Suchergebnisse

This thesis is an examination of the lives of Qassem Soleimani and Mustafa Kemal Ataturk through the lens of the political philosophies of Plato and Niccolò Machiavelli. Qassem Soleimani and Mustafa Kemal Ataturk were noted for their militant lives and share certain qualities of character in their pre-political careers that provide a unique opportunity for a direct comparison and the formulation of a normative claim assessing their relative successes and/or failures despite their many similarities. Through the course of this research the conclusion asserts that Mustafa Kemal Ataturk was a more capable man than Soleimani to ascend to a position of political power specifically due to his prioritization of Platonic principles from an early age which guided his pre-political career. Soleimani, on the other hand, pursued a militant path more consistent with the values of a Machiavellian prince and was therefore faced with a greater degree of difficulty in attempting to transition to political life. The theories of Plato and Machiavelli each propose strategies for moving toward an ideal state of governance but apply very different methods for achieving it. While Plato values the pursuit and inclusion of reason and enlightenment for all leaders, Machiavelli assigns more importance the object of power regardless of societal consciousness. Plato's most realistic model of a leader that is not the famed philosopher king, is the timocratic man, largely militant but not a stranger to the pursuit of reason. Machiavelli's model is a militant expert with a mastery of cunning and possibly duplicitous management of personal affairs. Ataturk more closely resembles the timocratic man than Soleimani in his early dedication to the goal of broad societal education and altruistic notions of political reform. Soleimani's life was more characterized by militancy and the elements of conflict and deception that arise in Machiavelli's model of leadership. As a result, Ataturk was more prepared to face the challenges of the political sphere and Soleimani was left vulnerable and ill-equipped to tackle international disputes.

BACKGROUND: Sexual and Reproductive Health (SRH) targets have been included as part of the United Nations Sustainable Development Goals and indictors are important to monitor progress towards these targets. SRH indicators are recommended for setting norms and measuring progress globally. However, given the diverse political, socioeconomic and cultural contexts in different countries, and lack of global agreement on broad indicators, it is important to select appropriate indicators for specific countries. Based on internationally recommended indicators and data availability in China, this paper selected four indictors to reflect SRH in China and interpreted these indictors by analyzing the underlying factors. METHODS: We employed secondary data analysis and key informant interviews. Secondary data were obtained from the China Health Statistical Yearbook (2005–2017), China Statistical Yearbook (2005–2017), and the sub-national estimates of the Global Burden Diseases Study 2016. We interviewed 36 key informants at national and sub-national levels. RESULTS: The four selected SRH indicators are contraceptive prevalence rate (CPR), adolescent birth rate, abortion rate, and availability of school sex education. CPR of married women has remained above 75% over the last three decades, indicating a high level of access to family planning (FP) services; however, unmarried but sexually active women have significant unmet needs for FP services. Although adolescent birth rates in China remain low, the abortion rate, abortion numbers, and the ratio of abortions to births increased from 2014 to 2016 while FP policy was relaxed. This suggests that abortion among unmarried women is a significant contributor to overall figures. Qualitative analysis of the availability of school sex education, reveals an absence of policy due to conservative attitudes of key stakeholders. CONCLUSION: Since SRH challenges vary significantly between contexts, indicators for measuring progress towards SRH targets should be selected based on country ...

Background: Sexual and Reproductive Health (SRH) targets have been included as part of the United Nations Sustainable Development Goals and thus indictors are important to monitor the progress towards these targets. SRH indicators are recommended for setting norms and measuring progress at global level. However, given the diverse political, socioeconomic and cultural contexts in different countries, and lack of global agreement on broad indicators, it is important to select appropriate indicators for specific countries. Based on internationally recommended indicators and data availability in China, this paper selected four indictors to reflect SRH in China and interpreted these indictors by analyzing the underlying factors. Methods: we employed secondary data analysis and key informant interview. The major secondary data were obtained from the China Health Statistical Year Book (2005-2017), China Statistical Year Book (2005-2017), and the sub-national estimates of the Global Burden Diseases Study 2016. We also interviewed 36 key informants at national and sub-national levels. Results: the four selected SRH indicators are contraceptive prevalence rate (CPR), adolescent birth rate, abortion rate, and availability of school sex education. CPR of married women has remained above 75% over the last three decades, indicating a high level of access to family planning (FP) services; however, unmarried but sexually active women have significant unmet needs for FP services. Although adolescent birth rates in China remain low, the abortion rate, abortion numbers, and the ratio of abortions to births increased from 2014-2016 while FP policy was relaxed in China. This suggests that abortion among unmarried women is a significant contributor to the overall figures. Qualitative analysis of the availability of school sex education reveals a situation of policy absence and the conservative attitude of key stakeholders. Conclusion: Since SRH challenges vary significantly between socio-economic, political and cultural contexts, indicators for measuring progress towards SRH targets of SDGs should be selected based on country context. The CPR and abortion rate are currently available and important indicators to monitor the most basic part of SRH in China, but require modification to ensure they can reflect universal access to quality reproductive healthcare by all reproductive age women, regardless their marriage status. Indicators on sex education need to be carefully developed to fit the context in China.

Background: In 2005–06, only 39 % of Indian women delivered in a health facility. Given that deliveries at home increase the risk of maternal mortality, it was in this context in 2005, that the Indian Government implemented the Janani Suraksha Yojana program that incentivizes poor women to give birth in a health facility by providing them with a cash transfer upon discharge. JSY helped raise institutional delivery to 74 % in the eight years since its implementation. Despite the success of the JSY in raising institutional delivery proportions, the large number of beneficiaries (105 million), and the cost of the program, there have been few qualitative studies exploring why women participate (or not) in the program. The objective of this paper was to explore this.Methods: In March 2013, we conducted 24 individual in-depth interviews with women who delivered within the previous 12 months in two districts of Madhya Pradesh, India. Qualitative framework analysis was used to analyze the data.Results: Our findings suggest that women's increased participation in the program reflect a shift in the social norm. Drivers of the shift include social pressure from the Accredited Social Health Activist (ASHA) to deliver in a health facility, and a growing individual perception of the importance for 'safe' and 'easy' delivery which was most likely an expression of the new social norm. While the incentive was an important influence on many women's choices, others did not perceive it as an important consideration in their decision to deliver in a health facility. Many women reported procedural difficulties to receive the benefit. Retaining the cash incentive was also an issue due to out-of-pocket expenditures incurred at the facility. Non-participation was often unintentional and caused by personal circumstances, poor geographic access or driven by a perception of poor quality of care provided in program facilities.Conclusions: In summary, while the cash incentive was important for some women in facilitating an institutional ...

Background In 2005–06, only 39 % of Indian women delivered in a health facility. Given that deliveries at home increase the risk of maternal mortality, it was in this context in 2005, that the Indian Government implemented the Janani Suraksha Yojana program that incentivizes poor women to give birth in a health facility by providing them with a cash transfer upon discharge. JSY helped raise institutional delivery to 74 % in the eight years since its implementation. Despite the success of the JSY in raising institutional delivery proportions, the large number of beneficiaries (105 million), and the cost of the program, there have been few qualitative studies exploring why women participate (or not) in the program. The objective of this paper was to explore this. Methods In March 2013, we conducted 24 individual in-depth interviews with women who delivered within the previous 12 months in two districts of Madhya Pradesh, India. Qualitative framework analysis was used to analyze the data. Results Our findings suggest that women's increased participation in the program reflect a shift in the social norm. Drivers of the shift include social pressure from the Accredited Social Health Activist (ASHA) to deliver in a health facility, and a growing individual perception of the importance for 'safe' and 'easy' delivery which was most likely an expression of the new social norm. While the incentive was an important influence on many women's choices, others did not perceive it as an important consideration in their decision to deliver in a health facility. Many women reported procedural difficulties to receive the benefit. Retaining the cash incentive was also an issue due to out-of-pocket expenditures incurred at the facility. Non-participation was often unintentional and caused by personal circumstances, poor geographic access or driven by a perception of poor quality of care provided in program facilities. Conclusions In summary, while the cash incentive was important for some women in facilitating an institutional birth, the shift in social norm (possibly in part facilitated by the program) and therefore their own perceptions has played a major role in them giving birth in facilities.

Abstract Background In 2005–06, only 39 % of Indian women delivered in a health facility. Given that deliveries at home increase the risk of maternal mortality, it was in this context in 2005, that the Indian Government implemented the Janani Suraksha Yojana program that incentivizes poor women to give birth in a health facility by providing them with a cash transfer upon discharge. JSY helped raise institutional delivery to 74 % in the eight years since its implementation. Despite the success of the JSY in raising institutional delivery proportions, the large number of beneficiaries (105 million), and the cost of the program, there have been few qualitative studies exploring why women participate (or not) in the program. The objective of this paper was to explore this. Methods In March 2013, we conducted 24 individual in-depth interviews with women who delivered within the previous 12 months in two districts of Madhya Pradesh, India. Qualitative framework analysis was used to analyze the data. Results Our findings suggest that women's increased participation in the program reflect a shift in the social norm. Drivers of the shift include social pressure from the Accredited Social Health Activist (ASHA) to deliver in a health facility, and a growing individual perception of the importance for 'safe' and 'easy' delivery which was most likely an expression of the new social norm. While the incentive was an important influence on many women's choices, others did not perceive it as an important consideration in their decision to deliver in a health facility. Many women reported procedural difficulties to receive the benefit. Retaining the cash incentive was also an issue due to out-of-pocket expenditures incurred at the facility. Non-participation was often unintentional and caused by personal circumstances, poor geographic access or driven by a perception of poor quality of care provided in program facilities. Conclusions In summary, while the cash incentive was important for some women in facilitating an institutional birth, the shift in social norm (possibly in part facilitated by the program) and therefore their own perceptions has played a major role in them giving birth in facilities.

For the large population living in Nairobi's informal settlements, the long-term effects of Covid-19 pose a threat to livelihoods, health, and wellbeing. For those working in the informal sector, who are the lifeblood of the city, livelihoods have been severely supressed by Covid-19 restrictions such as curfews, pushing many into further poverty. This article draws on community data, meetings, and authors' observations as community organisers, to explore the challenges posed by existing government responses from a community development perspective. We found that poor accountability structures and targeted income support only for the 'most vulnerable' exacerbates tensions, mistrust, and insecurity among already vulnerable communities. We draw on a rapid desk review of existing literature to argue that community-led enumeration to validate entitlement claims, improved accountability for distribution, and widening income support is required to build solidarity and improve the future resilience of these communities.

For the large population living in Nairobi's informal settlements, the long-term effects of Covid-19 pose a threat to livelihoods, health, and wellbeing. For those working in the informal sector, who are the lifeblood of the city, livelihoods have been severely supressed by Covid-19 restrictions such as curfews, pushing many into further poverty. This article draws on community data, meetings, and authors' observations as community organisers, to explore the challenges posed by existing government responses from a community development perspective. We found that poor accountability structures and targeted income support only for the 'most vulnerable' exacerbates tensions, mistrust, and insecurity among already vulnerable communities. We draw on a rapid desk review of existing literature to argue that community-led enumeration to validate entitlement claims, improved accountability for distribution, and widening income support is required to build solidarity and improve the future resilience of these communities. ; Irish Aid

Background and objectives: This study explores the perceptions of a wide range of stakeholders in Malawi towards the mental health impact of intimate partner violence (IPV) and the capacity of health services for addressing these. Design: In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in three areas of Blantyre district, and in two additional districts. A total of 10 FGDs, 1 small group, and 14 IDIs with health care providers; 18 FGDs and 1 small group with male and female, urban and rural community members; 7 IDIs with female survivors; and 26 key informant interviews and 1 small group with government ministry staff, donors, gender-based violence service providers, religious institutions, and police were conducted. A thematic framework analysis method was applied to emerging themes. Results: The significant mental health impact of IPV was mentioned by all participants and formal care seeking was thought to be impeded by social pressures to resolve conflict, and fear of judgemental attitudes. Providers felt inadequately prepared to handle the psychosocial and mental health consequences of IPV; this was complicated by staff shortages, a lack of clarity on the mandate of the health sector, as well as confusion over the definition and need for 'counselling'. Referral options to other sectors for mental health support were perceived as limited but the restructuring of the Ministry of Health to cover violence prevention, mental health, and alcohol and drug misuse under a single unit provides an opportunity. Conclusion: Despite widespread recognition of the burden of IPV-associated mental health problems in Malawi, there is limited capacity to support affected individuals at community or health sector level. Participants highlighted potential entry points to health services as well as local and national opportunities for interventions that are culturally appropriate and are built on local structures and resilience.

Abstract In 2003, China launched the New Cooperative Medical Scheme (NCMS) as a form of health insurance for rural areas. Counties play an important part in the management of the system, raising issues over the capacity of local government to manage complex health insurance systems. This paper examines the extent and impact of county level managerial capacity to manage the NCMS.The paper is largely based on qualitative data but supported by quantitative data. Policy makers, NCMS administrators, health providers and residents were interviewed in May 2006 in six counties in rural China.Management capacity was defined as the capability to bring together and use resources to carry out responsibilities. The results are grouped into three areas of management capacity: staff, organizational and contextual. Respondents complained about inadequate staffing, poor organizational resources and conduct of responsibilities in areas such as premium collection and remuneration. Key problems in contextual capacity included: counties are restricted in their ability to use resources for management; counties lack support from other organizations and suffer from a conflict of responsibilities.This paper underlines the importance of effective management capacity for NCMS at the decentralized level and suggests pointers for the content and process of management capacity development. Copyright (c) 2010 John Wiley & Sons, Ltd.

OBJECTIVES To explore community perceptions of voluntary health insurance (VHI) as factors influencing low enrolment in VHI. METHODS A qualitative study was conducted using focus group discussions with men and women who are members of VHI schemes and who are not members in four districts in rural Vietnam. Data was analysed using grounded theory. RESULTS Many perceived that illness and the costs of illness cannot be predicted. Knowledge and understanding about HI (health insurance) schemes was limited. There is a common perception that HI can help with the costs of health care, and this is linked to buying HI when ill. Information about HI schemes is not well disseminated: information is often insufficiently detailed and inconsistent, whilst methods do not reach many. There were several complaints about HI schemes: the premium is too high for individuals and families; delay in receiving HI cards and frequent mistakes on cards prevents people using HI; and the drug list is too narrow, so people need to buy additional drugs. Many people with insurance perceived that they received lower quality care than those who paid fees for healthcare. They reported receiving fewer and cheaper drugs and less sophisticated investigations and treatments. They also felt they had to wait longer to be seen by healthcare workers. These experiences limited willingness to enrol and use of HI cards at outpatient facilities. CONCLUSION Low enrolment in VHI is affected by low perceptions of ability to control health risks, lack of understanding of HI in general and specific schemes and perceived problems with scheme administration, benefits and quality of health services. The potential problem of adverse selection may influence the sustainability of the scheme. Recommendations to increase enrolment and benefit from the scheme include improving communication with the rural population on HI, reducing the premium level (consider additional government subsidy), adjusting the benefit package, reducing administrative problems in the schemes and addressing provider payment issues.