Friday, July 16, 2010

[EQ] The Politics of Poverty: Elites, Citizens and States

Putting Citizens at the Centre: Linking States and Societies for Responsive Governance


A policy-maker’s guide to the research of the Development Research Centre on Citizenship, Participation and Accountability

 

Prepared for the Conference on ‘The Politics of Poverty, Elites, Citizens and States’

Sponsored by the Department for International Development

June 21 – 23, 2010

Available online PDF [20p.] at: http://bit.ly/b6iYvL
http://www.research4development.info/PDF/Outputs/CentreOnCitizenship/Citizenship-DRC-Policy-Findings-Paper-2010.pdf

 

The Politics of Poverty: Elites, Citizens and States

A Synthesis Paper

DFID Research and Evidence Division

 

Available online PDF [104p.] at: http://bit.ly/9Z5aSx

 

Evidence shows that in order to deliver sustainable international development we must be able to understand and work with its politics.

Governance describes the way countries and societies manage their affairs politically and the way power and authority are exercised. For the poorest and most vulnerable, the difference that good, or particularly bad, governance, makes to their lives is profound: the inability of government institutions to prevent conflict, provide basic security, or basic services can have life-or-death consequences; lack of opportunity can prevent generations of poor families from lifting themselves out of poverty; and the inability to grow economically and collect taxes can keep countries trapped in a cycle of aid-dependency. Understanding governance, therefore, is central to achieving development and ending conflict

 

The research argues that the political settlement is central to all development; and one that does not exclude powerful players is more likely to prevent conflict. But settlements also need to work at the grass roots level, representing the interests of social groups. Security is a precondition for development; this is a matter of survival and must be prioritised in countries recovering from conflict. Evidence presented here shows that in countries where cultural or ethnic groups feel there is economic, political and social inequality, wars are more likely. The future face of insecurity is not restricted to civil wars – more and more people are dying in social violence, particularly in cities [Chapters 2, 3 and 4].

 

The research looks at how governments can become more inclusive, and therefore more stable. States that are accountable only to some groups or that do

not regard some members of society as ‘citizens’ create inequalities that can fuel conflict. When citizens actively participate in society through local associations and movements outside the state, there are benefits to both state and society [Chapters 5 and 6].


The poor, more than any other group, rely on basic public services. For vulnerable families, access to education and healthcare are important routes out of poverty. The politics matters: services work better for the poor when poor citizens participate in reform of service delivery and the research looks at how this can be most effectively achieved. In conflict affected states the provision of services is very sensitive. Service delivery targeting excluded groups can reduce political tensions and improved security [Chapter 7].


What Really Works? Lessons from 10 years of DFID-funded Research on Governance and Fragile States

Ten years of DFID-funded governance research has been brought into focus through a new report 'The Politics of Poverty: Elites, Citizens and States'.

http://www.research4development.info/news.asp?articleID=50643

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

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[EQ] School feeding for improving the physical and psychosocial health of disadvantaged students

School feeding for improving the physical and psychosocial health of disadvantaged students
(Review)

 

Betsy Kristjansson 1,Mark Petticrew 2, BarbaraMacDonald 3, Julia Krasevec 3, Laura Janzen 4, Trish Greenhalgh 5,George AWells 6, Jessie MacGowan 7 , Anna P Farmer 8, Beverley Shea 7, Alain Mayhew 7, Peter Tugwell 9, Vivian Welch 9


1 School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada.
2 PEHRU, London School of Hygiene and Tropical Medicine, London, UK.
3 C/O Cochrane Developmental, Psychosocial and Learning Problems Group, Bristol, UK.

4 Department of Psychology & Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.
5 Primary Care and Population Sciences, University College London, London, UK.
6 Cardiovascular Research Reference Centre, University of OttawaHeart Institute, Ottawa, Canada.
7 Institute of PopulationHealth,University ofOttawa,Ottawa, Canada.
8 Department of Agricultural, Food and Nutritional Science and The Centre for Health Promotion Studies, University of Alberta, Edmonton, Canada.
9 Centre for Global Health, Institute of Population Health, University of Ottawa, Ottawa, Canada
The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd. 2009

 

Available online PDF [76p.] at: http://bit.ly/bPJD8V

 

Background

Early malnutrition and/or micronutrient deficiencies can adversely affect physical, mental, and social aspects of child health. School feeding programs are designed to improve attendance, achievement, growth, and other health outcomes.

Objectives

The main objective was to determine the effectiveness of school feeding programs in improving physical and psychosocial health for disadvantaged school pupils .

Search strategy

We searched a number of databases including CENTRAL (2006 Issue 2), MEDLINE (1966 to May 2006), EMBASE (1980 to May 2006), PsycINFO (1980 to May 2006) and CINAHL (1982 to May 2006). Grey literature sources were also searched. Reference lists of included studies and key journals were hand searched and we also contacted selected experts in the field.

Selection criteria

Data from randomized controlled trials (RCTs), non-randomised controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series studies (ITSs) were included. Feeding had to be done in school; the majority of participants had to be socio-economically disadvantaged.

Data collection and analysis

Two reviewers assessed all searches and retrieved studies. Data extraction was done by one of four reviewers and reviewed by a second. Two reviewers independently rated quality. If sufficient data were available, they were synthesized using random effects meta-analysis, adjusting for clustering if needed. Analyses were performed separately for RCTs and CBAs and for higher and lower income countries.

Main results

We included 18 studies. For weight, in the RCTs and CBAs from Lower Income Countries, experimental group children gained an average of 0.39 kg (95% C.I: 0.11 to 0.67) over an average of 19 months and 0.71 kg (95% C.I.: 0.48 to 0.95) over 11.3 months respectively. Results for weight were mixed in higher income countries. For height, results were mixed; height gain was greater for younger children. Attendance in lower income countries was higher in experimental groups than in controls; our results show an average increase of 4 to 6 days a year. Math gains were consistently higher for experimental groups in lower income countries; in CBAs, the Standardized Mean Difference was 0.66 (95% C.I. = 0.13 to 1.18). In short-term studies, small improvements in some cognitive tasks were found.

Authors’ conclusions

School meals may have some small benefits for disadvantaged children. We recommend further rwell-designed studies on the effectiveness of school meals be undertaken, that results should be reported according to socio-economic status, and that researchers gather robust data on both processes and carefully chosen outcomes.

 

Content:

Header

Abstract .

Plain language summary .

Background

Objectives

Methods

Results .
Discussion

Authors’ conclusions

Acknowledgements .
References

Characteristics of studies

Data and history

Contributions of authors

Declarations of interest

Sources of support

Notes

Index terms


“……Health inequalities have been defined as “the virtually universal phenomenon of variation in health indicators ... associated with socio-economic status” (Last 1995); inequalities may also be seen between different sexes or geographic groups.
Health inequalities require three components for calculation: a valid measure of health status, a measure of social position or status, and a statistical method for summarizing the magnitude of the health differences between people in different social positions.
Health inequities ’are unfair and remediable inequalities’ (
Tan-Torres 2001; Peter 2001). Thus, health inequalities are measurable, while health inequities require a value judgment……………” page 5

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

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and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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[EQ] The Quality of Death: Ranking end-of-life care across the world

The Quality of Death: Ranking end-of-life care across the world

2010 The Economist Intelligence Unit

 

Available online PDF [39p.] at: http://bit.ly/9ToVuw

 “…………..“Quality of life” is a common phrase. The majority of human endeavours are ostensibly aimed at improving quality of life, whether for the individual or the community, and the concept ultimately informs most aspects of public policy and private enterprise.

Advancements in healthcare have been responsible for the most significant quality-of-life gains in the recent past: that humans are (on average) living longer, and more healthily than ever, is well established. But “quality of death” is another matter. Death, although inevitable, is distressing to contemplate and in many cultures is taboo.

Even where the issue can be openly discussed, the obligations implied by the Hippocratic oath—rightly the starting point for all curative medicine—do not fit easily with the demands of end-of-life palliative care, where the patient’s recovery is unlikely and instead the task falls to the physician (or, more often, caregiver) to minimise suffering as death approaches. Too often such care is simply not available: according to the Worldwide Palliative Care Alliance, while more than 100m people annually would benefit from hospice and palliative care (including family and carers who need help and assistance in caring), less than 8% of those in need access it.

Few nations, including rich ones with cutting-edge healthcare systems, incorporate palliative care strategies into their overall healthcare policy—despite the fact that in many of these countries, increasing longevity and ageing populations mean demand for end-of-life care is likely to rise sharply. Globally, training for palliative care is rarely included in healthcare education curricula. Institutions that specialise in giving palliative and end-of-life care are often not part of national healthcare systems, and many rely on volunteer or charitable status.

Added to this, the availability of painkilling drugs—the most basic issue in the minimisation of suffering—is woefully inadequate across much of the world, often because of concerns about illicit use and trafficking. The result of this state of affairs is an incalculable surfeit of suffering, not just for those about to die, but also for their loved ones. Clearly, the deeper inclusion of palliative care into broader health policy, and the improvement of standards of end-of-life care—raising the “quality of death”—will also yield significant gains for humanity’s quality of life……….”

Contents

Executive summary

Note on definitions

Introduction: new challenges in managing the end of life

1. The Quality of Death Index

Index methodology

A high quality of death

A low quality of death

2. Cultural issues in end-of-life care

Attitudes to death and dying

Levels of debate across the globe

The law and the decision to die

Three contrasting attitudes to death

3. The economics of end-of-life care

A variety of funding models

Romania: from last to leader

Kerala: the community model

Long-stay patients shift the balance

4. Policy issues in end-of-life care

Government recognition

The availability and use of opioids

Integration of care into mainstream services

Uganda: a beacon in Africa

Building capacity for home-based care

The importance of training

5. Conclusions

Appendix: Index methodology


This report and more information on the Quality of Death Index can be found at: www.eiu.com/sponsor/lienfoundation/qualityofdeath

More information on the Quality of Death Index is also available at the website created by the Lien Foundation, the sponsor of the research: www.qualityofdeath.org

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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http://graphics.eiu.com/upload/QOD_main_final_edition_Jul12_toprint.pdf





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