Towards universal health coverage in Zambia: impediments and opportunities

Universal health coverage has been given a prominent place in the post-2015 global development agenda, but there are concerns over its feasibility in low- and middle-income countries. This article assesses successive Zambian governments’ efforts to achieve this agenda. We discuss the recent restructuring of health governance to support policies that re-emphasise the social determinants of health and health equity. This includes a new Ministry of Community Development and Mother and Child Health alongside the Ministry of Health. We argue that recent innovations in policy and practice need to be extended to include ministries which focus on economic development.     

Child- and Family-Centered Practices in a Post-Bureaucratic Era: Inherent Conflicts Encountered by the New Child Welfare Professional

Various child welfare organizations are changing services by adopting child- and family-centered approaches and moving away from redundant bureaucracy, top-down strategies, and fragmented networks. This shift inevitably poses challenges. This article uses the case of intensive family case management in the Netherlands to explore conflicts perceived by professionals and associated coping strategies. Findings are that internal conflicts (leading to a relapse into old routines or to misinterpretation of purpose) and boundary conflicts (leading to a relapse into old collaboration agreements) cause challenges. Pioneering organizations need to provide support for learning and reflection between professionals, seeking alignment between accountability and learning.