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.     

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.     

The Challenges to Cooperation Posed by the Nexus of Terrorism and Organized Crime: Comparing the Situations Between the Andean and the Sahel Regions

The recent conflict in the Sahel area is another case where the nexus of terrorism and organized crime causes challenges to the international community. Comparing the situation with that of the Andean region brings forth the challenges faced when dealing with this type of conflict: the states’ weak presence in the remote regions, the insurgents’ ability to offer income and “security” to the people, immediate threat to international investments, unresolved political/regional issues, the marriage of convenience of insurgents/terrorists and organized crime, internal divisions of the insurgent groups and also ideologies surviving or suffering after the elimination of their leaders.     

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.