Socio-economic determinants of the family history of pulmonary tuberculosis patients in Pakistan

This article aims to assess the role of important socio-economic factors in the family history of tuberculosis patients in Pakistan. Data were collected from 269 patients, and a logistic regression was used to determine the association between risk factors and the vicious circle of TB. Results of the logistic model show that significant risk factors associated with TB history in patients were education, household size, house structure, rooms in the home, room ventilation, monthly income, income food sufficiency, smoking, diabetes, and heart disease. The current TB control programme needs to formulate strategies to target specific risk factors and poverty reduction simultaneously to break the vicious circle of tuberculosis.     

Reproductive health services: “Business-in-a-Box” as a model social innovation

Access to reproductive health services and products in remote and rural communities is a critical area of concern for developing countries. This article considers a pilot intervention in three districts of Pakistan where “Business-in-a-Box” as a model of place-based social innovation is used to improve the socio-economic conditions of women in remote rural settings through socially responsible micro-franchising. It finds that such programmes help build a sense of community, ownership and grassroots capabilities and skills. The article also discusses the impacts of such actions on the individual and community life, and the need to upscale and sustain these initiatives.     

Islamophobic conspiracism and neoliberal subjectivity: the inassimilable society

O’Donnell analyses the confluence of Islamophobia and anti-government conspiracy theory in the works of the far-right think tank, the Center for Security Policy (CSP). He argues that, rather than only being a contemporary form of the religious and racialized demonologies that code ‘Islam’ as being the constitutive outside of ‘the ‘West—irrational, religious and authoritarian versus rational, secular and democratic—Islamophobic conspiracism should also be examined in the context of anxieties over the erosion of personal and state sovereignty under neoliberalization. Mobilizing an Islamophobic demonology that constructs ‘Muslims’ as inassimilable to ‘American’ subjectivity, the CSP's Islamophobic conspiracism projects this construction of absolute alterity on to American social and state systems. In doing so, O’Donnell contends, Islamophobic conspiracism takes neoliberalization's estrangement of the state and its citizens to its logical conclusion, transfiguring the societal processes that impact on the freedom of the individual—notably the state and civil society—into something inassimilable to that individual's claims to self-ownership and self-mastery.     

Administrative reform assistance and democracy promotion: exploring the democratic substance of the EU’s public administration reform principles for the neighbourhood countries

International donors, particularly the European Union (EU), vehemently endorse institution-building and public administration reform (PAR) in their work on democracy support. Still, the linkages between externally sponsored reform and advancement of democratic governance in beneficiary countries constitute a blind spot in our understanding of democratization. This article contributes to examining this relationship by exploring the democratic substance of the EU’s PAR portfolio for the neighbourhood countries. The aim of the article is to focus attention on the PA–democracy interface in the study of democracy promotion by elaborating a conceptual framework for exploring the nature of externally supported administrative reforms and the substantive content of democracy being advanced. By using the OECD/SIGMA’s (Organization for Economic Co-operation and Development/Support for Improvement in Governance and Management) PAR framework for the European Neighbourhood Policy (ENP) countries as a case study, this article demonstrates how the EU’s approach to programming PAR accommodates elements from several formats of democratic governance while the conceptualization of the democratic effects of the PAR principles remains vague. The article concludes by highlighting the need for closer examination of the potentials and limits of external PAR strategies in democracy support, and for attuning the EU’s PAR design to its democratic implications.     

Public support for coercive diplomacy: Exploring public opinion data from ten European countries

Scholarship has increasingly acknowledged the importance of public attitudes for shaping the European Union's Common Foreign and Security Policy. Economic sanctions emerged as one of CFSP's central tools. Yet despite the emergence of sanctions as a popular instrument in the EU foreign policy toolbox, public attitudes towards sanctions are yet to be studied in depth. This article explains public support for EU sanctions, using the empirical example of sanctions against Russia. It looks at geopolitical attitudes, economic motivations and ideational factors to explain the variation in public support for sanctions. The conclusion suggests that geopolitical factors are the most important, and that economic factors matter very little. Euroscepticism and anti‐Americanism play an important role in explaining the support for sanctions at the individual level.     

Measuring Policy Success: Evaluating Public Sector Reform in Bhutan

There has been resurgence in evaluation of policy, reflected mostly by an increase in ex ante studies. Although there is a shift towards ex post evaluation, this has been gradual, resulting in a paucity of ex post evaluation literature. To address this gap, we apply a revisionist approach to evaluate a major public sector reform in the Bhutanese civil service. We conclude that it provides a more holistic approach for ex post evaluation policy, and also a more nuanced evaluation which moves us beyond the narrow binary view of success or failure in reform.     

The changing dynamics of policy experiment in Singapore: does the 2011 general election make a difference?

The city-state of Singapore is proactive in harnessing policy experimentation to incubate innovations, transfer knowledge and facilitate collaborations across different public sectors. Given the country’s strong knack for pragmatism, international practices and lessons are usually first tested and adapted in policy experiments before scaling up to nationwide policies. Singapore’s practice of policy experimentation, however, has also demonstrated evolution over time. This article reviews the evolving role of experimentation in Singapore’s policy decision-making and implementation, and analyses pilot programmes in public housing to elicit the key attributes and commonalities of its policy experiments. It finds that policy experiments have been increasingly used after the 2011 general election, which witnessed a radical political rebalancing in Singapore’s governance history. Pilot projects have thus transformed from a utilitarian to citizen-centric, design-thinking approach after 2011. Pilot programmes are used for multiple purposes in policy innovations, among which civil service mentoring, knowledge transfer and cross-boundary collaboration are the values primarily pursued. The article discusses the contributions of the findings to the literature and policy implications for practitioners.     

Self-rated health and barriers to healthcare in Ukraine: The pivotal role of gender and its intersections

The ongoing health crisis in the Ukraine has persisted for 48 years with a clear division of gender-based outcomes as seen in the decline of male life expectancy and stagnation of female longevity. The purpose of this paper is to investigate differences in self-rated health and system barriers to health care applicable to gender and its intersections because of the differing negative health outcomes for men and women. Intersectionality theory provides an analytic framework for interpreting our results. Utilizing a nationwide sample of the Ukrainian population (N = 1908), we found that low socioeconomic status (SES) women rate their health worse than men generally and any other socioeconomic group. Yet women also face the greatest barriers to health care until older ages when the ailments of men cause them to likewise face the obstacles. In reviewing the barrier to health care scale, one barrier—that of health care services being too expensive—dominated the responses with some 52.5 percent of the sample reporting it. Consequently, the greatest problem in Ukraine with respect to health reform reported by the population is the out-of-pocket costs for care in a system that is officially free. These costs, constituting some 40 percent of all national health expenditures, affect women and the aged the most.     

A comprehensive approach to providing services to survivors of sexual and gender-based violence in Democratic Republic of Congo: addressing more than physical trauma

ABSTRACT

The eastern Democratic Republic of Congo (DRC) is impacted by a prolonged conflict and humanitarian crisis. Sexual and gender-based violence (SGBV) affects an estimated 39.7% of women and 23.6% of men in the region, and is associated with serious medical, psychological, and socio-economic outcomes for survivors and communities. IMA World Health, a faith-based non-profit organisation, implements a USAID-funded project, Ushindi, which is a collaborative effort with three national NGOs and one technical partner in response to SGBV in eastern DRC. The consortium provides a comprehensive package of services to SGBV survivors, focusing on medical, emotional, psychological, legal, and socio-economic needs.     

Whole-person health and development: two South Indian initiatives

ABSTRACT

In responding to the 2016 reformulation of the United Nation’s Sustainable Development Goals, the development community’s efforts are focused on a sweep of initiatives aiming to promote whole-society, sustainable development. The ambition of the SDGs is inspiring, but also daunting, and does not always sit easily within national models of economic development. This viewpoint profiles two organisations in the south Indian state of Tamil Nadu, that have decades of experience in whole-person development among scheduled tribes and disability communities. Both organisations serve as timely examples of ongoing holistic, whole-person health and development in the context of new ideals and economic realities.