Suchergebnisse

Raportissa tarkastellaan sotilaallisen t&k-panostuksen ja kilpailukyvyn välisiä yhteyksiä. Aineistona käytetään brittiläisen International Institute for Strategic Studies -laitoksen (IISS) "The Military Balance" -raportin tietoja länsimaiden sotilaallisen t&kpanostuksen kehityksestä. Julkisen vallan sotilaallisia t&k-panostuksia verrataan maiden julkisiin siviilipuolen t&k-menoihin, sotilaallisiin hankintamenoihin, sekä suhteessa maiden BKT:hen ja puolustusbudjetteihin. Raportissa on mukana myös tiivis katsaus sotilaallisen t&k-panostuksen ja tuottavuuden välistä yhteyttä kuvaavista kansainvälisistä tutkimuksista. Raportin tulosten mukaan sotilaallisella t&k-panostuksella ja kilpailukyvyllä ei ole suoraa yhteyttä. ; This study discusses the relationship between military R&D and competitiveness. The study is based mainly on a British International Institute for Strategic Studies -institutes publication "The Military Balance", and furthermore its information about the development of Western countrye´s military R&D-stakes for the years 1994 -2001. Government military R&D is compared for government R&D, defence expenditure and also to the countries gross domestic product and defence budgets. The study also includes tight review about the previous international studies, which are focused to study the relationship between military R&D and productiveness. The study concludes, that there are no direct connection between military R&D and competitiveness.

Корупција представља једну од најважнијих тема међународне политике сузбијања криминалитета. Управо нас она упућује, заједно са савременим облицима коруптивног деловања, на потребу увођења одговорности правних лица за дела корупције. Дуго година владајућа максима societas delinquere non potest, која је одбацивала идеју о кривичној одговорности правних лица, у савременом кривичном законодавству је доведена у питање. О неопходности законског уређења проблематике одговорности правних лица за кривична дела говоре многобројни међународни документи које је наша земља ратификовала и на тај начин преузела обавезу имплементације норми међународног права. Овом приликом проблематизујемо питање које се односи на одговорност правних лица за кривична дела и кривичноправно сузбијање корупције. На овом месту размотрићемо да ли је потребно да се говори о кривичној одговорности правних лица, или је примереније терминолошки и са становишта теорије говорити о казненој одговорности правних лица. ; Corruption is considered a social problem not only in Serbia. This phenomenon is given more and more attention at the international level as well. This primarily means coordinated efforts in opposing this obstacle and threat to the development of every country. It is surprising how material-criminal legal norms were narrowly determined in the field of one of the most important topics of international and national policy of crime suppression. For decades, and particularly thanks to sensations of the last years, the practitioners, especially those in the field of judiciary and police, have been warning of corruption and the need of its suppression and limiting. The connection between corruption and organized crime has intensified even more the discussions on counter measures that could be incorporated into the existing laws and remove their weaknesses. Every country should undertake a number of measures and activities in the field of battle against corruption taking into account the international standards in this field. These measures may be of preventive or repressive character. This paper deals with criminal legal intervention that represents ultima ratio, i.e. the last resort that should not be used until all other means and manners to protect someone have been exhausted. Our legislator has responded in the meantime, removed the most important flaws that distort the picture about our criminal legal regulations and incriminated corruptive behaviour, taking into account at that the obligations undertaken based on international conventions. Very delicate field of the responsibility of legal persons for criminal act remains unregulated. In this paper we point out to the need and state the reasons, with parallel study of the achieved solutions in some countries and Anglo-Saxon and continental legal culture, why the issue of responsibilities of legal persons for acts of corruption and even more widely should be regulated by a separate law.

This paper is an analysis of the foreign Aid Policies of two OECD Development Assistance Committee member countries – Finland and Ireland. The analysis reveals that both Finland and Ireland share high principles on their relations with the developing world, although their current policy outlooks appear to differ significantly. Despite Finland's good economic performance and prosperity largely generated by the global demand and market access, the government has so far failed to include the increasing of ODA on its priority agenda. In addition to the declining commitment, the selection criteria for Finnish aid recipients appears to be partially commercially motivated. Ireland on the other hand has a solid record of targeting the poorest of the poor with its development assistance and has recently increased development country focus in national policies. The challenge for Ireland is the effective utilisation of these funds and even more importantly keeping the government's public, international commitment to the 0,7 percent recommendation level despite the possible future slowdown of the economy.

Докторска дисертација «Русија на почетку XXI века – геополитичка анализа» је рад који се састоји из шест делова. У првом делу «Теоретско – методолошки увод» је постављена методолошко појмовна основа рада, извршен преглед досадашњих истраживања на ову тему и сабрани и анализирани потребни извори и литература. Други део «Физичко – географске одлике територије данашње Русије» се бави анализом и вредновањем рељефа и педолошког покривача, климе, хидрографског потенцијала, биљног и животињског света, те рудног и енергетског блага на подручју савремене Русије. Док су први и други део рада квантитативно невелики (слично петом и шестом делу), трећи и четврти део обухватају највећи део дисертације. Трећи део «Историјска анализа геополитичке позиције Русије» се бави територијалним развојем руске државе кроз историју, при чему су анализирани и остали геополитички значајни фактори генезе њеног историјског положаја. Посебно је посматран утицај који су на Русију кроз историју имали континенти на којима се распростире, а извршена је и анализа билатералних историјских односа са најзначајнијим суседима и светским силама, где су уочене и извесне геополитичке правилности (по историчару Броделу то би биле историјске појаве «средњег» и «дугог трајања»). Четврти део «Геополитичка позиција савремене Русије» анализира данашњу Русију са унутрашње и међународне позиције. У оквиру унутрашње позиције се анализира економија, демографија, социолошка структура, култура и унутрашњо – политичка позиција савремене руске државе. У односу на окружење се анализира укупна позиција Русије у свету и посебно у односу на суседе и поједине важне државе (са свим државама Европе и Азије и са најважнијим силама на другим континентима). Пети део «Перспективе Русије у следећим деценијама XXI века» садржи основне елементе предвиђања унутрашњег развоја земље, као и њену позицију у светским токовима. Шести део је прегледни «Закључак». ; Doktorska disertacija «Rusija na početku XXI veka – geopolitička analiza» je rad koji se sastoji iz šest delova. U prvom delu «Teoretsko – metodološki uvod» je postavljena metodološko pojmovna osnova rada, izvršen pregled dosadašnjih istraživanja na ovu temu i sabrani i analizirani potrebni izvori i literatura. Drugi deo «Fizičko – geografske odlike teritorije današnje Rusije» se bavi analizom i vrednovanjem reljefa i pedološkog pokrivača, klime, hidrografskog potencijala, biljnog i životinjskog sveta, te rudnog i energetskog blaga na području savremene Rusije. Dok su prvi i drugi deo rada kvantitativno neveliki (slično petom i šestom delu), treći i četvrti deo obuhvataju najveći deo disertacije. Treći deo «Istorijska analiza geopolitičke pozicije Rusije» se bavi teritorijalnim razvojem ruske države kroz istoriju, pri čemu su analizirani i ostali geopolitički značajni faktori geneze njenog istorijskog položaja. Posebno je posmatran uticaj koji su na Rusiju kroz istoriju imali kontinenti na kojima se rasprostire, a izvršena je i analiza bilateralnih istorijskih odnosa sa najznačajnijim susedima i svetskim silama, gde su uočene i izvesne geopolitičke pravilnosti (po istoričaru Brodelu to bi bile istorijske pojave «srednjeg» i «dugog trajanja»). Četvrti deo «Geopolitička pozicija savremene Rusije» analizira današnju Rusiju sa unutrašnje i međunarodne pozicije. U okviru unutrašnje pozicije se analizira ekonomija, demografija, sociološka struktura, kultura i unutrašnjo – politička pozicija savremene ruske države. U odnosu na okruženje se analizira ukupna pozicija Rusije u svetu i posebno u odnosu na susede i pojedine važne države (sa svim državama Evrope i Azije i sa najvažnijim silama na drugim kontinentima). Peti deo «Perspektive Rusije u sledećim decenijama XXI veka» sadrži osnovne elemente predviđanja unutrašnjeg razvoja zemlje, kao i njenu poziciju u svetskim tokovima. Šesti deo je pregledni «Zaključak». ; The doctor dissertation named "Russia in the beginning of the 21th century – geopolitical analyses" is the work which is consisting of the six parts. In the first part "Theoretical methodological introduction" is a setup of the methodologicaly conceptual basis of this work and noticed previous researches of this subject matter and summarized and analyzed the resources and literature. The second part of the work "Phiysical and geographical attributes of the nowdays Russian territory" engages in analyzing and valuing relief and soil cover, climate , hidrographycal potential, wildlife, mineral and energy resources of nowdays Russia. While the first and the second part of this work quantitative are a small (alike the fifth and the sixth parts of the work ) the third and the fourt parts borders is the largest part of dissertation . The third part of the work "An historical analyses geopolitical positions of Russia" engages in territorial development of the Russian Government trough its history whereat are analyzed another geopolitically important factors of genesis its historical position. Especially is observed influence to Russia by continents of its broadcasting and noticed some analyses of the bilateral historical attitudes to the most important neighbourhood and other major world powers , where is noticed some geopolitically regularities (accordin to a famous historian Brodel there are a historical apparations named a period of medium-sized duration and a period of long- sized duration) . The fourth part of the dissertation "Geopolitical position of modern Russia" analyzes nowdays Russia in domestic policy and international context .Within interior position is analysing economy, demography, social structures, culture, and domestic policy position of modern Russia. Concerning to surroundings is analysing position of Russia in wholle especially concerning to the neighbourhood and some important countries ( and all countries of Europe, Asia, and the most important powers of other continents). The fifth part "Perspective of Russia in the next decades of the 21 th century" conteins a basic elements of the anticipations of internal development and Russia's position in the world. The sixth part is a previewed "Epilogue".

Diskriminacija kao česta pojava na ovim prostorima jedan je od najozbiljnijih problema sa kojima se susreću pripadnici i pripadnice marginalizovanih grupa. Netolerantnost društva u kome živimo dodatno otežava proces borbe protiv nje. Sistemska rešenja državnih institucija po pitanju koncepta antidiskriminacije, godinama nisu postojala. Veliko zalaganje pojedinih nevladinih organizacija kao i usmerenost ka evropskim integracijama, doprineli su da tokom nekoliko poslednjih godina, pomalo stidljivo i diskretno koncept antidiskriminacije počne da se ugrađuje i u ciljeve i strategiju naše države. Inkluzivni pokret u svetu nastaje sredinom prošlog veka ključna ideja formulisana je još 1948. godine u Univerzalnoj dekleraciji o ljudskim pravima a zatim 1989 u Konvenciji o pravima deteta. Kasnije se ovaj okvir razrađuje u drugim dokumentima Ujedinjenih nacija i nizu drugih međunarodnih dokumenata, u kojima su formulisane strateske smernice i standardna pravila izjednačavanja položaja marginalizovanih i isključenih grupa, posebno u pogledu ostvarivanja prava na obrazovanje. ; Discrimination, which can frequently be seen in this region, is one of the most austere problems being faced by the members of both genders of marginalized groups. The intolerance of the society we live in additionally procrats the process of fighting against it. Systematic solutions from state institutions related to the concept of anti-discrimination have not existed for years. Great efforts from certain nongovernmental organizations as well as their focus on European integrations have contributed in the last couple of years to shy and discreet embedding of antidiscrimination concept into the goals and strategies of our country. The inclusive movement in the world originated in 1950s while the key idea was formulated as early as 1948 in the Universal Human Rights Declaration and then in 1989 in the Convention on Children's Rights. Later, this frame has been elaborated in other United Nations documents and in numerous other international documents ...

26. jula 1963. godine katastrofalni zemljotres u Skoplju u kome je stradalo mnoštvo Ijudskih života i porušen ogroman broj zgrada, teško je pogodio i članove skopske Jevrejske opštine, a opštinsku zgradu demolirao i onemogućio njeno korišćenje. Zahvaljujući udruženim naporima i moralnoj podršci društveno-političkih faktora grada Skoplja, Saveza jevrejskih opština Jugoslavije, kao i jevrejskih međunarodnih humanitarnih organizacija i zajednica, jevrejska zajednica u Skoplju dobila je ponovo svoj dom, Jevrejski dom "dr Albert Vajs". Njegovo svečano otvaranje obavljeno je 11. oktobra 1966. godine, kao jedno od niza svečanosti organizovanih na dan jubilarne 25-godišnjice ustanka makedonskog naroda protiv fašističkog okupatora. Time su simbolizovani nastavak i obnavIjanje kontinuiranog rada ove Opštine i njena utkanost u kulturnu, političku i ekonomsku istoriju grada Skoplja. ; On July 26, 1963, the disastrous earthquake in Skoplje, which caused many human losses and destroyed the better part of the town, hit severely the members of the Jewish Community and demolished the Community building which had to be put out of use. Due to the united efforts, the moral and material assistance tendered by the social-political organizations of the city of Skoplje, the Federation of Jewish Communities in Yugoslavia, as well as by Jewish international humanitarian organizations and Jewish communities, the Skoplje Jewish Community received again its Home, the "Dr Albert Vajs Community Centre". The inauguration ceremony took place on October 11, 1966, in the frame of the celebrations honouring the 25th anniversary of the Uprising of the Macedonian people against the fascist occupation forces. This symbolized the continuation and renewal of this Community's activities and her kinship with the cultural, political and economic history of the City of Skoplje. ; Während seiner jahrzehnten langen Zrenjaniner und Banater Heimatforschungen wurde der Publizist und Historiker-Amateur Dragoljub Čolić (1908-1982) am meistens mit der Vergangenheit der jüdischen Volksgemeinschaft in diesem Gebiet beschaftigt. Er sammelte eifrig die auf die Banater Judentum bezüglichen historischen Quellen, sowie mundlichen Zeugnisse seiner jüdischen Mitbürgern; er verfasste verschiedenen statitischen auf die Juden betreffenden Übersichten und Listen, sowie zahlreiche Werke uber das Zrenjaniner und Banater Juden. In diese riesigen Forschungs- und Schaffungsprozessen, trat Čolić in Verbindung mit den bedeutenden gleichgesinnten und gleichwirkenden Personlichkeiten des judischen kulturellen und öffentlichen Lebens, nicht nur in Jugoslawien, sondern auch im Ausland (Israel). Aus dieser Kontakten entwickelte sich eine rege, inhaltsreiche und regelmaßige Korrespondenz, die heute innerhalb Čolić'schen Nachlass im Historischen Archiv Zrenjanin aufbewahrt ist (Archivbestand Nr. 667). Er wechselte Briefe mit dem Verein der jüdischen Kultusgemeinden Jugoslawiens, ferner mit Kuratorin des Jüdischen historischen Museum in Belgrad Vidosava Nedomački, sowie mit Yakir Eventov und Zwi Asaria aus Israel. Alle bis heutzutage hintergebliebenen Briefe zeigen eine rastlose und unermudliche Forschung- und Schaffungsnatur, sowie ein unerschopfendes Enthusiasmus für die Geschichte der Banater Juden, deren entsprechende Anerkennung jedoch bis heute ausgeblieben ist und deren Fruchte leider wenig bekannt und sehr unterschatzt sind. Deswegen ist die Herausgabe von Čolić'schen sehr interessanter jüdischen Korrespondenz, womit jüdische Kultusgemeinde in Zrenjanin ein Vierteljahrhundert-Jubilaum ihrer 1994-er Erneuerung feiert, nur ein Pladoye für die Veröffentlichung seiner sammtlichen Werken über die hiesigen Juden. Zweifellos wurde damit die große Lücke in ihrer Heimatgeschichte ausgefüllt worden sein.

VTT Symposium 191 ; Energian ja ympäristön leikkauskohdassa on viime vuosina tapahtunut suuria mullistuksia. Energiamarkkinat ovat vapautuneet ja osana kestävään kehitykseen pyrkimystä ekologinen ajattelu on saanut jalansijaa myös perinteisessä markkinataloudessa, tyyppiesimerkkinä vihreän sähkön käsite ja kierrätys. Ympäristöproblematiikassa on siirrytty megasarjaan, esimerkiksi ilmastokysymyksessä eletään suurten päätösten aikaa. Energia- ja ympäristöteknologian myynnissä myyjältä vaaditaan yhä enemmän osaamista. Tuotteiden käytön pitkäaikaiset ympäristöominaisuudet vaikuttavat ratkaisevasti kaupan syntyyn. Perinteisen kovan teknologian rinnalle tarvitaan uutta innovatiivista pehmoteknologiaa. SIHTI-ohjelma on paneutunut näihin kysymyksiin niin sanotuilla strategisilla selvityksillään. Ympäristönsuojelun ohjaukseen tarvittavaa tietoutta on luotu lukuisissa ympäristövaikutusten arvottamiseen liittyvissä hankkeissa sekä talouden ja ympäristönsuojelun optimia hakevissa selvityksissä. Yritystasolla tehtävää ympäristölaskentaa varten on luotu uusia työkaluja ja menetelmiä ja päästöpörssien monulotteisia vaiktuksia on analysoitu. Poliittisen päätöksenteon tueksi on kehitetty kasvihuonekaasujen kehitystä kuvaavia indikaattoreita ja analysoitu vaihtoehtoisten päästörajoitustekniikoiden kustannuksia ja tehokkuutta. SIHTI-ohjelmassa savukaasujen puhdistustekniikka-alueelle on syntynyt oma vahva tutkimuskokonaisuutensa, jonka ympärille on kehittynyt kansainvälisestikin arvostettuja tutkimusryhmiä. Pienhiukkasten tärkeimpiä päästölähteitä on kartoitettu, koostumuksia ja kokojakaumia mitattu ja erilaisia keinoja vaikuttaa pesureitten ja sähkösuodattimien erotustehokkuuteen tutkittu. Tutkimusryppääseen on kuulunut sekä teoreettisia mallinnuslaskelmia, laboratoriomitan laiteteknistä kehitystyötä että täyden mitan koetoimintaa. Osoituksena onnistuneesta panostuksesta on, että tutkimustuloksia on jo voitu hyödyntää kaupallisesti ja täyden mittakaavan laitetoimituksia ulkomaille on jo toteutettu. Uusia innovatiivisia teknisiä ratkaisuja ympäristöpäästöjen mittaamisella on myös kehitetty. Metsäteollisuuden ympäristövaikutusten hallinnan parantamiseksi on ohjelman puitteissa perusteellisesti mitattu ja mallinnettu haitallisten aineiden kulkeutumista eri virroissa ja prosessiyksiköissä sekä tutkittu ja kehitetty uusia säästävän teknologian ratkaisuja mm. sellutehtaan vesikiertojen sulkemiselle, viherlipeäsakan ja tuhkan hyödyntämiselle sekä siistauslietteen ja jätepaperin poltosta syntyvän tuhkan kierrättämiselle. Turvetuotannon valumavesien sekä pöly- ja melupäästöjen paremmalle hallinnalle on kehitetty uusia menetelmiä ja ohjeita, joita on jo otettu käyttöön. Vaihtoehtoisia ratkaisuja käytettyjen turvetuotantoalueiden jälkikäytölle on niin ikään tutkittu. Poikkitieteellisen lähestymistavan takia SIHTI-ohjelma on pyrkinyt tiedottamaan tutkimustuloksistaan mahdollisimman laajasti. Ohjelman vuosiseminaari ja sen yhteydessä pidettävät istunnot energiantuotannon päästöjen ympäristövaikutuksista, pienhiukkasten erottamisesta ja kiinteiden jätteiden hyötykäytöstä suovat oivallisen tilaisuuden niin esitelmänpitäjille kuin kuulijoillekin antaa oman panoksensa meitä kaikkia hyvin läheisesti askarruttavaan kysymykseen, mikä on oikea tie ja etenemistapa kestävään energiantuotantoon. ; Great revolutions have taken place in the intersection of energy and environment in recent years. The energy market has been liberated, and in part of sustainable development, an ecological pattern of thought has gained a footing in traditional market economy, typical examples being green electricity and recycling. As regards environmental problems, we have moved towards a mega-league; for example, we are living an era of great resolutions on environmental issues. More diversified knowhow is required from the sellers of energy and environmental technology. Long-term environmental impacts of the use of products are of decisive significance in business transactions. New innovative soft-line technology is required in addition to conventional hard technology. The Finnish National SIHTI Programme has attended to these issues via so-called strategic surveys. Knowledge required for the control of environmental protection was created in a number of projects on evaluation of environmental impacts and in assessments searching an optimum for economy and environmental protection. New tools and methods were developed for environmental accounting in enterprises, and diversified impacts of emission exchange were analysed. Indicators describing the development of greenhouse gases were developed and costs and efficiency of alternative technologies for limiting emissions were analysed to support political decision-making. In the SIHTI Programme, a strong research integrity was formed in the field of flue gas cleaning technology, and research groups with a high international esteem were also formed. Most significant emission sources of particulates were surveyed, their composition and particle size distributions were measured, and different tools of improving the separation capacity of scrubbers and electrical precipitators were studied. This research integrity included both theoretical modelling calculations, laboratory-scale equipment-technical development and full-scale testing. An indicator of successful focusing is that research results have already been utilised commercially, and industrial-scale equipment commissions have been executed. New innovative technical solutions for measuring emissions to the environment have also been developed. To improve the control of environmental impacts of the pulp and paper industry, the transportation of detrimental substances in different flows and process units were measured and modelled, and new solutions of non-waste technology were developed for closed water cycles in pulp mills, for the use of green liquor sludge and ash and for the recovery of ash from the combustion of deinking sludge and waste paper. In peat production, new methods and instructions were developed and introduced for the control of drainage waters and for dust emissions and noise problems. After-use alternatives for exhausted peat production fields were also studied. Due to the interdisciplinary approach, the SIHTI Programme has disseminated information about research results as widely as possible. The Annual Seminars of the Programme, and sessions on environmental impacts of emissions from energy production, separation of particulates, and utilisation of solid wastes have offered excellent opportunities to the lecturers and to the audience to bring their own contribution to the issue occupying our mind: what would be the right way of approaching sustainable energy production.

Pro gradu ­tutkielma koostuu seuraavista osista: Rouvinen, Kaisa. Lisääntymisterveydenhuollon haasteet ja naisten hyvinvointi vähiten kehittyneissä maissa. Tampereen yliopisto. Terveystieteen laitos. Kirjallisuuskatsaus. Osasuoritus Pro gradu ­tutkielmaan. 26 s. 2003 Rouvinen, Kaisa. Quality of care in reproductive health services at health posts in Nepal. International EuroQuan Conference on Quality and Nursing Practice. Proceedings. Norsk sykepleieforbund. 1997; 224-231. Rouvinen, Kaisa. Quality of care in reproductive health services at five government health posts in Siraha District, Eastern Nepal. A dissertation submitted to the University of Liverpool (School of Tropical Medicine) in partial fulfilment of the degree of Master in Community Health. 95 pages. 1996 ; 1. JOHDANTO 6 2. LISÄÄNTYMISTERVEYS KEHITYKSEN INDIKAATTORINA 7 3. NAISEN ELÄMÄN TÄRKEÄT JA KRIITTISET VAIHEET 10 3.1. RASKAUS JA SYNNYTYS - TURVALLISEN ÄITIYDEN TAVOITE 10 3.2. PERHESUUNNITTELU JA ABORTTI 15 3.3. HIV JA MUUT SUKUPUOLITAUDIT 17 3.4. LAPSETTOMUUS JA LAPSEN SUKUPUOLI 19 3.5. SUKUPUOLIELINTEN TRADITIONAALINEN SILPOMINEN 20 3.6. KÖYHYYDEN, TRADITIOIDEN JA OLOSUHTEIDEN MERKITYS 22 4. HAASTEET JA MAHDOLLISUUDET 23 LÄHTEET 26 QUALITY OF CARE IN REPRODUCTIVE HEALTH SERVICES AT FIVE GOVERNMENT HEALTH POSTS IN SIRAHA DISTRICT, EASTERN NEPAL ACKNOWLEDGEMENTS 1 TABLE OF CONTENTS III LIST OF TABLES VI LIST OF FIGURES VII LIST OF ABBREVATIONS AND ACRONYMS VIII GLOSSARY IX EXECUTIVE SUMMARY X CHAPTER 1. INTRODUCTION 1 1.1. THE CLIENT AND THE CONCERN 1 1.1.1. Save the Children US in Nepal 1 1.1.2. Save the Children Siraha project 1 1.1.3. Problem statement 2 1.2. THE STUDY 2 1.2.1. Study question 2 1.2.2. Aim and objectives of the study 2 1.2.1. Action plan and accomplishment of the study 3 1.3. STUDY LOCATION 4 1.3.1. Nepal 4 1.3.2. Siraha District 4 CHAPTER 2. LITERATURE REVIEW 6 2.1. GLOBAL VIEWS OF WOMEN'S HEALTH 6 2.2. PRIMARY HEALTH CARE IN NEPAL 8 2.2.1. Safe Motherhood and Family Planning 8 2.3. QUALITY IN HEALTH CARE 10 2.3.1. What is quality? 10 2.3.2. Approaches to assessment of quality in health care 10 2.4. SELECTED ISSUES IN QUALITY OF HEALTH CARE 14 2.4.1. The structure of the health care and its relevance in quality assessment 14 2.4.2. Health care providers' job motivation and its impact on quality of health care 15 2.4.3. User satisfaction 16 2.5. CONCLUSION 17 CHAPTER 3. METHODOLOGY 19 3.1. EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 20 3.1.1. Study location 20 3.1.2. Selection of health posts 20 3.1.3. Issues and variables used to explore the objective 20 3.1.4. Tools and strategies of data collection 20 3.2. EXPLORING HEALTH CARE PROVIDERS' PERCEPTIONS ABOUT THE QUALITY OF CARE 21 3.2.1. Study population 21 3.2.2. Selection of informants 21 3.2.3. Issues and variables used to explore the objective 21 3.2.4. Tools and strategies of data collection 21 3.3. DESCRIBING THE LEVEL OF USERS' SATISFACTION 22 3.3.1. Study population 22 3.3.2. Selection of informants 22 3.3.3. Issues and variables used to explore the objective 22 3.3.4. Tools and strategies of data collection 23 3.4 ADDITIONAL DATA COLLECTION METHODS 24 3.5. PRE-TESTING AND TRANSLATION 24 3.6. DATA HANDLING AND STORAGE 25 3.7. DATA ANALYSIS 25 3.8. QUALITY ASSURANCE AND ENCOUNTERED CONSTRAINTS IN DATA COLLECTION 25 CHAPTER 4. RESULTS 27 4.1. EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 27 4.1.1. Location and accessibility 27 4.1.2. Target population and service statistics 27 4.1.3. Sub-health posts, outreach clinics and staffing 28 4.2.4. Waiting facilities at health posts 28 4.1.5. Rooms for counselling and MCH and FP services 28 4.1.6. Infection prevention 29 4.1.7. Equipment and instruments for use in MCH and FP 29 4.1.8. Availability of contraceptives and essential medicines 29 4.1.9. IEC material and activities 29 4.1.10. Record keeping and reporting 30 4.1.11. Health post management and supervision 30 4.1.12. Conclusion 30 4.2. HEALTH CARE PROVIDERS' PERCEPTION ABOUT THE QUALITY OF CARE 31 4.2.1. Job satisfaction and experience as a health care provider 31 4.2.2. Health workers' perception of what is good quality in health care 32 4.2.3. Health workers' perception about users' expectations 33 4.2.4. Health workers' suggestions for improvement of health care 33 4.2.5. What are the specific reasons for low utilisation of FP and AN services 34 4.2.6. Conclusion 35 4.3. QUALITY OF CARE FROM THE USERS' POINT OF VIEW 35 4.3.1. The sample 35 4.3.2. Perceptions of the quality of care 37 4.3.3. Suggestions for improvement for the quality of care at a health post 40 4.3.4. Conclusion 40 4.4. SUMMARY OF RESULTS 41 CHAPTER 5. DISCUSSION 43 5.1. IMPACTS OF STRUCTURE OF HEALTH CARE ON QUALITY OF THE SERVICE 43 5.1.1. Accessibility 43 5.1.2. Clinical settings and procedures 44 5.1.3. Service arrangements 44 5.2. HEALTH WORKERS' ROLE 47 5.2.1. Users' expectations contradicting providers' perceptions 47 5.2.2. Implications of health workers' perceptions for improvement of quality 48 5.2.3. Job motivation 48 5.2.4. Quality assurance cycle 50 5.3. CONCLUSIONS 50 5.4. COMMENTS ON METHODS USED IN THE STUDY 51 CHAPTER 6. RECOMMENDATIONS 53 REFERENCES 54 APPENDICES APPENDIX 1 PHOTPGRAPHS: WALL PAINTINGS AND TBA TRAINING 58 APPENDIX 2 MAPS OF NEPAL AND SIRAHA DISTRICT 59 APPENDIX 3 INVENTORY FORM FOR HEALTH POST FACILITIES 60 APPENDIX 4. BACKGROUND VARIABLES 70 APPENDIX 5.A STRUCTURED QUESTIONNAIRE FOR USER EXIT INTERVIEW 71 APPENDIX 5.B MAITHALI TRANSLATION OF THE QUESTIONNAIRE 75 APPENDIX 6 EVALUATION OF HEALTH POST FACILITIES AND SERVICE ARRANGEMENTS 79 APPENDIX 7. FINDINGS FROM HEALTH PERSONNEL IN-DEPTH INTERVIEWS 84 APPENDIX 8. USERS' EXPRESSIONS OF THE QUALITY OF CARE. QUOTATIONS. 85

Marxismin mukaan kapitalistisen yhteiskunnan jäsenet jakaantuvat kolmeen luokkaan: porvaristoon, keskiluokkaan ja työväenluokkaan. Jotkut marxismin tukijat jakavat keskiluokan talonpojistoon ja muuhun keskiluokkaan. Talonpojisto on vähenevä luokka. Koska marxismin luokkateorian mukaan poliittiset puolueet vaalivat yhteiskuntaluokien intressejä, tutkin pitääkö tämä väite paikkansa. Ensin selvitin marxilaisen teorian luokista ja niiden intresseistä eli eduista, joiden puolustamiseski luokat järjestäytyvät poliittisiksi puolueiksi. Ne laativat itselleen yhteiskuntapoliittiset ohjelmansa, joita ne pyrkivät politiikansa avulla toteuttamaan. Tutkimusaineistona käytän Suomen eduskunnassa tutkimusvuosina edustettina olelleiden puolueiden tavoite- ja yleisohjelmia, joista selvitän sisällön analyysiä käyttäen niiden sisällön ja julkilausutut tavoitteet. Erityisesti pyrin selvittämään orientoituvatko puolueet ohjelmissaan tiettyjen luokkien etujen puolustajiksi vai missä määrin ne esiintyvät yhteiskunnan yleisten etujen vaalijoina. Tutkimus tapahtuu toisaalta puolueiden eduskuntoimintaa selvittämällä. Tällöin pyrin saamaan selville sen toimivatko puolueet periaate- ja tavoiteohjelmiensa mukaisesti laatiessaan lakialoitteita eduskunnassa. Kolmantena tutkimuskohteena on hallituksen esitysten sisällön eritteleminen intressiorientaation pojalta. Kysymys kuuluu palvelevatko hallituksen esitykset yleistä vai luokkien erityisetuja. Tutkimuksessa selvisi, että puolueet niin ohjelmalausumissaan kuin eduskuntatoiminnassaan vaalivat sekä yleistä etu, josta käytän nimitystä luokkien yhteisetu, että luokkien erityisetuja. Eniten puolueet vaalivat yhteisetua. Erityiseduista puolueet vaalivat kukin tiettyä luokkaetua enemmän kuin toista. Tämän perusteella puolueet jakaantuvat ensijaisesti porvariston, keskiluokan ja työväenluokanetuja vaaliviksi. Hallituksen esityksissä luokkaorientaatio on heikompaa kuin kansanedustajien lakialoitteissa. Tutkimustuloksistani selviää myös se, että vaikka puolueet ovat viime vuosikymmeninä ottaneet vaaliakseen aikaisempaa enemmän kaikkien luokkien intressejä ja niiden yleispuolueominaisuudet ovat lisääntyneet, tietty luokkaorientaatio on säilynyt. ; Classes continually alter and influence party strategies and also the behaviour of voters. The members of classes form economic, professional and political organisations. Every class aims to exert the greatest influence upon the state with the help of its political party. This study researches the class basis of political competition, the effect of class interests on the policies of nine Finnish parties in their political programmes and initiative work in the Parliament. The investigation is based on historical materialism and its class structure theory developed by Karl Marx, Friedrich Engels and other Marxists. The aim of study is to estimate how appropriate the class schema of historical materialism is for analysing the political partisanships and ideological conflicts in advanced industrial society. The statements and aims of political party programmes are put into practice in Parliament. This research analyses how parties represent their aims in their political programmes and what their parliamentarians do in Parliament. Is a party the representative of one class or does it equally promote the interests of many classes? Is it a class party or a generally oriented party? As in historical materialism, the programmes and legislative initiatives have been classified into five groups. The first group contains general class interest, oriented towards the common good. The next four groups comprise bills with a specific class interest orientation: bourgeoisie, the middle class, farmers and workers. The parties investigated are The National Coalition Party /The Conservative Party, The Swedish People`s Party, The Finnish Centre Party, The Finnish Social Democratic Party, The Left Alliance, The Liberals, The True Finns, The Christian Democratic Party and The Greens. The changes in politics and in party relationships over thirty years are investigated by comparing the parliamentary actions of parties from the 1960´s to the 1990´s. The study concerns the legislative initiatives of the years 1965, 1972, 1988 and 1999. The data on the programmes were collected from the two political programmes of nine parties from the years 1950 2003. The programmes of political parties are the public flag of the party as Engels expressed it, although their programmes have lost some of their class orientation. In the programmes of all nine political parties the contents aiming at the common good are the first, most important aim, the percentages being 76 98 %. Differences in the programmes of the political parties can still be found. The political parties emphasise their interests and aims in their own ways. The Conservative Party, The Swedish People´s Party and The Liberals have the next important interest in the bourgeoisie. The Swedish People´s Party, The Finnish Centre Party and The True Finns emphasise the middle class and the farmers. The Finnish Social Democratic Party, The Left Alliance and The Greens take care of working class. The main task of Parliament is to enact legislation. Bills can be submitted to Parliament by the Government or as private members bills. In this process the class interests notably emerge in private members bills of plenary sessions. The main Finnish political parties took into consideration the interests of all classes. All nine parties have made in the largest extent common good legislative initiatives. For all nine parties, the most prevalent type of legislative initiatives was those for the common good (84 -67 %). At the same time they tended to favour special class interests. The least specific class parties were The Christian Democratic Party, The Green Party and The Swedish People´s Party. Among special class interests all the parties oriented more to middle class interests in Parliament than in their declared objectives (18.8 7.0 %). The Liberals, The Conservative Party, The Social Democratic Party, The Left Alliance and The True Finns had the strongest middle class orientation. The Conservative Party were the most bourgeois party (10.2%). The strongest working class interest was found in The Left Alliance, The Social Democratic Party and The Green Party (18.8 13.1 %). The Finnish Centre Party and The Social Democratic party, The Left Alliance and The True Finns were closest to working class interests. Are there class oriented differences in the contents of the legislative initiatives and political programmes of the nine political parties? The contents were classified into eleven groups: administration, civil rights, nature conservation, economics, occupation structure, social policy, public health, education, culture, labour market and international affairs. All nine parties have the same three most important contents of legislative initiatives. These were finance/economics, social policy and administration systems. And all nine parties were more interested in financial and economic aims than their political manifestos suggest. The fourth important content for The Conservative Party, The Swedish People`s Party, The Liberals and The Christian Democratic Party was education. Employment was the fourth aim of The Finnish Centre Party and The True Finns. The Labour Market was also important to The Finnish Social Democratic Party, The Left Alliance and The Greens. Nature conservation was important to The Greens, too. The contents of government bills are more oriented towards the common good than are the private members bills. The conclusion is that the main Finnish political parties took the interests of all classes into consideration. At the same time they reveal preferences for special class interests. This emerges in political manifestos and legislative initiatives and government proposals. The Finnish political parties are not purely general parties devoid of class background. Finance and economics was the basis upon which the people arranged their lives and formed political opinions. The class structure of historical materialism is suitable to demonstrate political partisanship in Finland during the second half of the twentieth century. Social changes affect both the class structures and the political aims of parties and give rise to social and ideological conflicts in advanced industrial societies. The consensus policy is one appearance of civilized class struggle.

Kansalaisosallistuminen YVA-menettelyssä Ympäristövaikutusten arviointimenettelyn (YVA) yksi keskeinen tavoite on lisätä kansalaisten tiedonsaantia ja osallistumista ympäristövaikutuksiltaan merkittävissä hankkeissa. YVA-menettelyllä pyritään tuomaan kansalaisten näkemykset, huolet ja toiveet mukaan suunnitteluun ja päätöksentekoon mahdollisimman varhaisessa vaiheessa. YVA edustaa väitöstutkimuksessa modernia vuorovaikutteista ympäristöpolitiikan ohjauskeinoa ja osallistumisen välinettä. Väitöstyön ensimmäisenä tutkimustehtävänä oli luoda YVAan osallistumisen analyysille teoreettinen viitekehys: millaista demokratia- ja suunnitteluideaa YVA voi edustaa ja millainen politiikkaverkosto YVA on kansalaisosallistumisen kannalta. Toisena tutkimustehtävänä analysoitiin YVAan osallistumisen historiallista kehittymistä ja muutoksia Suomessa. Kolmantena tutkimustehtävänä tarkasteltiin osallistumisen käytännön toteutusta sekä arvioitiin osallistumisen vaikuttavuutta. Lisäksi analysoitiin vaikuttavuuden mahdollisia esteitä, miten läpinäkyviä ja avoimia YVA-menettelyt ovat ja miten hyväksyttävänä osallistumisvälineenä YVAa pidetään. Osallistumisen kannalta olennainen seikka on YVAn institutionaalisuus: se on julkishallinnon luoma väline, jonka lisäksi toimenharjoittajalla on keskeinen YVA-menettelyn käytännön toteuttajan rooli. Tämä luo osallistumisen kannalta rakenteita, joissa korostuu toimijoiden väliset epäsymmetriset valta-asemat. YVA-menettelystä tulee helposti kaikille osapuolille vallan käytön ja politiikan tekemisen väline ja niin osallistumisen järjestämistä kuin itse osallistumista ohjaavat toimijoiden poliittiset intressit ja tavoitteet. YVA on parhaimmillaan eri osapuolten välinen avoin keskusteluareena, joka lisää suunnittelun ja päätöksenteon läpinäkyvyyttä, mutta YVA on myös poliittisen kamppailun areena. Suomen YVA-lainsäädännössä osallistumisella on aina ollut tärkeä rooli. Suomalaisessa YVA-järjestelmässä on korostettu kansalaisten osallistumismahdollisuuksia. Ajan saatossa myös kriittisyys laajaa osallistumisoikeutta ja useita osallistumismahdollisuuksia kohtaan on lieventynyt. Haaste on kuitenkin siinä, että osallistumisen toteutus määritellään laissa väljästi, eikä lainsäädäntö takaa laadukasta osallistumista tai varsinkaan sen vaikuttavuutta. Toinen havaittu haaste on YVAn ja osallistumisen suhde päätöksentekoon. YVAn ulkopuoliset päätöksentekojärjestelmät ja edustuksellisen vallankäytön rakenteet eivät ole muuttuneet, ja siksi YVAn vaikuttavuus voi jäädä vähäiseksi. Vaikka YVA edustaisikin osallistuvaa demokratiaa ja toteuttaisi vuorovaikutteista ja moniäänistä suunnittelua, voi osallistumisen merkitys vesittyä ja kansalaisten osallistumisaktiivisuus hiipua. Ilmiöön liittyy myös tarpeetonta kriittisyyttä. Osallistumisen vaikuttavuus ei ole kertaluonteista, vaan se on usein välillistä ja ajoittuu prosessin eri vaiheisiin. Osallistumisen merkitystä ja vaikutuksia ei aina tunnisteta. YVAsta ei ole muodostunut Suomessa laajojen joukkojen osallistumisvälinettä. Ennemminkin YVAan osallistuvat tyypillisesti harvat kansalaisaktiivit, jotka hyödyntävät YVAn lisäksi lukuisia muitakin osallistumisen ja vaikuttamisen keinoja. Osallistujien määrän sijaan huomio tulee kuitenkin kiinnittää sisältöön ja suunnittelun moniäänisyyteen. Olennainen kysymys on se, millaisen roolin kansalaiset ja maallikkoasiantuntijuus voivat saada perinteisesti asiantuntijavetoisessa suunnittelukulttuurissa. ; Public participation in environmental impact assessment Environmental impact assessment (EIA) is a policy instrument based in law and used to prevent harmful environmental impacts, increase public information access, and improve public participation opportunities. EIA is an open process for discussion and participation of different actors: it increases the transparency and broadens the information base of environmental policy planning and decision making. One aim of EIA is to incorporate citizens views and opinions, concerns and desires into planning at an early stage. EIA is a process of identifying and evaluating potential impacts from proposed activities. It is also an interactive and communicative policy instrument and should facilitate direct participation. EIA is an example in the development process of direct participation in Finland during 1990 s. In this study EIA is approached as a participation instrument. Public participation is the perspective from which the EIA-process is analysed. The aim of the research is to examine participation in EIA both a theoretical and empirical way, and to interpret and explain the operation logic and efficacy of participation. There are three main research tasks in the study. The first task is to create a theoretical framework for analysis of public participation in EIA. For this purpose, the theoretical and methodological triangulation is made in the study. There are four main parts in the triangulation. Firstly, the elements of participative and deliberative democracy and communicative planning theories are combined. This theoretical discussion shows what kind of democracy and planning EIA can represents. Secondly, network analysis and evaluation are integrated in the methodological triangulation. The concepts of policy networks and intervention theory are used in theoretical and methodological manner. The outcomes of theoretical and methodological triangulation are criteria of deliberative EIA and four policy network models of EIA as an instrument of public participation: 1) EIA as a negotiation process; 2) EIA as a technical process of information collection, 3) EIA as an information instrument; and 4) EIA as tool for controlling of participation. While the theoretical part of the thesis has its own analytical objectives, these policy network models are utilized with evaluation criteria in the empirical part of the study. The second research task is to analyse the historical development of participation in Finnish EIA legislation. The focus of this part is on the long lasting political process and arguments behind the enacting of Finnish EIA Act in 1980 s and 1990 s. The most important amendments of EIA legislation and the international and national reasons behind them are also considered. According to results of this part of thesis, the role of participation has been central to the Finnish EIA system. Even if the EIA Act was implemented in Finland relatively late in 1994, the legislative foundation for public participation has always been strong. Though the implementation of participation is defined in a flexible way, Finnish EIA legislation supports public participation and in principle creates possibilities for deliberative democracy. The third research task is to evaluate public participation in two case studies. This part includes following questions: 1) what kind of objectives do different actors seek from participation; 2) how does participation impact EIA and what are the obstacles of effective participation; and 3) how transparent and acceptable is the EIA process? The two cases used, the EIA of a road project and the final disposal of nuclear waste, show how much the aims, the implementation and the effectiveness of public participation can not only vary between different projects, but also during the planning process in one certain project. Notably, in the nuclear waste case, the nature of top-down instrument of EIA was clearly observed, while the developer of the project assumed a dominant role. The three elements of policy network (actors, arenas and agenda) were defined by the developer. Even if participation was carried out with great visibility, professional implementation and sufficient resources, the impact of public participation and lay people expertise was not so essential, while the economic and political interests of the project and the role of experts were in central role. In this case study EIA represents the policy network model of controlling of participation: the role of governance was more important than deliberative participation. In the road case the planning situation was more open. There did not seem to be the same need to define and control participation and the agenda of the EIA. The contribution of citizens was used in planning in a more effective manner. The EIA assumed a more traditional role ­ as an information distribution tool, and as a place for open discussion and effective participation. The case studies suggest that the legislative base can not alone guarantee the effectiveness of public participation. Most important factor is the attitude of main actors. Each EIA process is unique and general theories of participation in EIA are difficult to create. In practice, the EIA is more or less an institutional process of power division between different actors, and the developer has the central role. EIA is an open arena that allows political disagreements to form and emerge into the open. However, EIA can also be used to promote political interests. EIA and participation can be harnessed by the proponent, but EIA can also feed the so called NIMBY (Not In My Back Yard) phenomenon. It is also possible, that policy instruments like EIA create a new elite ­ active lay experts. Theoretical ideas of deliberative democracy or communicative planning are challenging to implement in practice. At the same time it is important to estimate the criteria and expectations concerning participation. One can see, that EIA has lot of deliberative potential, but the main challenges are in the relationship between EIA and decision making, and in the structures of political power and decision making outside of EIA.