Opening up the black box: looking for a more capacious version of capacity in global health partnerships

Abstract

Some versions of capacity building construe the goal of North?South partnerships as rendering African laboratories, doctors, scientists, and universities indistinguishable from their counterparts in wealthier nations. The specificities, histories, peculiarities, or inner workings of African institutions and individuals are black-boxed ? no one needs to know about them. This article draws on research at Malawi’s College of Medicine and the work of other social scientists and historians to sketch out a more capacious model of capacity, one in which capacity building is grounded in specificity, attends to material difference, is flexible and innovative, and involves as much learning as teaching. This model of capacity building requires consideration of areas in which the Northern partners in “global health” can be brought to the level of their colleagues in Africa.     

Financial Health in Australian Local Government: The Application of a Funding Assessment Model to Brisbane and Sydney City Councils

Local government financial viability measurement in an accrual budgeting environment poses complex challenges. Financial measures frequently generate conflicting results. A rating scale to assess financial management, constructed originally for South African municipalities (Dollery & Graves, 2009), represents a useful tool to analyze financial health trends. Applying a “Likert-like” scale to financial performance measures to assess “funding compliance”, the model in this article assists municipalities to avoid financial difficulties. To demonstrate the applicability of this model, we apply the model to the Brisbane City Council and the Sydney City Councils. Results show that the model represents a valuable aid to financial management decision-making.     

Feedback on Forensic Mental Health Assessments in a Juvenile Court Clinic Certification Program

Public-sector mental health systems have set forth specialized practice competencies for forensic mental health clinicians conducting court-ordered examinations. This study examined a sample of feedback letters to clinicians who submitted mid-training and final reports for review as part of the requirements for certification as a juvenile court clinician. The most common feedback points were insufficient/irrelevant historical data, problems with clarity/organization of the report, problems with interview/mental status examination, and problems with competency to stand trial data/opinions. Clinicians had fewer deficiencies in their final report compared to their mid-training report, supporting the perspective that forensic training and supervision is associated with better quality reports.     

Public administration reform for Aboriginal affairs: An institutionalist analysis

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.     

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.     

Political Trust,Ideology, and Public Support in the United States for Government Spending on Health Care

The U.S. health-care costs have increased at a rapid rate over the last several decades. How much responsibility the government should bear with the increase in health-care costs is one of the main questions that lack consensus among the American people. Utilizing the 2016 General Social Survey data, this study shows that over two-thirds of Americans want to see more or much more spending on health care by the government. An ordered logit regression model shows that political trust and ideology are significant correlates in predicting attitudes toward government spending on health care. The policy implications of the findings are discussed in the “Conclusion” section.     

A Profile of Violent Offenders in Spanish Prisons

In Europe, it is relatively uncommon to find studies that investigate the criminal profiles of violent offenders, especially infrequent are those that pay special attention to offenders’ mental health/substance use disorders and histories of violence during childhood. The current research explores whether inmates who are incarcerated for violent offenses (n = 536) in Spain are different in terms of the aforementioned factors as compared to inmates incarcerated for non-violent offenses (n = 536). Multivariate logistic regression analysis revealed that violent offenders, as compared to their non-violent counterparts, were more likely to be younger, younger at the time of their first arrest, single, use alcohol, receive treatment in prison for anxiety or schizophrenia, and report physical abuse during childhood.     

Co-Production and Health System Reform – From Re-Imagining To Re-Making

There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.     

A health management research on the insured group who participate in medical insurance

Taking the insured group who participate in medical insurance as the main subject, Wendeng city carries out the health management and establishes health files for the insured. Through the free health checkup for the high-risk group, the targeted health interventions are conducted according to the physical examination results of those people, and relative health education has achieved satisfying effects. The health education in different western countries has been carried out for more than 20 years, which accumulates a wealth of experiences. However, health education in China has not yet gained sufficient attentions, and to develop the domestic health education becomes an imperative task at present.