Emerging social assistance regimes in middle income countries: Turkey in comparative perspective

Global Development, Converging Divergence and Development Studies: A Rejoinder

The United Nations Universal Declaration of Human Rights of 1948 asserts that social security is an inalienable human right. Realizing this human right is often considered, simply, as a matter of political will and of administrative aptitude. In these terms, the progressive realization of the human right to social security may be viewed as the outcome of an appropriately‐resourced political and bureaucratic process. Such a perspective, however, is clearly inadequate. Characteristically, bureaucracies are designed to cater to the needs of all, based on common procedures and common deliverables designed for the “typical” case. Yet such approaches often lack the necessary flexibility and resources to make a distinction between individuals, which acknowledge their respective differences and needs. To meet the international commitment to progressively realize universal social security coverage, social security administrations are key actors. However imperative this role may be, if the pursuit of this commitment fails to respect people's differences this will put at risk the meeting in full of what is envisioned by the human right to social security. To this end, this special issue aims to foster an understanding that the goal of universal coverage must necessarily also respect and respond to the individual needs of each and every person.

Says who? Northern ventriloquism, or epistemic disobedience in global health scholarship

Can we live within environmental limits and still reduce poverty? Degrowth or decoupling?

Social work programs in the Global North are increasingly engaged in international student exchange with countries in the Indo-Pacific that belong to the Global South. However, there is a paucity of literature exploring the experiences of the institutions that host these exchanges. This article reports on the findings of a qualitative project that sought host institutions’ perspectives on the value of student exchanges. The findings indicate a perception that some mutual benefit and reciprocity can be established in international exchange but that disparity in resourcing, absence of opportunities for hosts to travel to Australia, and the privileged status of knowledge produced in the Global North maintains an inequity between exchange partners. These findings highlight the need for steps that can be taken toward reciprocity while demonstrating the impact power imbalance can have on the nature of Global South–North student exchange programs. IMPLICATIONS Research has shown that student exchange programs between the Global North and the Global South are often underpinned and shaped by a significant power imbalance in favour of the Global North. Findings show that Australian (Global North) knowledge is privileged over knowledge that is Indigenous to the host country and that financial constraints prevent host organisations from equal participation in programs. A form of reciprocity can be established whereby organisations in the Global South can access benefits associated with the programs, without sending their own students on exchange.

Much attention has been paid to how immigrants are incorporated into welfare states in the Global North, but the Global South has been overlooked. This article studies barriers that immigrants face when accessing social policy in middle-income South American countries with high rates of immigration. With a focus on Chile and Argentina, I argue that immigrants’ barriers to accessing social policy depend on political elites’ views—as policies are expanded, policymakers will lower access barriers for universal policies, while they will raise more hurdles for targeted policies. This is because public officials view universal policies as “social rights” that include immigrants, while they view targeted policies as “costs” that must be contained. Barriers to access are measured through qualitative coding of social assistance, social pensions, and public health care that build on legal documents, information requests, and secondary literature from 1990 to 2022. Public officials’ views are measured through 80 in-depth interviews. In analyzing barriers to accessing social policy, this study contributes to the literatures on comparative welfare states and immigration, as well as comparative social policy in middle income countries.

BackgroundExpanding social protection programme is a major target of the Sustainable Development Goals. Previous studies provided evidence for the relationship of social protection programme to greater use of health services and some improved health outcomes for children. Yet, its impact on child mortality has not been clearly revealed. In this study, we examined the association between social protection programmes and child mortality.MethodsWe obtained child mortality data from 379 nationally representative surveys involving 101 low- and middle-income countries (LMICs). We included five child mortality outcomes in the study, which were neonatal mortality rate (NMR), post-neonatal mortality rate (PMR), childhood mortality rate (CMR), infant mortality rate (IMR), and under-5 mortality rate (U5MR). We extracted data on social protection programmes from multiple data sources (eg, Atlas of Social Protection Indicators of Resilience and Equity). Social protection and labour programme (SPL) was the major type of social protection we included. We also included four subtypes of SPL - social assistance, cash transfer, social insurance, and labour market protection. Both unadjusted and adjusted regressions were conducted to measure the associations between characteristics of social protection programmes and child mortality, as well as inequalities in child mortality.ResultsAmong the 101 countries, the median coverage rate of SPL was 28.5%, with an interquartile range between 6.5% and 55.2%. Using the adjusted model, we found a one-percentage-point increase in SPL coverage is associated with a reduction of 0.09 (95% confidence interval (CI) = 0.04, 0.14) per 1000 live births in NMR, 0.11 (95% CI = 0.04, 0.18) in PMR, and 0.25 (95% CI = 0.11, 0.38) in CMR. Social assistance programme was the only subtype of SPL to be significantly associated with lower mortality rates. A higher SPL coverage was associated with better equity in child mortality – as the coverage of SPL increased by one percentage point, the concentration index of CMR would increase by 0.08 (95% CI = 0.03, 0.13) in the adjusted model, suggesting an improvement in equity.ConclusionsThe strong association between social protection programme and child mortality suggests that to achieve the SDG targets of universal social protection and to reduce child mortality, LMICs shall consider prioritizing the expansion of social protection programmes.

Low- and middle-income countries have upscaled social assistance provisions in the new century, with the aim of addressing poverty and disadvantage. This chapter offers a concise description and analysis of the emerging trends in social assistance in low- and middle-income countries. The specific coverage includes: discussion of the boundaries of social assistance and the relationship between poverty perspectives and “ideal types” of provision; exploration of the trends in the various forms of social assistance provision in low- and middle-income countries; summary of the innovations in social assistance program design and implementation; and assessment of the effectiveness and sustainability of social assistance programs in reducing poverty.

The world of drinking: national alcohol control experiences in 18 countries

Despite the commendable progress made in addressing global health challenges and threats such as child mortality, HIV/AIDS, and Tuberculosis, many global health organizations still exhibit a Global North supremacy attitude, evidenced by their choice of leaders and executors of global health initiatives in low- and middle-income countries (LMICs). While efforts by the Global North to support global health practice in LMICs have led to economic development and advancement in locally led research, current global health practices tend to focus solely on intervention outcomes, often neglecting important systemic factors such as intellectual property ownership, sustainability, diversification of leadership roles, and national capacity development. This has resulted in the implementation of practices and systems informed by high-income countries (HICs) to the detriment of knowledge systems in LMICs, as they are deprived of the opportunity to generate local solutions for local problems. From their unique position as international global health fellows located in different African countries and receiving graduate education from a HIC institution, the authors of this viewpoint article assess how HIC institutions can better support LMICs. The authors propose several strategies for achieving equitable global health practices; 1) allocating funding to improve academic and research infrastructures in LMICs; 2) encouraging effective partnerships and collaborations with Global South scientists who have lived experiences in LMICs; 3) reviewing the trade-related aspects of intellectual property Rights (TRIPS) agreement; and 4) achieving equity in global health funding and education resources.

Current research practices in the field of medical and veterinary entomology have been shaped by longstanding traditions of colonialism in entomology (Campbell et al., 2021). This is a culture that has allowed individuals from high-income countries (HIC) to shape a research agenda that aims to help disadvantaged people in low- and middle-income countries (LMIC) (Olusanya et al., 2021). These researchers benefit from increased funding, career advancement opportunities, higher international esteem and invitations to participate in policy fora. Investment in researchers and research infrastructure is high in the global North; however, there is a heavy reliance on expertise, resources and samples from vector-borne disease endemic countries, which are often LMICs. The geographical disconnect between the institutes that receive the majority of research funding and the communities most impacted by the burden of vector-borne diseases leads to a cycle of inequity that can only be broken through positive action by researchers, institutes, publishers, and funders. There has recently been increased attention to call out ‘parachute’ or ‘helicopter’ research: research conducted in low-income countries by individuals from HIC, without inclusion of host country researchers or benefits to the host institution. Often the clearest indicator of parachute research is the author byline. Of the 69 manuscripts published by Medical and Veterinary Entomology in 2021, 38 were conducted in LMICs or analysed samples originating from LMICs. Of these, 37 (97.4%) included at least one LMIC-based author and 34 (89.5%) included an LMIC-based first or last author. While this is promising, these data should be interpreted with caution because the inclusion of authors from the local research institutes or governments does not guarantee that the work arose from an equitable partnership. Part of our role as journal editors is to ensure that the research we publish meets internationally excellent standards for research ethics and integrity. To do this, we evaluate declarations of conflict, evidence of plagiarism, ethical reviews of human subject research and adherence to suitable animal use protocols. We also have a responsibility to ensure that equitable principles have been applied from research conception to delivery and dissemination. While many journal editors can recognize suspected parachute research, specific guidance has been lacking on how to address this during publication, which is late in the research process. Denying publication of public health findings could lead to adverse impacts in study communities, while allowing the late addition of LMIC authors is contradictory to International Committee of Medical Journal Editors standards (ICMJE, 2021) and our authorship policy, and may mask exploitative research partnerships. We want to prevent the exclusion of LMIC researchers in medical and veterinary entomology and ensure LMIC-based research appropriately addresses the needs of impacted communities. To address inequity in global North–South research partnerships we will follow guidance proposed by the Equitable Authorship Consensus Statement Group (Saleh et al., 2022) and ask authors to submit a reflexivity statement to describe their approach to partnership (Morton et al., 2021). The statement does not focus on authorship alone and it allows authors to reflect on and describe the ways that study communities and local researchers were included in the research process. These will be evaluated by the editorial board and published online as appendices. They will be compulsory for any studies that were based in or used samples from an LMIC but where funding is primarily attributed to an HIC-based author, and encouraged for all other submitted manuscripts. We will review and refine this approach after 6 months and share our recommendations more broadly among the editors of the Royal Entomological Society's publications. The reflexivity statement can be found in Appendix S1. An updated list of LMICs is published by the World Bank. Appendix S1. Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Social Security Priorities and Patterns: A Global Perspective

Reform of research funding processes could pave the way for progress in global health

Background: Social protection is increasingly used by governments in low- and middle-income countries (LMICs) as a strategy for alleviating poverty “in all its forms”. People with disabilities are frequently targeted as key beneficiaries due to high levels of poverty and marginalisation. Little is known, however, on whether people with disabilities are accessing existing programmes, and whether these programmes adequately meet their needs. Aim: To explore the need for, access to and adequacy of social protection amongst people with disabilities in LMICs. Methods: Systematic reviews were used to compile and evaluate evidence from across LMICs on 1) the link between monetary poverty and disability, and 2) access to and impact of social protection amongst people with disabilities. Case studies were then undertaken in the districts of Cam Le, Vietnam and Tanahun, Nepal in 2016 to explore in-depth the need for, access to and adequacy of social protection amongst people with disabilities in these areas. Data was collected through population-based surveys (n=12,397, across both settings), with nested case-control studies of people with and without disabilities (n=359, each) matched by age, sex and location. Further, qualitative research was conducted with people with disabilities recruited from the surveys and key informants involved in the design or implementation of social protection. Need for social protection was assessed using monetary and multidimensional indicators of poverty amongst people with disabilities ages 15+. Access to social protection was measured through participation in disability-targeted and non-targeted programmes. Adequacy of social assistance was then evaluated by measuring levels of monetary and multidimensional poverty amongst social assistance recipients. All analyses compared indicators between people with and without disabilities, and amongst people without disabilities (e.g. recipients versus non-recipients). Key findings: Evidence from the systematic review and research in Nepal and Vietnam indicate a high need for social protection among people with disabilities. In the systematic review, 80% of the 150 included studies found a link between disability and economic poverty. In both Vietnam and Nepal, people with disabilities were more likely to be living in both monetary and multidimensional poverty compared to people without disabilities, and faced high disability-related extra costs. People with disabilities in Vietnam and Nepal were more likely to access social assistance compared to people without disabilities (Vietnam: aOR 9.6, 5.6-16.5; Nepal: aOR 3.0, 1.6-5.3). However, evidence from the case studies and from the systematic review indicate that many people with disabilities are not accessing social protection benefits for which they are eligible. Factors affecting access included the accessibility of the application process, complexity of disability assessment procedures, awareness of programmes and their eligibility requirements and the perceived utility of benefits. Further, the systematic review and research in Vietnam and Nepal indicated that social protection is often inadequate to protect many recipients with disabilities from poverty. For example, a quarter to a third of social assistance recipients with disabilities were living in monetary poverty and half were multidimensionally poor in Vietnam and Nepal. Social protection was particularly insufficient at promoting social inclusion amongst people with disabilities, as well as ensuring sustainable livelihoods. Conclusion: People with disabilities face a substantial need for social protection, given high levels of monetary and multidimensional poverty, in both absolute terms and relative to people without disabilities. However, many people with disabilities were not accessing programmes for which they were eligible, indicating a need to increase awareness of programmes and address barriers encountered during the application process. Further, evidence from this research indicates that more transformational approaches to social protection design and delivery are necessary, such as providing meaningful coverage for disability-related extra costs and addressing drivers of social exclusion.

The relationship between trade openness and government size: Does disaggregating government expenditure matter?