South European Healthcare Systems under Harsh Austerity: A Progress–Regression Mix?

This article addresses the question of whether the economic crisis provides a politically opportune time to drastically curtail public healthcare in South Europe or whether, instead, there are signs of longer-term reform strategies for potentially balancing fiscal targets with the quest for enhanced value and health outcomes, when eventually growth resumes. After a brief examination of the profile of healthcare systems in Greece, Italy, Portugal and Spain prior to the crisis, we comparatively assess the mix of retrenchment, restructuring and recalibration strategies. The effects of the austerity-driven reforms on current (and expected) health outcomes are also briefly analysed. We conclude with reflections on the future of public healthcare in South Europe.     

For Health,Strength, and Daily Food: The Dual Impact of Remittances and Public Health Expenditure on Household Health Spending and Child Health Outcomes

Abstract

Child and infant mortality in developing countries decreased 33.5 per cent and 30.9 per cent, respectively, during 1995–2009, while remittances and public health spending more than doubled. I examine how remittances and government health spending improve these child health outcomes. Neither government health spending nor remittances causally affect household health spending. Public health spending has an insignificant negative impact on mortality. The increase in remittances causally accounts for 32 per cent and 37 per cent of the decline in child and infant mortality, respectively. Remittances reduce mortality through improved living standards from the relaxation of households’ budget constraints.     

INSTITUTIONAL LAYERING IN GOVERNING HEALTHCARE QUALITY

Since the 1980s, regulated markets and New Public Management have been introduced in the public sector across the world. How they have affected existing governance mechanisms such as self‐regulation and state regulation has remained largely unexplored, however. This article examines the origins and consequences of institutional layering in governing healthcare quality. Dutch health care, where a market‐based system has been introduced, is used as a case study. The results show that this market‐based system did not replace but modified existing institutional arrangements. As a result, hospitals have to deal with the fragmentation of quality demands. Using the concept of institutional layering, this study shows how different arrangements interact. As a consequence, the introduction of a certain policy reform will work out differently in different countries and policy sectors. Our ‘archaeological’ study in this layering can be seen as an example of how such incremental change can be studied in detail.     

Jihadist Radicalization in East Africa: Two Case Studies

Al-Shabaab, the Somali militia currently fighting against African forces in Somalia, has seen varying degrees of success in its regional recruitment efforts. As it continues to struggle against the forces of the African Union Mission in Somalia (AMISOM), the militia has tried to step up these efforts. To this end, the group has seen significant success in countries such as Kenya, while it has struggled in Somaliland. The strategies and tactics employed by al-Shabaab in order to successfully recruit vary depending on geographical location, as do the motivations to join, and drawing on fieldwork in both Kenya and Somaliland this study will compare and contrast the effectiveness al-Shabaab recruitment in both of these countries. In doing so, it will examine which local conditions either enhance or limit these efforts, identifying some of the determinants of the success and failure of jihadist recruitment in east Africa.     

Grabbing back: essays against the global land grab

ABSTRACT

Extensive research, mainly undertaken by nutrition scientists and economists, indicates that the presence of a home garden is positively associated with improved household nutrition in rural households of the global South. However, this literature is relatively silent on the contexts that influence home garden uptake. This is problematic given rapidly changing social and economic landscapes, which reshape the place and scope for home gardens within households’ livelihood and food provisioning arrangements. Original research from Myanmar reported here reveals that emergent socio-economic contexts for rural households are posing heightened challenges for home gardens to contribute to food and nutrition security.     

Re-examining Social Work Roles and Tasks with Foster Care

In order to promote developmental outcomes with children and young people and to nurture their positive health and well-being in foster care, social workers and case managers are required to direct professional attention toward both the child or young person and her/his daily living environment(s)—at home, at school, and in the local neighborhoods in which they live. When viewed from an ecological perspective, foster care environments are represented conceptually as a nested cluster of settings ranging from immediate life spaces and networks of relationships in a foster home, at school, and in a neighborhood, to organizational contexts holding a statutory duty of care for children and young people assigned looked after status, along with national policies and statutes which frame foster-care environments. This article explores how social-work roles and tasks with children and young people in foster care change as Social Workers transition from case management roles within state, provincial, or local authority departments to become Supervising Social Workers, or Team Managers of Foster Carers, or Directors of foster care services.