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Persistent underperformance of public policy and program implementation in Aboriginal affairs is widely recognised. We analysed the results of two case studies of attempted reforms in public administration of Aboriginal primary health care in the Northern Territory, using a framework based on the institutionalist and systemic racism literatures, with the aim of better understanding the sources of implementation failure. Implementation of the agreed reforms was unsuccessful. Contributing factors were as follows: strong recognition of the need for change was not sustained; the seeds of change, present in the form of alternative practices, were not built on; there was a notable absence of sustained political/bureaucratic authorisation; and, interacting with all of these, systemic racism had important consequences and implications. Our framework was useful for making sense of the results. It is clear that reforms in Aboriginal affairs will require government authorities to engage with organisations and communities. We conclude that there are four requirements for improved implementation success: clear recognition of the need for change in ‘business as usual’; sustainable commitment and authorisation; the building of alternative structures and methods to enable effective power sharing (consistent with the requirements of parliamentary democracy); and addressing the impact of systemic racism on decision-making, relationships, and risk management.  相似文献   
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Often portrayed as behaviour that is inconsistent with policy goals, public noncompliance poses a significant challenge for government. To explore what compliance efforts entail on the ground, this study focuses on childhood immunization as a paradigmatic case where a failure to ensure compliance poses a public health risk. The analysis draws on 48 semi‐structured interviews with frontline nurses and regional/national public health officials in England (N = 15), Sweden (N = 17) and Israel (N = 16), all of which have experienced periodic noncompliance spikes, but differ in direct delivery of vaccination provision. Compliance efforts emerged as a joint decision‐making process in which improvisatory practices of personalized appeals are deployed to accommodate parents’ concerns, termed here ‘street‐level negotiation’. Whereas compliance is suggestive of compelling citizens’ adherence to standardized rules, compliance negotiation draws attention to the limited resources street‐level workers have when encountering noncompliance and to policy‐clients’ influence on delivery arrangements when holding discretionary power over whether or not to comply.  相似文献   
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The documentary filmmaker Kim Longinotto talks to Catherine Fowler about her latest film The Day I Will Never Forget (2003) about female genital mutilation (FGM) in Africa. Longinotto’s films have consistently interrogated our understanding of womens’ place in the world, and her latest film is no exception. She discusses how she found her subjects: Fardohsa, a midwife who has been campaigning against FGM, a group of girls who have (successfully) taken their parents to court in order to prevent FGM being practised, and Fouzia, a girl of nine who reads a poem that she wrote the day after she was circumcised, asking her mother to explain why she put her daughter through such a painful experience. Longinotto also discusses the ethical issues raised by her filming of a circumcision of two sisters, and the wider issues that her film engages: the powerless position of women in African societies, the confusion of religion and culture in discussions of FGM, and the impact of saying ‘no’ to this practice.  相似文献   
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