child HLA-haplotype dualisms (MHDs) occurred in 5% of all cases. Frequency of exclusion of the accused men in cases demonstrating MHD, was compared with the remaining paternity cases.No significant difference was found in overall exclusion rates between MHD cases and controls when exclusion produced by HLA and red cell antigen systems were observed. However, there was a greater rate of exclusion in MHD cases when comparing exclusions produced by red cell antigen systems regardless of whether HLA tests excluded paternity (p < 0.025). MHD cases involving teenaged mothers differed from control cases in frequency of exclusion of paternity only on the basis of red cell antigen phenotyping (p < 0.005).The HLA system's usefulness in paternity testing is diminished when there is MHD; multiple, independently-inherited systems are relatively more useful in these circumstances.The search method detects only half of potential incest cases; proof of incest requires more extensive testing for homozygosity among other polymorphisms. Since calculations of likelihood of paternity are inappropriate in cases involving close consanguinity, detection and follow up studies are important.Data suggest that one-fifth of MHD cases may involve first degree consanguinity and that the incest rate among paternity cases may be as high as 2%.     

CHILD SUPPORT REFORMS

The use of the Australian equivalent to the Internal Revenue Service is described and the far-reaching efforts of the Australian government to collect. Readers from other countries will recognize similar themes: noncompliance with orders, establishing orders in a majority of cases, providing an efficient means for modifying support awards, creation of two classes of enforcement—for those receiving public support and for those who are entitled to support and do not receive pensions, the use of statistics regarding compliance, and many others. This article documents the common concerns for all modern, industrialized nations in ensuring adequate support for children.