Suchergebnisse

Актуальность. В перспективе 2020-2030 гг. потребность в паллиативной и хосписной помощи (ПХП) во всем мире будет значительной, что обусловлено, в частности тем, что количество пожилых людей неуклонно растет, а также будет увеличиваться количество людей, умирающих ежегодно от хронических заболеваний. Цель работы: определить основные социально-медицинские, социально-экономические и технологические факторы, влияние которых на развитие ПХП и паллиативного ухода будет определяющим в ближайшие 10-15 лет на фоне обострения глобального социально-экономического кризиса в результате пандемии COVID-19. Материалы и методы. В работе были использованы национальные и международные литературные источники, наработки БО «Ассоциация паллиативной и хосписной помощи», которая применила методы моделирования будущего, предложенные социологической компанией «Актив-Групп», результаты социологического исследования; были применены библиосемантические, статистические и социологические методы исследования. Результаты. Одним из важных трендов, связанных с глобальным экономическим кризисом вследствие пандемии COVID-19 является усиление потребности учреждений ПХП и паллиативного ухода в государственном и муниципальном финансировании и повышении роли правительств в поддержке хосписов. Другим трендом на ближайшие 10-15 лет является то, что в учреждениях ПХП и паллиативного ухода будет развиваться использование новых информационно-коммуникационных технологий. Выводы. Одним из важных трендов, связанных с обострением глобального социально-экономического кризиса в результате пандемии COVID-19, является сокращение государственного и муниципального финансирования учреждений ПХП и паллиативного ухода, что потребует увеличения их финансирования за счет фандрейзинга и доноров (благотворителей). В сферу оказания ПХП и паллиативного ухода все шире будут интегрироваться современные информационно-коммуникационные технологии, связанные с искусственным интеллектом и виртуальными технологиями. Будущее ПХП и паллиативного ухода в условиях экономического спада в результате пандемии COVID-19 в значительной степени будет зависеть от осознания ценности человеческого капитала и адекватного обеспечения учреждений ПХП и паллиативного ухода квалифицированным и мотивированным персоналом. В Украине также сейчас существуют значительные проблемы с комплектованием стационарных учреждений ПХП персоналом, что требует от государства разработки и внедрения программы мотивации и профессиональной подготовки кадров. ; Актуальність. У перспективі 2020-2030 рр. потреба у паліативній та хоспісній допомозі (ПХД) в усьому світі буде значною, що зумовлено зокрема тим, що кількість людей похилого віку невпинно зростає, а також буде збільшуватись кількість людей, які помирають щороку від хронічних захворювань. Мета роботи: визначити основні соціально-медичні, соціально-економічні та технологічні чинники, вплив яких на розвиток ПХД та паліативного догляду буде визначальним у найближчі 10-15 років на фоні загострення глобальної соціально-економічної кризи внаслідок пандемії COVID-19. Матеріали та методи. У роботі були використані національні та міжнародні літературні джерела, напрацювання БО «Асоціація паліативної та хоспісної допомоги», яка застосувала методи моделювання майбутнього, запропоновані соціологічною компанією «Актив-Груп», результати соціологічного дослідження; застосовані бібліосемантичні, статистичні і соціологічні методи дослідження. Результати. Одним із важливих трендів, пов'язаних з глобальною економічною кризою внаслідок пандемії COVID-19, є посилення потреби закладів ПХД та паліативного догляду у державному та муніципальному фінансуванні і підвищенні ролі урядів у підтримці хоспісів. Іншим трендом на найближчі 10-15 років є те, що у закладах ПХД та паліативного догляду буде розвиватися використання нових інформаційно-комунікаційних технологій. Результати соціологічного дослідження свідчать, що в Україні також існують значні проблеми з комплектуванням стаціонарних закладів ПХД персоналом. Висновки. Одним із важливих трендів, пов'язаних з загостренням глобальної соціально-економічної кризи внаслідок пандемії COVID-19, є скорочення державного та муніципального фінансування закладів ПХД та паліативного догляду, що вимагатиме збільшення їх фінансування за рахунок фандрейзингу та донорів (благодійників). У сферу надання ПХД та паліативного догляду усе ширше будуть інтегруватися сучасні інформаційно-комунікаційні технології, пов'язані зі штучним інтелектом і віртуальними технологіями. Майбутнє ПХД та паліативного догляду в умовах економічного спаду внаслідок пандемії COVID-19 значною мірою залежатиме від усвідомлення цінності людського капіталу і адекватного забезпечення закладів ПХД та паліативного догляду кваліфікованим та мотивованим персоналом. В Україні також зараз існують значні проблеми з комплектуванням стаціонарних закладів ПХД персоналом, що вимагає від держави розробки та впровадження програми мотивації та професійної підготовки кадрів. ; Background. In the period 2020-2030, the need for palliative and hospice care (PHC) worldwide will be significant, due in particular to the fact that the number of elderly people is constantly growing and the number of people dying each year from chronic diseases increasing too. The purpose was to identify the main socio-medical, socio-economic and technological factors whose impact on the development of PHC will be decisive in the next 10-15 years in the background of the global socio-economic crisis due to the ­COVID-19 pandemic. Materials and methods. There were used national and international literature sources, results gained by the Charitable organization "Association of palliative and hospice care", which used methods of modeling the future, proposed by the sociological company "Active Group", the results of a sociological study; there were applied bibliosemantic, statistical and sociological research methods. Results. One of the important trends in the global economic crisis due to the COVID-19 pandemic is the growing need of PHC in state and municipal funding and the increasing role of governments in supporting hospices. Another trend for the next 10-15 years is that the use of new information and communication technologies will develop in PHC. Conclusions. One of the important trends in the actualisation of the global socio-economic crisis due to the ­COVID-19 pandemic is the reduction of state and municipal funding for PHC, which will require increased funding from fundraising and donors (philanthropists). Modern information and communication technologies related to artificial intelligence and virtual technologies will be increasingly integrated into the field of PHC. The future of PHC in the context of the economic recession due to the COVID-19 pandemic will largely depend on awareness of the value of human capital and adequate provision of PHC by qualified and motivated staff. In Ukraine, too, there are currently significant problems with staffing PНC, which requires the government to develop and implement a program of the staff motivation and training.

There has been an increase in the integration of global agricultural value chains in recent decades. This trend has created opportunities for smallholder farmers and agrifood industries in developing countries through forms of international exchange. At the same time, demographic changes and rising incomes across the developing world have affected the food security status of citizens in developing countries. Institutions have a prominent role to play in how integrated countries and smallholder farmers are in global value chains. This dissertation seeks to answer these questions first by studying coconut value chains. The first paper does this by first on a macro level by analyzing the role of institutions on the trade of coconut products. Second, I study a case study in Fiji qualitatively to understand the discourses and perceptions of farmers involved in coconut farming. Finally, the third paper takes a theoretical model to assess the effects of a transition of rural smallholder farming to selling or renting landholdings and supplying labor to larger commercial farms on the food security and economic welfare of in-country urban consumers. In line with the two previous papers, it emphasizes the importance of institutions since positive and negative institutional forces within the home country play a part in the persistence of smallholder farming. Chapter 2 presents the first paper, titled "The role of institutional quality on the performance in the export of coconut products." It aimed to answer three research questions. First, we are interested in how the overall institutional environment in exporting countries affects the bilateral trade of coconut products. Second, we look into whether improvements in the exporters' individual indicator scores lead to an increase in trade with consideration to the exporters' and importers' overall institutional setting. Lastly, we investigate the effects of institutional similarities for coconut trade and its different compositions of value addition. To address these questions, we utilized structural gravity models to measure how institutional quality affects the trade performance of the top 26 coconut producing countries to the top 15 importing economies over the span of 20 years. The results suggest that increased government effectiveness enhances trade of high-value products, whereas better voice and accountability scores decrease the trade of coconut products in both categories of value addition. The second paper, presented in Chapter 3, investigates the coconut value chain in Fiji. It is titled "Fiji's participation in the global coconut value chain: Opportunities and constraints." Field research was conducted in the islands of Fiji. I use predominately a qualitative approach to understand the rhetoric and discourses of each stakeholder group involved in the coconut sector and their perceptions of the challenges and opportunities. This chapter then follows the first paper and looks into the effect of institutional indicators on the performance in the export of coconut products from Fiji. The empirical results show that increased scores in the government's effectiveness and voice and accountability indicators enhance coconut exports from Fiji, suggesting that domestic institutions play an important role. Interviews with key actors reveal that communications among each stakeholder group are fragmented. The main institutional actors and the producers have different perceptions of the industry's challenges, thus resulting in different ideas on how to address the issues. Chapter 4 of this dissertation is titled "Modern agricultural value chains and food security of urban consumers in developing countries." The work is a collaboration stemmed from my research stay at the University of California Davis. The study builds on previous research (Ma & Sexton, forthcoming) that assessed the future of smallholder farming systems in modern agricultural value chains. Their findings show that smallholders gain higher incomes and larger production outputs when they can supply inputs and labor to large commercial farms compared to working on own small farms across a range of plausible market settings. We address the unanswered question of how this improved productivity effect can affect the welfare and food security of domestic smallholders and urban consumers. We obtain price elasticities of demand for staple food commodities in developing countries from 15 peer-reviewed articles. Based on these figures, we embed a demand-side framework into the Ma-Sexton model to study the impacts of land consolidation and the advent of commercial farming systems on the dietary diversity of home country urban consumers. Some general conclusions and implications can be drawn from the results of these chapters. First, we confirm that institutions matter, but not merely as one entity. Different aspects of institutional quality affect integration differently. When assessing coconut producing countries collectively, the findings of our first paper suggest that government effectiveness matters the most when enhancing trade of coconut products of varying degrees of value edition, while the indicator, voice and accountability, had contrasting effects. However, chapter 3 demonstrates that for Fiji, a small island economy, both government effectiveness and voice and accountability increase Fiji's export of coconut products. This implies that the heterogeneities of each country play a role and must be taken into consideration for future research. Each country has its specific institutional set-up and enabling environment. The integration of each country will differ albeit to a lesser or greater degree than another. Findings from the last paper suggest that urban consumers, especially the poorer households, can benefit when prices of staple crops increase. Their overall welfare and diet improve as a result. Smallholders also see an improvement in welfare as the utility in consumption and leisure increases. Though governments and international donors have an egalitarian and development in mind when implementing policies and strategies that support smallholder farming, our findings suggest that there is a large welfare gain if policies enable smallholders to supply land and labor to commercial farms.

Alex De Waal's new book, Mass Starvation: The History and Future of Famine, cannot be assessed as an enjoyable read; instead it is a book that will (and should) leave the reader unsettled, concerned and angry.". we have come full circle, back to where we were before the invention of "Famine", in which we understand famines as desperate societal crises, including hunger and other forms of distress, that threaten a way of life, created by the powerful, resisted and mediated by human skills and societal structures." (De Waal 2018 p52)The author presents a well-researched account of famines, over the last two centuries and uses his research and experience, to reflect on the future of famines. His presentation of famines begins with "the year without a summer" (De Waal pg. 54), the 1816 famine caused by crop failure, due to the eruption of a volcano, in Indonesia. This was the last famine, De Waal reflects, that was caused by an act of nature. He then moves onto act one of a 'tragedy in five acts", which refers to the Imperial Holocausts from 1870 until 1914. These are famines caused by colonial settlers, using hunger to subjugate indigenous populations. Although he begins his reflections in 1870, he notes correctly that such famines have occurred down through the ages. However reliable data does not exist in relation to numbers affected prior to this time. Act two brings the merging of the two world wars into one extended world war from 1915 – 1950. He presents this period as the worst for famine deaths in modern history, where forced starvation was used a means of extermination or tolerated for military gains. Act three, 1950-1985, reveals one of the worst famines in history, when Mao Zedong's 'Great Leap Forward' resulted in 25-30 million famine deaths between 1958 and 62. The smaller famines related to wars from 1960s onwards is set out in act four, occurring largely in war torn countries of Sub Saharan Africa.The book catalogues all recorded calamitous and great famines since 1870, estimating that over 103 million people have lost their lives through famines in this time span. Of these deaths, 77 million occurred during war or periods of political repression. He demonstrates that between 1870 and 1970 an average of about 1 million lives were lost every year due to famine. However, fewer deaths are being lost since then due to increasingly professional humanitarian responses and improvements in health care and prevention strategies, such as routine immunisation programmes—a fact that many aid agencies and donors would like global media to take more notice of. One may begin to feel relief at such progress being presented, only to have such hope dispelled by De Waal's increasing concern on the recent increased use of hunger as a political tool. De Waal (pg. 172) summarises the basic thesis of his book as ".better politics have led to fewer famines" and better general health services have reduced the deaths caused as a result of continuing famines. Over half of all famine deaths since 1870 were actually Chinese citizens. Setting out famines in this way challenges common lay perceptions of famine deaths occurring only in Sub Saharan Africa due to a simple, ongoing lack of food. De Waal's evidenced-based approach towards Malthusian population principles is refreshing, in a world where such perceptions continue to be cited by many academic scholars and political parties as a reason to justify limiting population size and curbing migration flows. De Waal presents evidence to show that rising population levels have not resulted World Nutrition 2018;9(1)71in more famine and deaths. However, he does not seek to paint a happy ending, he challenges the global complacency which allows hunger to co-exist in a world with enough food for all. De Waal waits until chapter ten to discuss act five, "the new atrocity famines". He seeks to answer the question: are we seeing "the resurgence of great famines?" (pg. 179). Chapter ten begins with the fact that in 2017 there was 70 million people in acute need of aid, an increase from 45 million in 2015. He goes on to state that there were twenty million people, in four countries (Nigeria, Somalia, Sudan and Yemen), facing the risk of famine. The people in these countries are suffering from hunger due to political decisions and conflict, not a shortage of food--a failure of political leaders to implement international laws. In act four De Waal presents the good news that famines and the deaths they led to had dramatically reduced, being localised to SSA. However, the most dramatic food shortages, due to conflict, in this decade, have occurred in the Middle East. With countries like Syria denying food and aid to its citizens as a weapon of war, while 51% of the citizens in Yemen are in urgent need of assistance that is not reaching them. Due to the role of politics in present day famines, De Waal calls for forced starvation to be classed asan atrocity, in a similar way to genocide. His book presents compelling arguments, which will fuel many a midnight debate, between scholars and students alike. However, as an academic practitioner, I find his analysis to be a welcome trumpet call, in the present wilderness of false news. This book will be of interest to aid workers, nutritionists and activists who believe that social justice approaches to development need to take precedence over neo-liberal economic growth models. De Waal's book will become a new core reader on my list of essential books for students, as I strive to fuel the debate to support the right to food and health for all amongst the future leaders in the field of Global Public Health Nutrition.

International audience ; This paper examines the usefulness of recognizing the commons governing irrigation water. It harnesses the commons to understand the power interactions at play in transformations over local, national and international scales. It proposes to harness the positive externalities commons generate in order to transform political and economic interactions at the national and international scales. Although it uses a Palestinian case study, this conceptual development can apply anywhere.Palestinians have long managed irrigation as commons at the local level. But the overwhelming attention paid to their national struggle has led most researchers to focus on national institutions instead. It has also favored treating water as a stock rather than a flow. All West Bank aquifers are shared with Israel. The Oslo agreements treated them as a stock and divided them quantitatively between two users: Israel and the Palestinian Authority. Recognising the existence of commons in Palestinian irrigation allows treating water as a flow. Indeed, the same water drops flow successively through several institutions, some Palestinian and others Israeli, deploying different property regimes over varying scalar levels.This paper examines the usefulness of considering water as a flow that is managed successively by such a variety of institutions. At the local level, it allows us to understand the interactions between smallholders and neighboring agribusinesses, for example. It allows us to understand the upheaval in power interactions when a merchant economy attempts to supplant a human economy. At the national level, it allows us to address the governance of the paracommons. This term designates the material gains potentially generated by the improvement of efficiency within various systems all drawing on the same source of water. Such gains are dynamic because the efficiency gain in one system often entails a loss in a neighbouring system or in a distant, yet interlinked, system. These material gains thus constitute a new commons, the appropriation of which needs to be governed. It is a paracommons because it doesn't exist until the projects designed to improve the efficiency of different systems are implemented. Donors are funding heavily projects purporting to improve irrigation efficiency. Addressing the governance of the paracommons of Palestinian irrigation is now urgent. This paper analyses the manner the social capital developed in existing commons can contribute to this. Finally, at the international level, including the institutions emerging from the commons into an institutional structure that manages water as a flow allows us to break the deadlock of present water negotiations between Israel and the Palestinian Authority. The paper details the manner this can be achieved. ; Cet article explore l'utilité de reconnaître les communs qui gouvernent l'eau destinée à l'irrigation. Il mobilise la notion de communs pour comprendre les interactions de pouvoir en jeu au sein des transformations se réalisant sur des échelles locale, nationale et internationale. Il propose de se saisir des externalités positives générées par les communs afin de transformer les interactions politiques et économiques aux échelles nationale et internationale. Bien qu'il s'appuie sur une étude de cas palestinienne, ce développement conceptuel peut être appliqué n'importe où.Les Palestiniens gèrent depuis longtemps l'irrigation en tant que communs au niveau local. Cependant, l'attention massive qu'a suscitée leur combat national a mené les chercheurs à se focaliser sur les institutions nationales plutôt que sur les institutions locales. Cette focalisation sur l'échelle nationale a aussi favorisé la perception de l'eau en tant que stock plutôt qu'en tant que flux. Tous les aquifères de Cisjordanie sont partagés avec Israël. Les accords d'Oslo les ont traités comme un stock et les ont divisés quantitativement entre deux utilisateurs : Israël et l'Autorité Palestinienne. Reconnaître l'existence de communs au sein de l'irrigation palestinienne nous permet de traiter l'eau comme un flux. En effet, la même goutte d'eau coule successivement au travers de plusieurs institutions. Certaines sont palestiniennes et d'autres sont israéliennes. Chacune déploie des régimes de propriété définis sur des niveaux d'échelle différents.Cet article examine l'utilité de considérer l'eau comme un flux qui est géré successivement par cette variété d'institutions. Au niveau local, ceci nous permet de comprendre les interactions entre les petits agriculteurs et les agribusiness voisines, par exemple. Ceci nous permet de comprendre les bouleversements au sein des interactions de pouvoir qui ont lieu lorsqu'une économie marchande entre en interaction avec une économie humaine. Au niveau national, ceci nous permet de nous pencher sur la gouvernance des paracommuns. Ce terme désigne les gains matériels qui sont potentiellement générés par l'amélioration de l'efficience au sein de différents systèmes s'approvisionnant tous auprès de la même source d'eau. De tels gains sont forcément dynamiques car l'amélioration de l'efficience au sein d'un système implique souvent une perte pour un système voisin ou pour un système éloigné mais lié au premier. L'ensemble de ces gains matériels potentiels constituent un nouveau commun dont l'appropriation doit être gouvernée. Il s'agit d'un paracommun car il n'existe que si les projets d'amélioration de l'efficience de différents systèmes sont réalisés. Les bailleurs financent massivement de nombreux projets visant à améliorer l'efficience de l'irrigation. Il est maintenant urgent de faire face à la question de la gouvernance des paracommuns de l'irrigation palestinienne. Cet article analyse la façon dont le capital social élaboré au sein des communs existants peut contribuer à cela. Enfin, au niveau international, inclure les institutions émergeant des communs au sein d'une structure institutionnelle qui gère l'eau en tant que flux nous permet de sortir de l'impasse actuelle des négociations concernant l'eau entre Israël et l'Autorité Palestinienne. Cet article détaille la façon dont ceci peut être réalisé.

Heutzutage wurden die Wasserressourcen als ein wichtiges Element für die nachhaltige Entwicklung der Welt in verschiedenen akademischen Disziplinen diskutiert. Als Bestandteil der Wasserressourcen könnten die grenzüberschreitenden Wasserressourcen, die eng mit den internationalen Wasserläufen zusammenhängen, die internationalen Beziehungen, die Politik und auch die wirtschaftliche Entwicklung beeinflussen. Als wichtiges Instrument für die internationale Gemeinschaft bemerkt das Völkerrecht, insbesondere das internationale Wasserrecht, auch die Bedeutung dieses Phänomens. Die Autorin ist daran interessiert, das Grundwissen des internationalen Wasserrechts zu klären und eine neue Entwicklung in diesem Bereich zu entdecken. Und darum geht diese Dissertation von zwei wesentlichen Punkten aus: dem internationalen Recht, und den grenzüberschreitenden Wasserressourcen in einem internationalen Wasserlauf. Die Autorin versucht durch eine Studie, nämlich die Analyse des internationalen Rechtswasserregime des Mekong-Fluss-Becken, zu erläutern, wie das internationale Recht dem Schutz und der Bewahrung der grenzüberschreitenden Wasserressourcen in einem internationalen Wasserlauf dient. Diese Dissertation stellt einige neue Perspektiven für dieses Thema vor, die Lücken bestehender Forschungsprojekte abdecken und relevante Inspirationen für die zukünftige Entwicklung des Mekong Wasserregimes liefern könnten. Entsprechend der raschen Entwicklung des Mekong-Beckens sowie der Änderung des Rechtsstatus der UN Wasserläufe Konvention von 1997 ist der Zusammenhang zwischen internationalem Wasserrecht und dem Mekong-Becken in akademischen Kreisen wieder in den Fokus gerückt. Die Entwicklung des internationalen Wasserrechts spielt seit jeher eine wichtige Rolle im Völkerrecht. Die Fokussierung auf eine spezielle Region und die Erforschung eines spezifischen internationalen Wasserlaufs kann explizit und sinnvoll für die Entwicklung des internationalen Wasserrechts auf Makroebene sein. Aus diesen Überlegungen geht hervor, dass die Autorin das internationale Rechtswasserregime des Mekong-Beckens als Forschungsgegenstand dieser Dissertation gewählt hat, und für alle Leser eine umfassende Karte erstellen möchte, um ihre Reise zum Mekong-Wasserregime zu begleiten. Nach dem Oxford English Wörterbuch bezeichnet das Wort "Regime" eine Methode oder ein System von Regel, Regieren oder Kontrolle; ein System einer Organisation; eine Art, Dinge zu tun, vor allem eine mit weit verbreiteten Einfluss oder Prävalenz. Das "internationale Rechtswasserregime" in dieser Dissertation bezeichnet ein System, das basierend auf dem internationalen Recht zur Verwaltung der Wasserressourcen und Wasserressourcen bezogenen Angelegenheiten entlang eines internationalen Wasserlaufs ist. Um zu definieren, was das Mekong-Wasserregime ist und wie es funktioniert, ist eine entscheidende Grundlage, um Mekong-Wasserregime besser zu verstehen und weiter zu forschen. Die Autorin hat auch beschlossen, zwei Vergleiche zu machen, um Nachteile des Mekong-Wasserregimes herauszufinden. Einer von ihnen ist der funktionale Vergleich des Mekong-Wasserregimes mit dem Rhein-Wasserregime, der andere ist der Vergleich des 1995 Mekong-Übereinkommens mit der 1997 UN-Wasserlaufkonvention. Die Ergebnisse dieser Vergleiche wiederum bestimmen die Richtung für Verbesserungen dieses Regimes. Diese Verbesserungen können nicht nur für das Regime selbst, sondern auch für die regionale Nachhaltige Entwicklung von Mekong, die internationale Zusammenarbeit und eine bessere Kommunikation in der Zukunft von Bedeutung sein. Zusammenfassend kann die Forschungsfrage beschrieben werden, um: das Mekong-Wasserregime zu charakterisieren, die Punkte zu analysieren, die in diesem Regime verbessert werden müssen, und dann die besten Methoden zur Realisierung dieser Verbesserungen zu finden. Angesichts der Tatsache, dass sich diese Forschungsfrage auf die internationale Rechtsordnung und den Zusammenhang zwischen dem internationalen Wasserrecht und dem Mekong-Becken konzentriert, werden die relevanten rechtlichen Regelungen auf nationaler Ebene in dieser Dissertation nicht detailliert erörtert. Diese Dissertation bietet nicht nur den Lesern eine explizite und umfassende Karte des internationalen Rechtswasserregimes des Mekong-Beckens, sondern auch einen Vergleich zwischen den Funktionen des Mekong-Wasserregimes und dem Rhein-Wasserregime. Dieser Vergleich hervorhebt einige Besonderheiten des Mekong-Wasserregimes, und erklärt auch, wie ein internationales Wassermanagement durch seine Institution in Wirklichkeit funktioniert. Das letzte Kapitel dieser Dissertation liefert mehrere Vorschläge, die verwendet werden können, um zukünftige Maßnahmen zur Verbesserung des Mekong Wasserregimes zu führen. Diese Dissertation gibt nicht nur eine sinnvolle Berücksichtigung der Auswirkungen der UNWC, die im Jahr 2014 in Kraft getreten ist, sondern auch die Mittel, mit denen ein wirksamer internationaler Wasserrecht rechtlicher Rahmen einen spezifischen internationalen Wasserlauf beeinflusst. Schließlich kann die Diskussion über die chinesische Beteiligung am Mekong-Wasserregime das Verhältnis zwischen China und anderen nachgelagerten Ländern fördern, was für die regionale Entwicklung in Bezug auf ökonomische, ökologische und soziale Aspekte von großem Nutzen ist. Diese Dissertation verwendet ein dreistufiges Modell, um die ganze Geschichte zu beschreiben. Der erste Schritt besteht darin, das Mekong-Wasserregime detailliert zu beschreiben und die Grundlage für die gesamte Dissertation zu schaffen. Der anschließende zweite Schritt ist der funktionale Vergleich zwischen dem Mekong-Wasserregime und dem Rhein-Wasserregime. Dieser funktionelle Vergleich konzentriert sich nur auf die Funktionen, die von diesen beiden Regimen durchgeführt werden, und erlaubt uns, diese beiden Regime auf der Ebene der Implementierung zu vergleichen. Die mit diesem Vergleich gewonnene Erleuchtung bringt Inspiration für die Verbesserung des Mekong-Wasserregimes. Der dritte Schritt dieser Dissertation wurde der Suche nach Möglichkeiten zur Verbesserung des Mekong Wasserregimes gewidmet. Die Verbesserung der Rechtsgrundlage und der Institution, die Beteiligung Chinas, sind alle hier dargestellt. Zusammenfassend ist diese Dissertation eine juristische Untersuchung des Mekong-Wasserregimes und zielt darauf ab, die Wege zu seinen Verbesserungen zu finden. Die Autorin hofft, dass diese Dissertation Beiträge zu anderen verwandten Forschungsarbeiten, und zur Verbesserung der Effizienz und der ökologischen Nachhaltigkeit des gesamten Mekong-Wasserregimes leisten könnte. Grundlage für diese Forschung sind vor allem Vergleichsarbeiten in Aspekten der Rechtsgrundlage und Umsetzung. Diese Dissertation ist ein umfassender und detaillierter Wegweiser für die Erforschung des Mekong Wasserregimes. Die Leser können aus diesem Leitfaden viele Informationen gewinnen, was eine aussagekräftige Grundlage für die Erkundung der Leser in diesem Bereich darstellt. ; On 27 August 2014, the world famous 1997 Convention on the Law of the Non-navigational Uses of International Watercourses (the 1997 UNWC) entered into force. This event once again made international water law become a hot topic in the academic field, especially that of international public law. Moreover, according to the rapid development of the economy in Southeast Asia and also China, the Mekong River basin is gaining more and more attention in many respects. This dissertation focuses on international water law as it specifically applies to the Mekong River basin. The research presented herein analyzes the Mekong water regime firstly; secondly, it identifies the problems with this regime by means of assessment and comparison; lastly, it designated ways in which the regime could be improved upon. The author presents an in-depth analysis of the international legal water regime of the Mekong River basin and proposes an assessment thereof. She also uses another famous and mature international water regime, namely the Rhine water regime, to make a functional comparison focusing merely on the realistic functions of these two regimes. This comparison is an integral point of this dissertation, and draws a clear picture for people to understand what an international water regime can do in reality. At the same time, this comparison provides a series of inspirations for considerations on how to improve the Mekong water regime. In order to lay a more effective foundation for suggestions on how to achieve this objective, the author also uses the 1997 UNWC, which entered into force in 2014, as a model for the improvement of the only specific legally binding basis of this regime, namely the 1995 Mekong Agreement. Based on the analysis, assessment, and comparisons just described, the author distinguishes the optimal direction for efforts to improve the Mekong water regime. In the last chapter, the author expresses that not only the legal basis but also the regime's institution should be improved; furthermore, the relationships with the donors, the NGOs, the public and also the upstream countries, especially China, must also be taken into account for its future development. The objective of the dissertation is to give its readers an explicit understanding of the Mekong River basin's international legal water regime and know its characters and drawbacks. Two of the comparisons laid out in this dissertation are also two crucial new points for readers to draw inspiration from. The improvement suggested provides several meaningful ways of achieving the future development of the Mekong water regime, as well as a good basis for guiding the actions of the Mekong River Commission and also for regional cooperation and communication.

Gradussani 'Kun paikallinen saa globaalin fokuksen: Ebolan leviämisen narratiivit vuosina 2014 – 2015 Toronto Star -lehdessä' tutkin otsikon mukaisesti Ebolan leviämisen narratiiveja viimeisimmän Ebolaepidemian ajalta. Toronto Star on Kanadan suurin päivittäin ilmestyvä sanomalehti, jonka julkaisupaikka on Torontossa Ontarion provinssissa. Teoreettisena viitekehyksenä käytän Melissa Leachin vuonna 2008 kehittelemää temaattisten narratiivien kategorisointia verenvuotokuumeista (esimerkiksi Ebola ja Marburgin virus). Hänen kategorisointi sisältää seuraavat narratiivit: (1) Globaali uhka: Afrikasta nousevaa ruttoa vastaan taisteleminen, (2) Tappavat paikalliset sairaustapaukset: globaali nopea reagointi paikallisiin tapahtumiin, (3) Kulttuuri ja konteksti: paikallisen tiedon ja osaamisen hyödyntäminen, (4) Mysteerit ja kuolleisuus: ekologisen ja sosiaalisen dynamiikan huomioiminen. Näiden pohjalta graduni tutkimuskysymykset ovat vastaavasti (1) Millaiset leviämisen narratiivit Toronto Star esitteli vuosina 2014 – 2015? (2) Ketkä Toronto Star esitteli päätoimijoina Ebolaepidemian aikana vuosina 2014 – 2015? (3) Millaiset roolit päätoimijat saivat Ebolaepidemian aikana Toronto Star – lehden mukaan? Teoreettisena viitekehyksenä toimijoille käytän sekä Proppin (1968) että Sealen (2002) ajatusta siitä, että hyvä tarina sisältää niin sankareita, auttajia kuin vastustajia. Tarinan lopussa vastustajat häviävät ja sankarit voittavat. Terveyteen liittyvissä tarinoissa sairaus ja kuolema esitetään vastustajana. Sitä vastoin lääkärit ja hoitajat nähdään sankareina, sillä he yrittävät taltuttaa sairauden ja voittaa kuoleman. Tutkimuksessani käytän myös sekä Katzin, Kornbletin, Arnoldin, Liefin ja Fischerin (2011) että Brownin, Mackeyn, Shapiron, Kolkerin ja Novotnyn (2014) teorioita, jotka esittelevät toimijoita globaalin terveysdiplomatian kentällä. Kyseiset teoriat auttavat Ebola-alueen toimijoiden löytämisessä Toronto Starin artikkeleista. Aineistoni koostuu 97 relevantista Ebola-artikkelista, jotka on julkaistu Toronto Star lehdessä vuosina 2014 – 2015 ja kerätty ProQuest Central -palvelun avulla. Analyysini tulokset osoittavat, että Toronto Star esitteli seuraavat päänarratiivit: (1) Ebola globaalina turvallisuusuhkana, (2) Tappavat paikalliset sairaustapaukset ja hidas globaali reagointi tapahtumiin, (3) Kulttuuri ja konteksti: enemmän olisi pitänyt kiinnittää huomiota paikallisten osallistamiseen, (4) Ebolan vuosina 2014 – 2015 leviämisen taustalla pitkään jatkunut köyhyys ja vaillinnaiset terveydenhoitojärjestelmät Länsi-Afrikassa. Tämän lisäksi Guinean, Sierra Leonen ja Liberian terveysministeriöt ja maiden presidentit nähdään globaalin terveysdiplomatian ydintoimijoina. Sen sijaan YK-järjestelmän olennaiset toimijat, Kanadan hallitus, Kanadan ulkoministeri, Yhdysvaltain hallitus ja Yhdysvaltain presidentti nähdään monisidosryhmäisen globaalin terveysdiplomatian toimijoina. Lääkärit ilman rajoja, Punaisen Ristin ja Punaisen Puolikuun yhdistysten kansainvälinen liitto, PHAC, CDC, terveydenhuollon työntekijät, sosiaalisen liikkuvuuden auktoriteetit, hautaustiimin jäsenet, paikalliset kyläpäälliköt, karanteeniviranomaiset, kansanterveyden asiantuntijat, viranomaiset, tutkijat, laivayhtiöt, lentöyhtiöt, lääkeyhtiöt ja yksityiset lahjoittajat nähdään epävirallisen globaalin terveysdiplomatian toimijoina. Ebola-tarinassa roolit eri toimijoille vaihtelevat uhreista sankareihin ja avunantajista avun vastustajiin. ; In my Master's Thesis 'When local gets a global focus: Ebola outbreak narratives in 2014 – 2015 in Toronto Star' I research Ebola outbreak narratives of the most recent Ebola outbreak. Toronto Star is Canada's biggest daily newspaper which is being published in Toronto, Ontario. As my theoretical background, I use Melissa Leach's (2008) categorization on thematic narratives related to haemorrhagic fevers (for example Ebola and Marburg virus). Her categorization includes: (1) A global threat: tackling the emerging plague out-of-Africa, (2) Deadly local disease events: the building of universal rapid response, (3) Culture and context: building positively on local knowledge, (4) Mysteries and mobility: taking long-term ecological and social dynamics seriously. Building on these, my research questions in this Thesis are (1) What kinds of outbreak narratives on Ebola were presented by Toronto Star during 2014 – 2015? (2) Who were presented as the main actors during the 2014 – 2015 Ebola outbreak by Toronto Star? and (3) What kinds of roles did the main actors receive over the outbreak period by Toronto Star? As a theoretical background for analysis of actors and different roles, I use Propp's (1968) and Seale's (2002) idea that a good story includes heroes, helpers and villains. At the end of a story, villains loose and heroes win. In the health-related stories, disease and death are being portrayed as a villain. Instead, doctors and nurses are seen as heroes because they are trying to tackle the disease and overcome death. I also use theories by Katz, Kornblet, Arnold, Lief and Fischer (2011) as well as by Brown, Mackey, Shapiro, Kolker, Novotny (2014) which introduce global health diplomacy actors. These theories help me to identify the main Ebola actors being presented in the research data. My research data consists of 97 relevant articles related to the Ebola outbreak published in Toronto Star in 2014 – 2015, collected through the database ProQuest Central. The results of my analysis indicate that Toronto Star represented the following main narratives: (1) Ebola as a global security threat, (2) Deadly local disease events and slow universal response, (3) Culture and context: more attention should have been given on how to include locals into the outbreak response and (4) The 2014 – 2015 Ebola outbreak as an outcome of long-lasting poverty and lacking health care systems in West Africa. Further, the analysis showed how the ministries of Health in Guinea, Sierra Leone and Liberia as well as the presidents of the three mentioned countries are considered as the core global health diplomacy actors. Instead, the relevant actors of UN system as well as the Canadian government, Canada's Minister of Foreign Affairs, the U.S. Government and the U.S. President are considered as multi-stakeholder global health diplomacy actors. Médecins Sans Frontières, International Federation of Red Cross and Red Crescent Societies, the Public Health Agency of Canada, Centers for Disease Control and Prevention (CDC), health care workers, social mobilization authorities, burial team members, local chiefs, quarantine officers, public health experts, officials, scientists, shipping companies, airline companies, pharmaceutical companies and private donors are considered as informal global health diplomacy actors. In the Ebola narrative, the roles for different actors vary from victims to heroes as well as from aiders to opposers.

This report examines the conservation economy in the Monsoonal North of Australia. It first describes the drivers behind the development of a conservation economy in the region and why this is important. It then takes a step back to describe what a conservation economy is, and provides simple explanations for the concepts and terms that populate the literature. It identifies how investments are prioritised and where priority areas for conservation management are located in the Monsoonal North. Finally, it provides a compendium of conservation economy opportunities operating in the region, and examines prospects for future development. The conservation economy has largely been driven by community concern over the deteriorating condition of our land, seas, water and atmosphere; by consumer demand for ethically and sustainably-produced products; and Indigenous people's desire to derive income from their traditional lands. The conservation economy literature provides a framework for assessing the value of conservation management and who should bear the cost of this management. Its basic principles include recognition of the dependence of humans on ecosystem services and the valuation of managing those services. There is the expectation that production systems should be managed sustainably, and where it is profitable to do so, the producer should bear the cost of adopting sustainable management. Payment can be expected for conservation management that is beyond reasonable expectations, and provides public rather than private benefit. Conservation economy priorities are driven by international conventions covering biodiversity conservation and social justice. As a signatory to these conventions, the Australia Governments has accepted obligations to list and protect threatened species and World Heritage sites; operate a protected area estate; mitigate climate change; adhere to sustainable development goals and alleviate poverty among Indigenous people in Australia and the third world. Non-government organisations (NGOs) also largely subscribe to these aims. The Monsoonal North has extensive tracts of intact landscapes that are largely in good condition. It scores well in conservation prioritisation schemes based on these natural values, but poorly in schemes prioritising habitat fragmentation, land degradation and threatened species. Priority areas for biodiversity conservation largely coincide with areas of Indigenous held land, so are attractive areas for conservation investment that incorporates social justice goals. External investment in the conservation economy in the Monsoonal North comes from governments, NGOs and the voluntary efforts of property owners and managers. Most funding comes from the Australian Government, either through grants programs or fee-for-service arrangements. This funding has declined over the last decade, and disproportionately so in the Monsoonal North. This has left a sizeable dint in the region's conservation economy. However, funding for Indigenous cultural and natural resource management has been largely maintained, because Indigenous economic development continues to be a high national priority. The Australian Government has also established the Emission Reduction Fund as a marketplace to purchase emission reductions from land and agricultural management, and is considering a national marketplace for water. The Queensland and Western Australian governments also subsidise conservation management through grant programs and conservation covenants, though this funding has also declined in recent years. In the Northern Territory, conservation agreements are brokered by the Natural Resource Management (NRM) body. Most NRM groups in the north also run devolved grants schemes, though these are funded by the Australian Government's National Landcare Programme. Governments also regulate for adherence to duty-of-care principles in the management of weeds, pest animals, vegetation management and water quality management; and provide extension program and structural adjustment loans to support adoption of sustainable practices. NGOs are increasing their presence in northern Australia, particularly working in partnership with Indigenous communities to support their cultural and natural resource management aspirations. Indigenous communities are active participants in the conservation economy. Indigenous Protected Areas (IPAs) now constitute one-third of Australia's National Reserve System. Indigenous rangers are employed to undertake cultural and natural resource management, including protection of cultural heritage; transfer of Traditional Knowledge; weed, fire and feral animal management; and biodiversity monitoring and management. Fee-for-service arrangements operate for biosecurity surveillance, collection of marine debris and emission abatement. The pastoral industry can also benefit from the conservation economy. However, other than entering into agreements to reserve parts of their land for biodiversity conservation and reducing methane emissions from cattle, this is unlikely to be in the form of external payments. Rather, adopting recognised best practice herd management will not only reduce emissions and improve land condition by decreasing grazing pressure, it will also increase profitability. Voluntary uptake of such practices is also likely to circumvent increased government regulation of the industry. Because such practices are profitable, they are unlikely to attract stewardship payments. However, assistance through the necessary transition can be provided through extension programs and structural adjustment loans. In summary, the principal prospects in the conservation economy in the Monsoonal North are: • Greenhouse gas abatement activities • Indigenous Land and Sea Management supported by governments and NGOs • Protection of high priority biodiversity on private or leasehold land funded through development offsets, and through government-funded programs • Taking advantage of the inherent financial benefits of herd management to improve animal performance and land condition. Hence, the conservation economy is operating in northern Australia and is likely to grow, but it is also subject to variation with shifting government policy and consequent market opportunities. Growth is most likely to be driven by the international priorities of conservation of listed threatened species, protection of World Heritage values, establishment of a protected area estate and alleviation of poverty among Indigenous people and in the third world, adherence to sustainable development goals and mitigation of climate change. These priorities are likely to inform future investments by governments, NGOs and private donors.

El trasplante de órganos es considerado uno de los avances más significativos de la medicina moderna y es un procedimiento cada vez más exitoso en términos de supervivencia de los pacientes, siendo actualmente la mejor opción de tratamiento para los pacientes con innumerables patologías. El proceso de donación es insuficiente para cubrir las necesidades de trasplante de la población, por lo tanto, se hace necesario el desarrollo de nuevas estrategias para fortalecer la experiencia y efectividad de los programas existentes. La falta de conocimiento de los profesionales de la salud, su percepción y actitud hacia temas relacionados con el proceso de donación, pueden convertirlos en facilitadores o barreras para la identificación de potenciales donantes. Por esta razón, los recursos disponibles, las actitudes hacia la donación, la legislación y conocimiento de los procesos involucrados en la donación de tejidos y órganos son críticos. Dada la influencia de los profesionales de salud se definen los objetivos de este proyecto de tesis: determinar cuál es el conocimiento y las habilidades de los profesionales de la salud encargados de los trasplantes de órganos y de tejidos en la regional 1, evaluados mediante una herramienta educativa para contribuir a mejorar un programa eficiente de Donación de Órganos y tejidos y así mismo, fijar recomendaciones en aras de aumentar las tasas de donación, con especial énfasis en la actividad hospitalaria en el país. METODOLOGIA Se realizó un estudio basado en el análisis de la evaluación de conocimientos del proceso donación- trasplante de órganos y tejidos en el personal de salud participante en la herramienta educativa llamada "Curso taller primer respondiente del potencial donante de órganos y tejidos". Este curso incluía un formato evaluativo que fue diligenciado de manera anónima por los participantes antes y después de recibir el contenido del curso. El estudio se desarrolló en personal de la Salud de IPS pertenecientes a la Regional I, de la Red Nacional de donación y trasplantes de órganos y tejidos. Con el fin de evidenciar si existen diferencias en el conocimiento de los participantes del curso antes y después de asistir al mismo, se utilizó la prueba de McNemar (p< 0.05). RESULTADOS Entre julio del 2011 y junio del 2012, se realizó el "Curso taller primer respondiente del potencial donante de órganos y tejidos" y se obtuvieron 303 encuestados incluidos médicos, enfermeras y auxiliares de enfermería. Al inicio del curso las respuestas acertadas con relación a legislación, selección del donante, muerte encefálica y mantenimiento del donante estuvieron alrededor del 50%. No fue posible detectar la profesión que pudiese generar riesgo en la detección del donante y los procesos asociados. Posterior al curso, el 72% de las preguntas se respondieron de manera correcta, lo que representa un incremento estadísticamente significativo. Este cambio evidenció significancia estadística al usar la prueba de McNemar y arrojar un valor de p=0.00. .DISCUSIÓN El personal de salud participante en el curso taller proveniente de unidades involucradas como generadoras de donantes muestra un déficit de conocimientos del proceso donación trasplantes lo que puede convertirlos en limitantes para dicho proceso ; Organ transplantation is considered one of the most significant advances in modern medicine and is a successful procedure in terms of patients survival, being nowadays the best treatment option for patients with many pathologies. The donation process is insufficient to cover the transplantation needs of population, therefore, is necessary the development of new strategies to strengthen the experience and effectiveness of existing programs. The lack of knowledge of health professionals, their perception and attitude towards topics related with the donation process, could turn them into facilitators or barriers for potential donors identification. For this reason, the available sources, attitude towards donation, legislation and knowledge of involved processes in tissue and organ donation are critic. Given the influence of health professionals the objectives of this project are defined: determine which is the knowledge and skills of health professionals in charge of organ and tissue transplantation in the REGIONAL 1, assessed through an educative tool to contribute to the improvement of an efficient program of Organ and Tissue Donation and in that way, establish recommendations to increase donation rates, with an special focus in health centre's activities in the country. Methodology There was an study performed based on the analysis of knowledge evaluation in the organ and tissue donation-transplantation process with participant health staff in the educative tool called ¨Curso taller primer respondiente del potencial donante de organos y tejidos¨ (¨Workshop course first respondent of organ and tissue potential donor¨). This course included an evaluative format that was filled in anonymously by participants before and after receiving the course's content. The study was developed in IPS health staff who belong to the REGIONAL I, of National's organ and tissue donation and transplantation network. In order to evidence if there are differences in course participant's knowledge before and after assisting to it, we used McNemar's test. Results Between july-2011 and june-2012, the ¨Workshop course first respondent of organ and tissue potential donor¨ was completed and there were 303 respondents doctors, nurses and nurse assistants included. At the beginning of the course answers were accretive related to legislation, donor selection, brain death and donor maintenance were around 50%. It wasn't possible to determine the profession that could generate risk i donor detection and associated processes. After the course, 72% of the questions were answered correctly, which represents an statistically significant increase. This change shows statistic significance using McNemar's test and provide a value of: p=0.00. Discussion The health staff participating in the workshop course coming from involved units donor generators, show a knowledge shortfall regarding the donation transplantation process, which could turn them into barriers for the process

Haiti's new Dictatorship: The Coup, the Earthquake and the UN Occupation.By JUSTIN PODUR. Pluto Press, 2012. $29.95Reviewed by Natali DownerThe controversial book Haiti's new Dictatorship: The Coup, the Earthquake and the UN Occupation is a significant contribution to current discussions around globalisation, political economy, development, post-colonialism, and human rights. Podur's work provides welcome insight and a critical perspective on the struggle for sovereignty in modern day Haiti. The author takes the reader through Haiti's political history, beginning with the slave revolution of 1804, which established Haiti as the world's first independent black Republic. The historical account grounds the reader in Haiti's reality—the ongoing battle for economic and political sovereignty within its borders. Since its independence, Podur argues, the successful slave revolt in Haiti has been an ontological challenge to those who would seek to impose colonialism; it is the challenge they posed in 1804 and today.Podur sections the book into historical eras, including the Duvalier dictatorship followed by Haiti's popular movement and Jean-Bertrand Aristide, which act as signposts for his study. In Podur's analysis of the second and pivotal coup against Aristide in 2004, he argues that the new dictatorship was imposed and solidified under the control of the U.S., Canada, France and later, the United Nations. Specifically, under the guise of the Responsibility to Protect doctrine (the new iteration of the "White Man's Burden",) western countries employed the old colonial pretext in order to "overthrow Haiti's elected government and replace it with an internationally constructed dictatorship." Drawing on Michel-Rolph Trouillot's concept of dictatorship, as the use of violence and centralization of power, Podur adds "impunity" to the description as it characterizes how violations by the regime and its supporters go unpunished. Podur categorises the new international variety of dictatorship as a "laboratory experiment in a new kind of imperialism."Podur discusses the contradictory role of the domestic and international media as contributing to the success of the coup. He argues that the media misrepresented the details surrounding the kidnapping and replacement of a democratically elected prime minister with the dictatorship of the United Nations. He describes the "media disinformation loop" as part of the coup infrastructure by shaping beliefs and actions. Podur's work is an attempt to publicize an alternative to corrupt mainstream reporting.The media did not question the legitimacy of the coup regime or the United Nations' Stabilization Mission in Haiti (MINUSTAH). Podur argues that the occupation of Haiti by the MINUSTAH occurred under peculiar justifications. He reports that, "in Haiti an internationalized military solution is being offered for what even the UN admitted were problems of poverty and social crime that occur in many places." He argues that violence and murder rates are higher in other countries, including the Dominican Republic, Guyana, Trinidad, and Jamaica. The mainstream rationale for UN occupation in Haiti has evaded inquiry.Podur's analysis of the coup extends to the role of non-governmental organizations (NGOs) in the new dictatorship. In Haiti, Podur argues, NGOs perform tasks that belong in the hands of a functioning public service, accountable to the people. Instead, NGOs operate in the interests of their donor countries—"offering wealthy countries a morally responsible way of subcontracting the sovereignty of the nations they exploit." Making NGOs "less non-governmental and more 'over governmental'" and revealing the determinant role of external intervention in corrupting sovereignty.NGOs are responsible for the bulk of disaster response in Haiti. Podur's analysis of the earthquake of 2010 reveals a stunning account of how well-meaning donors are part of a feedback loop that (in part) finances a corrupt system. This system of local elites, international enterprises, and NGOs acts with impunity as they create and reinforce vulnerabilities because funds are controlled by western technocrats and corporations (particularly in times of crisis). Rather than geographic factors, Podur argues that social factors are the major cause of Haiti's horrific death toll following disasters. The decapitation of Haiti's government and the subsequent program cuts demobilizes the public service while it enables the rise of the "republic of NGOs" and the UN Dictatorship. As Haiti lacks the sovereignty to orchestrate its own disaster response, the failure to rebuild after the earthquake marks the failure of the new dictatorship and not the people of Haiti.Podur illustrates the character of the new dictatorship allowing readers to understand the truly gruesome nature of the post-coup occupiers. Podur's report leaves the reader spinning from accounts of murder and corruption; page after page the reader experiences Haiti's grim reality in the new imperialist regime. While the lists of events in the book become disorienting to read, they serve to demonstrate the brutality of actions performed by western nations, the Haitian elite, and armed factions.In this book Podur argues that Haiti is engaged in a historical struggle for democracy against external control. Podur's work on Haiti reveals how a multilateral violation of sovereignty is organized and carried out, and exposes the "new face of dictatorship in the twenty-first century global order." However, the larger project of this book suggests a call to action. Podur recounts the illegitimacy of the occupation and its atrocities so that widespread recognition can be achieved and policies changed. Podur challenges us to consider what it truly means to help Haiti, to face the consequences of our "do-good" attempts at aid and instead aim to assist Haitians to reclaim national sovereignty.Work CitedTrouillot, Michel-Rolph. Haiti, State Against Nation: The Origins and Legacy of Duvalierism. New York: Monthly Review Press, 1990. Print.~NATALI DOWNER is a PhD candidate in the Faculty of Environmental Studies at York University. Her research explores the contradictions of capitalism as expressed in the twin crisis of peak oil and climate change.

In Disclosure V. Anonymity in Campaign Finance, Ian Ayres broaches a very particular issue in the design of democratic institutions, discusses that issue in a very particular context, and advocates a very particular institutional remedy. The specific issue concerns the regulation of information concerning political donations. The specific context has two relevant dimensions. Ayres is clearly concerned with the case of the US, and, implicitly and explicitly, the discussion takes many other aspects of the US political environment as the relevant background. At the same time, Ayres is primarily concerned with the prevention of corruption, so that the relevant criterion by which alternative institutional regimes are judged is just the extent to which corruption is deterred. Within this context, Ayres argues that the norm of full anonymity in respect of political donations would operate more effectively to prevent corruption than would the norm of full disclosure; so that rather than 'sunlight [being] the best of disinfectants; electric light the most efficient policeman', Ayres argues that total darkness is the real cure for corruption. Ayres's constructed 'veil of ignorance' is nothing like Rawls's, but it does involve a putatively constructive use of ignorance in the same way that Rawls's construction does. The essential argument is simple enough. Under full information, all campaign donations are matters of public record, so that there can be nothing covert about the funding process; nevertheless, the possibility of buying political favours is still present. Indeed, in the limit, one might imagine that competitive political donations constitute a straightforward market for political influence that operates alongside the electoral process to determine political outcomes. Whether or not we describe open financial transactions in such a market as 'corrupt'1, or 'unfair' (given an unequal distribution of income and wealth), there is certainly a presumption that such a 'market' might be expected to influence political outcomes and so reduce the reliance of political outcomes on the electoral process and other more strictly 'political' mechanisms. At the other extreme, under perfect anonymity, campaign donations are organised in such a way that no one (other than the donor - and specifically not the recipient) has any reliable information about the existence, or size, of any individual donation. In this case, so the argument goes, since there can be no proof that a donation has been made, there can be no political deals struck: it is impossible to buy influence if it is impossible to demonstrate payment. Of course, this sketch does not do full justice to Ayres's argument, but we believe that it suffices to focus attention on the key issues: the idea that corruption takes the form of market-like deals that 'pervert' the democratic process in the sense that political outcomes differ from those that would be realised under purely political process; and the argument that such deals are effectively ruled out by complete anonymity. We also note that Ayres's discussion is informed by a recurring analogy with the process of voting itself - and with the idea, in particular, that the secret or 'Australian' ballot provides an appropriate exemplar for secrecy in the political process. We will return to the significance of this analogical reasoning, and to other aspects of Ayres's specific argument, in due course but first we wish to make some effort to widen the discussion a little. The design of democratic institutions may be approached in either of two styles - a 'piecemeal' style or a 'synoptic' one. A piecemeal style characteristically focuses on this or that piece of institutional practice and subjects it to scrutiny. A synoptic style is one that attempts to work from general principles in developing an overview of the operation of democratic institutions and to develop thereby implications for the design of particular institutional devices2. Clearly, neither style holds a monopoly on usefulness, and it is likely that the iteration between these styles offers the most plausible route to reasonable conclusions. It is for this reason that, initially at least, we wish to respond to Ayres's piecemeal proposal in a rather more synoptic mode. Even if we narrow our range of concern to the institutional framework for financing democratic politics, we must recognise that a number of inter-related issues are raised: the relative merits of private and state funding of political parties or candidates; the possibility of regulating either the set of agents who may make political contributions, or the size of the political contributions they may make; the possibility of regulating the flow of information about the financial affairs of donors, parties or candidates; the possibility of regulating expenditures made by parties or candidates; and so on. None of these issues is trivial either in the sense that the normatively appropriate answer is obvious, or in the sense that the same practice has developed almost universally across democratic countries. And matters become still more complicated if we open up the possibility of interactions between these various issues, or with other aspects of the institutional fabric such as voting rules, the structure of representation, and so on. Indeed, it is not even obvious how we should go about addressing these matters. Two ingredients seem essential however - a reasonably clear statement of the model of democratic politics to be used as the test-bed within which to conduct the relevant thought-experiments, and a reasonably clear statement of the relevant normative criteria. Unfortunately, neither ingredient is readily available or widely agreed. The first aim of this brief essay is to say something about the appropriate ingredients to use in constructing particular arguments concerned with the funding of democratic politics or, indeed, any other aspect of the design of democratic institutions. Only then will we return to the specific issue of anonymity in political donations.

In Disclosure V. Anonymity in Campaign Finance, Ian Ayres broaches a very particular issue in the design of democratic institutions, discusses that issue in a very particular context, and advocates a very particular institutional remedy. The specific issue concerns the regulation of information concerning political donations. The specific context has two relevant dimensions. Ayres is clearly concerned with the case of the US, and, implicitly and explicitly, the discussion takes many other aspects of the US political environment as the relevant background. At the same time, Ayres is primarily concerned with the prevention of corruption, so that the relevant criterion by which alternative institutional regimes are judged is just the extent to which corruption is deterred. Within this context, Ayres argues that the norm of full anonymity in respect of political donations would operate more effectively to prevent corruption than would the norm of full disclosure; so that rather than 'sunlight [being] the best of disinfectants; electric light the most efficient policeman', Ayres argues that total darkness is the real cure for corruption. Ayres's constructed 'veil of ignorance' is nothing like Rawls's, but it does involve a putatively constructive use of ignorance in the same way that Rawls's construction does. The essential argument is simple enough. Under full information, all campaign donations are matters of public record, so that there can be nothing covert about the funding process; nevertheless, the possibility of buying political favours is still present. Indeed, in the limit, one might imagine that competitive political donations constitute a straightforward market for political influence that operates alongside the electoral process to determine political outcomes. Whether or not we describe open financial transactions in such a market as 'corrupt'1, or 'unfair' (given an unequal distribution of income and wealth), there is certainly a presumption that such a 'market' might be expected to influence political outcomes and so reduce the reliance of political outcomes on the electoral process and other more strictly 'political' mechanisms. At the other extreme, under perfect anonymity, campaign donations are organised in such a way that no one (other than the donor - and specifically not the recipient) has any reliable information about the existence, or size, of any individual donation. In this case, so the argument goes, since there can be no proof that a donation has been made, there can be no political deals struck: it is impossible to buy influence if it is impossible to demonstrate payment. Of course, this sketch does not do full justice to Ayres's argument, but we believe that it suffices to focus attention on the key issues: the idea that corruption takes the form of market-like deals that 'pervert' the democratic process in the sense that political outcomes differ from those that would be realised under purely political process; and the argument that such deals are effectively ruled out by complete anonymity. We also note that Ayres's discussion is informed by a recurring analogy with the process of voting itself - and with the idea, in particular, that the secret or 'Australian' ballot provides an appropriate exemplar for secrecy in the political process. We will return to the significance of this analogical reasoning, and to other aspects of Ayres's specific argument, in due course but first we wish to make some effort to widen the discussion a little. The design of democratic institutions may be approached in either of two styles - a 'piecemeal' style or a 'synoptic' one. A piecemeal style characteristically focuses on this or that piece of institutional practice and subjects it to scrutiny. A synoptic style is one that attempts to work from general principles in developing an overview of the operation of democratic institutions and to develop thereby implications for the design of particular institutional devices2. Clearly, neither style holds a monopoly on usefulness, and it is likely that the iteration between these styles offers the most plausible route to reasonable conclusions. It is for this reason that, initially at least, we wish to respond to Ayres's piecemeal proposal in a rather more synoptic mode. Even if we narrow our range of concern to the institutional framework for financing democratic politics, we must recognise that a number of inter-related issues are raised: the relative merits of private and state funding of political parties or candidates; the possibility of regulating either the set of agents who may make political contributions, or the size of the political contributions they may make; the possibility of regulating the flow of information about the financial affairs of donors, parties or candidates; the possibility of regulating expenditures made by parties or candidates; and so on. None of these issues is trivial either in the sense that the normatively appropriate answer is obvious, or in the sense that the same practice has developed almost universally across democratic countries. And matters become still more complicated if we open up the possibility of interactions between these various issues, or with other aspects of the institutional fabric such as voting rules, the structure of representation, and so on. Indeed, it is not even obvious how we should go about addressing these matters. Two ingredients seem essential however - a reasonably clear statement of the model of democratic politics to be used as the test-bed within which to conduct the relevant thought-experiments, and a reasonably clear statement of the relevant normative criteria. Unfortunately, neither ingredient is readily available or widely agreed. The first aim of this brief essay is to say something about the appropriate ingredients to use in constructing particular arguments concerned with the funding of democratic politics or, indeed, any other aspect of the design of democratic institutions. Only then will we return to the specific issue of anonymity in political donations.

La tesi è stata intitolata "Change the System From Within". La participatory democracy e le riforme istituzionali negli Stati Uniti degli anni Sessanta e si compone di cinque capitoli. Nel primo capitolo si riprende l'idea di participatory democracy emersa in seno alla New Left e ai movimenti sociali dei lunghi anni Sessanta. In questo contesto il concetto di participatory democracy assunse due principali accezioni: da una parte rappresentava la rivendicazione politica di un maggior coinvolgimento attivo della cittadinanza nelle politiche - locali, statali e federali - frutto della crisi di legittimità che la democrazia americana stava attraversando in quegli anni; dall'altra, il concetto venne adottato come principio organizzativo all'interno dei gruppi stessi di attivisti, con la funzione di prefigurare quelle riforme politico-istituzionali cui gli stessi militanti aspiravano. Dalla stessa temperie di contestazione sorse del resto anche la critica che alcuni studiosi mossero alla teoria liberale pluralista e alla sua esemplificazione nella coeva democrazia americana. Nel primo capitolo si mostra proprio come da quelle rielaborazioni critiche degli anni Sessanta emerse anche il primo modello di participatory democracy in seno alla teoria politica, sviluppato pienamente negli anni Settanta e Ottanta da Carole Pateman, Crawford B. Macpherson e Benjamin Barber. Questa parte del lavoro di tesi si propone quindi di accostare alle pratiche partecipative introdotte dai movimenti anche la ricostruzione dello sviluppo graduale di una teoria politica della participatory democracy. Tale riflessione è completata da un'analisi storica di ampio raggio, necessaria a meglio contestualizzare il fenomeno e ad includere le nuove richieste democratiche nell'ambito di una tradizione democratico-rappresentativa già dotata di istituti partecipativi di democrazia diretta. Chiarito il quadro storico-politico degli anni Sessanta, il secondo capitolo analizza la ricezione dell'idea di participatory democracy nelle politiche federali. A questo proposito si illustra come il principio di citizen participation fosse stato recepito già con la War on Poverty promossa da Lindon B. Johnson alla metà degli anni Sessanta e fu mantenuto, con esiti istituzionali differenti, almeno fino alla fine della presidenza Carter. Si dimostra inoltre che, malgrado il dettato legislativo federale fosse spesso approssimativo sulle modalità operative, quel principio ebbe in realtà un notevole impatto sulle relazioni intergovernative. Tale principio favorì ad esempio l'intraprendenza di molti amministratori locali nel promuovere il decentramento amministrativo e politico su base di quartiere. Nel terzo capitolo l'analisi affronta le principali trasformazioni in senso partecipativo avvenute nei sistemi di governo statali e locali negli anni Settanta, mettendole in relazione anche alle dinamiche intergovernative di più lungo periodo. Il capitolo è strutturato in modo tale da evidenziare il tendenziale recupero e rafforzamento di istituti già esistenti, come l'initiative, i public hearing e gli school district come strumenti di rivendicazione del community control in alcune città di grandi dimensioni. Mentre il secondo e terzo capitolo tendono a osservare le riforme istituzionali degli anni Settanta in senso partecipativo in seno al governo federale, statale e locale, i due successivi capitoli mirano ad osservare l'impatto della participatory democracy nel confronto tra attivismo militante e pratiche amministrative tradizionali degli anni Settanta. Il quarto capitolo è infatti dedicato all'ingresso della nuova generazione di politici progressisti nelle amministrazioni locali e statali fra la fine degli anni Sessanta e la prima metà degli anni Settanta. Per analizzarlo si è deciso di analizzare come principale caso di studio la Conference on Alternative State and Local Policy (CASLP), una organizzazione e forum nazionale che mirava proprio ad unire alle istanze dei progressisti una expertise di governo. Nell'ambito della CASLP, la cosiddetta Coalizione progressista di Berkeley, CA, fornì un caso esemplare di strategia di confronto con le istituzioni locali e per questo il capitolo le dedica una attenta disanima. La pluriennale esperienza di azione collettiva dei progressisti di Berkeley nell'arena istituzionale è infatti rilevante sia per l'innovazione nella strategia istituzionale, sia per attestare una evoluzione dell'idea di participatory democracy nel tempo. Il quinto capitolo ricostruisce ed analizza la carriera politica di Tom Hayden negli anni in cui passò dall'attivismo alla politica istituzionale, con la campagna elettorale per diventare Senatore della California in Congresso (1975-1976) e la successiva Campaign for Economic Democracy (1976-1982), confermando la spiccata propensione del leader all'innovazione istituzionale in senso partecipativo. In particolare, nella campagna elettorale per il Senato del Congresso del 1976 Hayden riuscì a implementare forme di decision-making partecipato in seno allo staff. Nella gestione del personale cercò inoltre di favorire l'empowerment di volontari e cittadini senza perdere di vista i requisiti essenziali per la sopravvivenza della campagna: fundraising e propaganda. In linea con la sua battaglia contro le distorsioni economiche del big business, scelse di non accettare fondi da corporation e banche e riuscì nell'intento di essere sostenuto per gran parte da small donors. Hayden dunque introdusse pratiche di participatory democracy in seno alla campagna elettorale e continuò a rivendicare la sua fiducia nella forza dei movimenti grass-roots. L'analisi storica, ad ogni modo, evidenzia anche le criticità che derivavano dall'uso di pratiche partecipative nella governance della campagna elettorale. Atttraverso l'analisi teorica e politico-istituzionale della democrazia partecipativa americana fra gli anni Sessanta e Settanta su vari livelli istituzionali (federale, statale e locale), questo progetto di ricerca tenta quindi di colmare un vuoto storiografico e, al tempo stesso intende contribuire alla definizione storico-istituzionale della participatory democracy in seno alla democrazia rappresentativa degli Stati Uniti. Infine, la presente ricerca mira a inserirsi nel dibattito pubblico contemporaneo sulla participatory democracy, offrendo una visione storico-istituzionale importante per meglio comprendere il fenomeno e che, finora, non ha ricevuto l'attenzione che meriterebbe. ; Chapter 1 retrieves the idea of participatory democracy stemmed from the Long 1960s New Left and the following social movements. Indeed, the concept of participatory democracy mainly acquired two slightly different shapes in that historical framework. From one hand, it meant the broad political call for common citizens' greater involvement in the policy-making - at the local, state and federal level. That request was in fact a reply to the ongoing crisis of the American democracy, in terms of political legitimacy and social representation of minorities and poor people. In the other hand, participatory democracy represented the organizing principle adopted by most of the grass-roots groups of that period, with a clear prefigurative function. Indeed, making the activist groups' inner decision-making participatory was a way for the collectives to anticipate the institutional changes they aspired to. In the meantime, because of the same disaffection against the raising social and political inequalities, some political science scholars elaborated a critique to the pluralist version of the liberal democracy - then the most praised one, as well as credited as it was embodied in the American democracy. Those 1960s critiques were eventually used to conceive the first political theory of participatory democracy in the 1970s and 1980s, as Chapter 1 shows. The participatory democracy's canon was in fact mostly developed by Carole Pateman, Crawford B. Macpherson and Benjamin Barber. Beside the intellectual history of participatory democracy from 1960s to 1980s, Chapter 1 allows to contextualize ideas and practices of common citizens' participation into the wider history of the American Political Development. According to that, chapter 1 also provides a detailed analysis of the participatory political institutions that were traditionally part of the United States representative democracy. Chapter 2 verifies whether the 1960s idea of participatory democracy actually affected the federal public policies of the late 1960s and 1970s. Indeed the principle of "citizen participation" was introduced in some of the War on Poverty legislations, promoted by Lyndon B. Johnson since the mid-1960s. Although the heterogeneous institutional effects, that principle was maintained in some grant-in-aid projects until the end of the Carter administration, through the Nixon and Ford administrations. Therefore, the political meanings assumed by the idea of "citizen participation" and its institutional consequences from 1964 to 1980 are carefully analyzed in chapter 2. Moreover, chapter 2 shows that the principle of citizen participation had such a strong impact on the intergovernmental relations. It thus brought forward, for instance, the local public officers' entrepreneurship towards the local devolution, shifting the administrative and political power base from the center to the neighborhood. Chapter 3 deals with the 1970s main institutional reforms aimed at introducing the common citizens' participation in the government decision-making at the state and local levels. Those reforms are deeply related to some long-lasting intergovernmental dynamics and this relationship is also argued. The same chapter's lay-out is vowed to underline the 1970s general trend of retrieval and enhancing of traditional institutions, such as the initiative (direct democracy), the public hearings and the school districts. The school board was indeed reevaluated and reshaped as a means of community control in the biggest cities. As chapters 2 and 3 aim at exploring the implementation of participatory reforms in the federal, state and local level of government, chapters 4 and 5 aim at inquiring the participatory democracy's impact on the 1970s boundary of polity - the space where activism meets political institutions. Chapter 4 inquires the new generations of progressive politicians entering the local and state administrations from the late 1960s to the mid-1970s. To frame that national phenomenon, the historical analysis use the Conference of Alternative States and Local Policies (CASLP) as a case study. CASLP was indeed a national organization born in 1975 to give voice to the progressive public officers around the country and allowed them sharing their government experiences for a more effective institutional impact. Inside CASLP, the progressive coalition of Berkeley, CA (called Berkeley Citizens' Action, BCA) was especially spotted for its exemplary strategy to confront local political institutions. The 1970s BCA's political actions are thus specifically analyzed. In fact, the institutional approach of the Berkeley progressive coalition resulted to be innovative in terms of strategy as well as successful in introducing new forms of participatory democracy into the local government, assessing the 1970s evolution of the participatory democracy political theory and practices. Chapter 5 retraces the political career of the former New Left leader Tom Hayden during the years of turning from activism to institutional politics. Especially, the analysis focuses on the 1975-1976 U.S. Senate Campaign and the following Campaign for Economic Democracy (CED), a coalition project and organization led by Hayden with the goal of mobilizing activists and public officers around the issues of economic justice, environmental and economic public policies (1976-1982). That period - just before Hayden was elected representative at the California Legislature in 1982 - is thus analyzed as a testing ground to verify his long-lasting commitment towards participatory democracy. The historical and political analysis, based on original archival findings, confirms Hayden's inclination for institutional innovation in the participatory realm. In particular, during the 1975-1976 electoral campaign for the U.S. Senate in California Hayden introduced participatory forms of decision-making involving staff people, volunteers and supporting grass-roots groups. Moreover, that campaign's staff and people management was conceived in order to directly empower citizens and volunteers, without losing track of the campaigning basic requirements (e. g. fundraising and propaganda). As he stood against big business and economic inequalities, he chose to reject fundings from corporations and banks. Therefore his electoral campaign was mostly sustained by small donors. Hayden successfully made the campaigning more open, accountable and participatory and kept on sponsoring his trust in community organizing and grass-roots social movements even in his following political endeavour, CED. Eventually, the investigation casts lights on the strengths, as well as the critical issues, produced by the Hayden's participatory governance of campaigning. By the means of analysing the intellectual history and the institutional implementation of participatory democracy during late 1960s-1970s United States, this research project firstly aims at making up the lack of historiography about the topic. In the second stance, grounding the institutional and political history of participatory democracy in the United States representative democracy - where the concept was born - this research project intends to provide a first genealogy of the participatory democracy's institutional implementation. In this sense, the research projects wants also to contribute to the contemporary debate on the participatory democracy. It is indeed a compelling and popular issue in many worldwide political arenas, but it is still rarely defined by its historical and institutional terms.

Smallholder irrigation schemes are regarded as a key strategy to eliminate poverty and increase food security in rural areas in South Africa. While the South African government has invested heavily in rural development schemes, most irrigation schemes face a myriad of challenges, including deficient infrastructure, weak institutional arrangements and water insecurity. Weak institutions have been identified as a major bottleneck in the performance of smallholder irrigation schemes in developing countries, including South Africa. Two main reasons have been identified for this challenge. Firstly, the agency of the irrigators was ignored during the design of the schemes. Treating farmers as passive rather than active agents resulted in institutional arrangements that were not context-specific, as well as weak farmer commitment to the ownership and management of the schemes, leading to system breakdown. Despite being noble in intention or design, institutions designed by outsiders often fail due to a lack of legitimacy. Secondly, institutions have failed to evolve to cope with dynamic challenges and opportunities in the sector. Stability over a reasonable period is required for institutions to effectively perform their crucial role of establishing reasonable expectations in dealings among people. Institutional innovations are required to keep up with the changing nature of development. In particular, farmer-led institutional innovations have been touted as key to improving the management of water resources in irrigation schemes. Farmer-led institutional innovation refers to a process, in which farmers themselves initiate, establish, and improve institutions based on their context-specific challenges or opportunities. Farmers' groups are regarded as an important institutional arrangement to reduce transaction costs, improve social networks, and increase livelihood outcomes. However, little is known about the internal dynamics of these farmer groups, how they operate, and whether or not they are inclusive and innovative, as well as what makes certain groups more successful than others. Furthermore, there is a paucity of research on whether these farmer groups embrace institutional innovations to improve water security and strengthen their design principles that are crucial for collective action. It is against this background that this study aimed to examine the internal group dynamics within the farmer groups; determine whether smallholder farmers are capable of implementing institutional innovations that are novel, useful and legitimate; determine the nature of these innovations (incremental or radical) and their role in improving water security. The main theories that underpinned the study were induced institutional innovation theory, collective action theory, random utility theory and Ostrom's eight design principles. Multistage sampling was used to collect data from 28 farmer groups and 401 irrigators in smallholder irrigation schemes in KwaZulu-Natal (Tugela Ferry and Mooi River) and the Eastern Cape (Qamata and Zanyokwe). Data were gathered by means of focus group discussions, key informant interviews and household surveys. Several empirical tools were employed to analyse the data (descriptive statistics, thematic analysis, logit model, propensity score matching, PCA and OLS). The study found that group membership was associated with higher levels of water access, adoption of inorganic fertiliser, incomes and assets. Group members had an additional four days' access to water in a month and applied at least 130 kg/ha more inorganic fertiliser than non-group members. Group members also had a higher household income per capita and more assets than non-group members. However, the results revealed a heterogeneous effect among group members, with the benefits varying according to members' socio-economic characteristics as well as internal group dynamics. The results suggest that organising farmers into groups should be promoted to improve farmers' access to productive assets such as water, technology adoption and welfare outcomes. However, the study findings also indicate that smaller groups should be promoted, programmes targeted at empowering women should be prioritised, and that it is imperative to invest in improving farmers' human capital through various training initiatives. The results indicated that farmers could develop and implement institutional innovations that are novel, useful and legitimate. Of the 28 groups, 21 (75%) had implemented institutional innovations in the past three years. Examples of innovations include, among others, the introduction of a secret voting system to improve marginalised people's participation in decision-making processes, designing daily rotation rosters to reduce conflict, using an attendance register for participation in group activities, and rewarding members according to their participation levels. Most of these innovations were designed to improve the graduated sanction mechanism (22.2%), enhance the penalty system for non-compliance; improve collective action arrangements (27.8%); monitor attendance of group meetings (18.5%); democratise decision making; and ensure equitable water distribution. However, they mainly focused on addressing challenges rather than exploiting opportunities and were largely incremental (94%), involving an adjustment or reinterpretation of rules and regulations. Furthermore, the innovative groups were small in size and were dominated by male farmers. Based on these results, it is recommended that the government should build on the irrigators' agency to improve the effectiveness and legitimacy of institutional arrangements in irrigation schemes. The findings also suggest that small groups should be actively promoted, while tailored training should be offered based on the groups' specific needs to improve institutional innovations in the smallholder irrigation sector in South Africa. A positive association was established between belonging to an innovative group and water security, highlighting the importance of institutional innovations in water security. The propensity score matching indicated that water secure irrigators produced an additional 569-622 kg of maize and earned additional income of R2 037.81. The study's findings suggest that organising farmers into groups is a promising strategy to improve farmers livelihoods and water security. The government and private donors should thus continue to promote the formation and organisation of farmers into groups. The innovative agency of the irrigators should be acknowledged and harnessed to strengthen institutional innovations. The focus should be on strengthening the institutions designed by farmers themselves, as these are locally contextualised and socially embedded, and hence legitimate. It is recommended that small groups should be actively promoted, while tailored training should be offered based on groups' specific needs to improve institutional innovations in the smallholder irrigation sector in South Africa. ; Thesis (PhD) -- Faculty of Commerce, Economics and Economic History, 2022

Background: Tuberculosis (TB) is one of the world's leading infectious killers. Every year, an estimated 10 million people fall ill with the disease, of whom 2.9 million people are never diagnosed and treated. Thirty low- and middle-income countries account for almost 90% of the global TB burden. The World Health Organization's (WHO) End TB Strategy highlights active case-finding (ACF) as one approach to finding people with TB who are currently being missed by health services. ACF has been shown to find more people with TB at an earlier stage of the disease compared to passive case-finding. Passive case-finding is the standard approach to TB screening, relying on people seeking care when they have TB symptoms. Given the relatively limited evidence on both the epidemiological impact of ACF and optimal implementation strategies, questions remain about what influences ACF policy development and implementation and how these processes can be improved. This thesis aims to contribute to the knowledge base on ACF policy development and implementation in high TB burden countries. Objectives: To review antecedents, components and influencing factors for ACF policy development and implementation based on the literature. To explore how international experts and National TB Programme (NTP) managers from high TB burden countries perceive ACF policy development and implementation, and to identify facilitators, barriers and "how-to" strategies for ACF implementation in Nepal and Vietnam, which serve as example countries. Methods: A scoping review of the literature (n=73) was performed, and a frequency and thematic analysis applied. Qualitative semi-structured interviews were conducted with 39 experts from a variety of institutions worldwide. The experts' perceptions were analysed using framework analysis. A mixed methods survey with NTP managers (n=23) was implemented, yielding both quantitative and qualitative data. The data were analysed in parallel and merged in the interpretation of the findings. The survey results were further complemented by a narrative review of national TB strategic plans (n=22). Qualitative semi-structured interviews were conducted with 17 key-informants in Nepal and 39 key-informants in Vietnam. Participants comprised implementers of ACF and people with TB identified through ACF. Thematic analysis was applied, using an implementation science framework. Results: The results presented in this thesis provide insights into experiences with ACF, from global policies to local implementation. Study I: The evidence base for ACF has been growing, especially since 2010. Although much is known about factors influencing ACF implementation (e.g., resources), evidence on what influences ACF policy development (e.g., politics) remains scarce. Articles described the WHO's recent emphasis on ACF as a crucial antecedent of the increasing interest in ACF, especially in high TB burden countries. Study II: Experts had a wide range of views on ACF, from ACF being a "waste basket" for resources to it being "common sense" and something that should be done. They described the influence of and "power plays" between donors, governments and non-governmental organisations on ACF policy development and highlighted the need for different types of evidence to inform ACF policy development and implementation. Experts also stressed the importance of existing systems, processes and experience in influencing ACF implementation, e.g., ACF could build on experience from other screening programmes. Study III: Perceived benefits of ACF were linked to its objective of finding people with TB early, while ACF was also perceived as a "doubleedged sword" that could cause harm, if inappropriately designed and implemented. Study IV: NTP managers unanimously agreed on the need for ACF scale-up in high TB burden countries. This was also reflected in the national TB strategic plans, even though not all documents included explicit aims and targets related to ACF. At the same time, 90% of the NTP managers also described a lack of financial and human resources for ACF. Strategies to increase resources included generating local evidence for advocacy. Managers in districts or regions were the only ones among a list of stakeholders that NTP managers considered crucial for both ACF policy development and implementation. Studies V and VI: In Nepal and Vietnam, the main themes revolved around how people (the implementers and people with TB) could "make or break" TB screening, but also how projects could provide a context that is conducive to ACF implementation (e.g., through human resources, equipment and training). Many similar facilitators and barriers for ACF implementation were identified in Nepal and Vietnam, such as the implementers' dedication, motivation, skills and network. Barriers and facilitators at the societal and organisational levels were more context specific. For instance, in Nepal, poverty and community support were mentioned as critical. In Vietnam, participants elaborated on the importance of commitment and support from various stakeholders for ACF implementation. In both countries, the implementers requested increased incentives and training. Conclusions: Based on these results, evidence remains limited with regards to factors influencing ACF policy development. Experts have opposing views on ACF policy development and implementation, while NTP managers unanimously agree on the need for ACF scale-up, which is also reflected in the national TB strategic plans. Yet, 90% of the NTP managers state that human and financial resources are currently insufficient, and funds for ACF might have to be sought from alternative domestic and external sources. Benefits and harms of ACF must be considered throughout the screening and diagnostic pathway to avoid possible negative effects for people screened, as well as communities and health systems. Furthermore, the use of different types of evidence and the engagement of stakeholders (e.g., managers in districts and regions) are necessary to mitigate "power plays" that might otherwise mislead ACF policy development and implementation. Most facilitators, barriers and "how-to" strategies for ACF implementation identified in Nepal and Vietnam are similar across contexts, but there are also nuances, e.g., based on the predominant social determinants of TB. ACF projects can provide a context that is conducive to ACF implementation, but implementation success still depends on individuals. Ultimately, if done well, ACF can be an important, complementary tool to contribute towards ending TB, while more resources and evidence are needed to improve ACF policy development and implementation.