Building State Capacity Research Articles

Nepal’s Geriatric Health Strategy 2021–2030: A Narrative Review

Abstract Nepal’s national geriatric health strategy 2021–2030 focuses on enhancing the health and well-being of senior citizens by providing comprehensive health services and promoting healthy aging. The strategy addresses the increasing prevalence of chronic conditions and multimorbidities among the older people, emphasizing the need for tailored health-care services. Key priorities include improving access to quality health services, promoting social health insurance, and strengthening family and community support systems. The strategy also aims to integrate geriatric health issues into the national health system, enhance the capacity of health facilities, and ensure gender-equitable and inclusive services. By fostering multisectoral coordination and collaboration, the strategy supports Nepal’s pursuit of universal health coverage and aims to build state capacity to support healthy aging, ensuring that senior citizens can lead active and quality lives.

Unanticipated Outcomes

In contexts where political corruption is endemic, why would political elites build state capacity to prosecute corruption? Prior studies emphasize exogenous pressure from social movements or international organizations and the rise of political leaders committed to fighting corruption. While important, these factors are not sufficient to explain the case of Brazil, where politicians empowered investigative bureaucracies, even though several political elites later became victims of prosecution. Drawing on document analysis of charges and sentences and on 110 in-depth interviews with prosecutors, judges, and politicians, I develop a framework that focuses on the processes through which corruption is criminalized on the ground. By examining the initiatives of politicians in interaction with the actions of civil servants who investigate and prosecute cases of corruption, I show that political elites empowered investigators because, at the time, these steps seemed innocuous. Prosecutors later reframed how they talked about corruption—getting other colleagues to pay attention to this issue—and learned new strategies to uncover corruption schemes, but these changes happened under the radar: they were not visible to politicians. Popular pressure also led courts to broaden the definition of corruption and lower the threshold of evidence for it, but these decisions took place after the politicians’ actions.

The role of professionalization in the South African public service and its contribution to the UN’s SDGs, Agenda 2063, and NDP 2030

The South African National Framework towards the Professionalization of the Public Service, moots the belief that professionalizing public administration is one of the key requirements for building state capacity. An efficient and effective public service may positively impact the state’s development agenda. The United Nations’ (UN) 17 sustainable development goals (SDGs) serve as a blueprint to achieve a better and more sustainable future for all with the focus on an end to poverty, and inequality, the protection of the planet, and the assurance that global citizens enjoy health, justice and prosperity. The core question that this paper addresses is: To what extent will professionalization of the South African public sector through learning and training programs offered at the National School of Government (NSG), contribute to the UN’s SDGs specifically and Africa Agenda 2063 (Agenda 2063) and the South African National Development Plan (NDP) 2030 in general? The paper is premised on a systematic stand-alone literature review. Content analysis was used to make sense of the secondary data consulted by honing in on pre-identified search terms. The study found that while the training programs offered at the NSG are aligned with the government’s focus on professionalization of the public service, specific mention of the SDGs, the NDP and Agenda 2063, are not made. It is recommended that with much talk around the re-calibration of the public sector by way of the NSG, an opportunity exists to explicitly teach the principles, objectives and aims of the aforementioned SDGs, NDP goals and Agenda 2063 objectives, in all its training programs, or that new programs are devised by the NSG solely focused on the attainment of the SDGs.

Rationale and design for Healthy Hearts for Michigan (HH4M): A pragmatic single-arm hybrid effectiveness-implementation study

BackgroundThe burden of cardiovascular disease (CVD) is particularly high in several US states, which include the state of Michigan. Hypertension and smoking are two major risk factors for mortality due to CVD. Rural Michigan is disproportionally affected by CVD and by primary care shortages. The Healthy Hearts for Michigan (HH4M) study aims to promote hypertension management and smoking cessation through practice facilitation and quality improvement efforts and is part of the multi-state EvidenceNOW: Building State Capacity initiative to provide external support to primary care practices to improve care delivery. MethodsPrimary care practices in rural and underserved areas of Michigan were recruited to join HH4M, a pragmatic, single-arm hybrid Type 2 effectiveness-implementation study during which practice facilitation was delivered at the practice level for 12 months, followed by a 3-month maintenance period. ResultsFifty-four practices were enrolled over a 12-month recruitment period. At baseline, the mean proportion (standard deviation) of patients at the practice level meeting the clinical quality measures were: blood pressure, 0.72 (0.12); tobacco screening, 0.80 (0.30); tobacco cessation intervention, 0.57 (0.28); tobacco screening and cessation intervention: 0.78 (0.26). ConclusionThis three-year research program will evaluate the ability of rural and medically underserved primary care practices to implement the quality improvement model by identifying drivers of and barriers to sustainable implementation, and test whether the model improves (a) blood pressure control and (b) tobacco use screening and cessation.

Building bridges in policy implementation during a pandemic: insights from an e-survey on Indian Producer Organisations

ABSTRACT Despite the widely acknowledged importance of consultative policymaking, interventions to encourage stakeholder participation remain scarce. The presence of exigencies, such as the pandemic, can further normalise the lack of participative processes unless serious alternatives are presented. This paper presents the results of an exercise, during the pandemic, on Farmer Producer Organisations (FPOs) through an e-survey of stakeholders whose views, if considered, could have avoided some of the implementation gaps and challenges before the rollout. The survey process demonstrates how facilitated and well-designed consultations can enable a better buy-in in policy implementation and importantly help build state capacity through such processes, despite the pandemic. The paper also highlights the need for scholars and citizens to pay greater attention to the everydayness of policy implementation beyond presenting critiques of policy formulation.

States, Markets, and Foreign Aid by Simone Dietrich

Developing countries face multiple challenges. Beyond lacking resources, their governments may be corrupt or of low capacity. This poses risks for donor states, whose financial aid might not help those who need it most. However, donors do not handle the risk identically: some continue to funnel much aid through those governments, others redirect large portions to nonstate actors. When facing similar risks, why would donor states deliver foreign aid differently? According to Simone Dietrich's book States, Markets, and Foreign Aid, the answer is donors’ ideological differences, long enshrined in their aid institutions. Some donors are ideologically more “statist,” others are more “neoliberal.” Statist donors tend to have an active public sector themselves, and when distributing aid internationally they favor public-sector partners. Neoliberal donors tend to have active nonprofit and private sectors, and when distributing aid internationally they favor nonstate partners. Moreover, whereas neoliberal donors emphasize shorter-term poverty relief, statist donors aim for longer-term state capacity. Over time, these diverging ideologies have shaped domestic institutions, with donors’ aid systems becoming more incentivized toward particular delivery modes. Institutionalized incentive structures constrain current aid officials: even when a recipient government has corruption or capacity problems, individuals working in a statist system cannot easily bypass it. Similarly, even when breaking poverty's vicious cycle would require building state capacity, individuals working in a neoliberal system cannot easily redirect resources that are usually channeled through nonstate partners.

In the interim: administering art in India, after independence, before institutions

ABSTRACT The article focuses on the Indian state’s relationship with art, and art institutions to gain insights into approaches to nation/state formation and administration. It asks two questions: How was art administered in India between 1947 and 1953, the period after India’s independence but before formal institutions for it came up? And what were the implications of decisions taken during this period on subsequent institutional choices? I argue that matters of art were addressed here–in the “interim”–not merely in a formal manner through political and administrative procedures, but as the very question of political and administrative matters, intricately intertwined with appeals of taste, rule, disinterest, gains, penny pinching, but most of all, of problem solving. From the commitment to solve problems were at hand, in a country ravaged by Partition, unemployment, and a poor economy, what emerges is not a pious approach to tradition; nor do decisions affecting art practice follow some predetermined path to modernity. Neither does the state’s approach simply correspond to the view generally taken in existing literature where the starting point tends to be the framework of secular nationalism. Rather, by being attentive to everyday problem-solving and decision-making processes of statesmen who led the project of institution-building–Nehru, Azad, Patel among others–we discover the priority they gave to building state capacity; everything else, including nation-building followed from this. In this regard, even though there was no specific programme yet in place for looking into the arts, the arts got looked after in almost all matters concerning politics.

Historical social contracts and their legacy: a disaggregated analysis of the medieval republics

We study the comparative political economy within the territories ruled by the medieval republics in Northern Italy. Building on the historical evidence, we conceptualize the emergence of more inclusive vs. extractive institutions in these sovereign polities as driven by the interests of local rulers and their need to build state capacity. We provide novel insights on the role of geography and historical contingencies in the development of public governance, individual attitudes, and social-inclusion, which mutually supported each other and persisted over time. We measure the origin, territorial evolution, and disappearance of all the sovereign polities that ruled over the Italian peninsula during the period of 1000-1800 AD. The empirical analysis connects contemporary socio-economic outcomes across spatially disaggregated northern Italian localities, at the municipality level, to local political history. We distinguish between so-called “communal” and “maritime republics” and show that the intensity and stability of exposure to the different types of republican rule in pre-industrial times continues to shape local public good provision and individual fiscal compliance, and has left a tangible imprint on today’s population diversity.

Spatial political economy: the case of metropolitan industrial policy

Industrial policy has become the focus of much more interest in recent times. Of particular note is mainstream economists’ fascination and their peculiar claims about how and why this new industrial policy promotes growth, redistribution, and sustainability. Such contentions warrant scrutiny. Using metropolitan data, plans, and laws, along with regional and national data from census and survey reports, this paper addresses three questions related to growth, inequality, and sustainability. On the basis of the evidence, collected and interpreted from the lens of original institutional economics, it is argued that industrial policy has been too strictly tied to (urban) economic growth which has not, contrary to expectations, led to ecologically sensitive and inclusive (urban) economic development. Instead, growth policies have cumulatively generated rising urban inequalities and ecological problems in cities and regions. This lack of congruence between the case for, and outcomes from, the pursuit of a particular type of industrial policy can be partly explained by the presence of absentee land ownership. Its entanglements with rent theft, profit seeking, and problematic engagement with persistent inequalities and unsustainability complement the explanation. A different industrial policy could seek to recoup socially-created, but privately appropriated, unearned income, reinvest this resulting revenue in ways that directly build state capacity, address persistent urban inequalities, attend to ecological challenges, and seek to create industries that avoid the problems of ‘progress and poverty’.

Building State Capacity: What is the Impact of Development Projects?

Building State Capacity: What is the Impact of Development Projects?

The Weak State Trap

Development outcomes come in ‘clusters’ that seem difficult to exit. Typically juxtapositioned are states that are both weak in the sense of lacking fiscal resources, but also patrimonial or clientelistic in the way in which they operate. We document the individual behaviour underlying such a cluster using original data from Colombia. We show that tax evasion, as a measure of state weakness, and vote buying, as a measure of clientelism, are highly correlated at the individual level. We argue that while state weakness creates the right environment for clientelism to flourish, clientelism sets in place a structure of incentives for politicians and citizens that is detrimental to building state capacity. We also document that both practices are widely accepted in society, a result consistent with a deeply entrenched relationship of mutually reinforcing influences. Finally, we present evidence of a vector of other types of behaviour and beliefs that are highly correlated with both clientelism and tax evasion, which suggest the presence of multiple feedback loops that we argue justifies calling this situation a trap.

Is cohesive capitalism under threat?

Abstract This paper argues that a distinctive form of capitalism, cohesive capitalism, emerged in the post-war period supporting the wellbeing of its citizens through building state capacities alongside open and democratic forms of government. The paper identifies a range of threats that this model now faces and speculates on what it would take, particularly in terms of international cooperation, to respond to them.

The United Nations and 21st century security challenges in Colombia

Multifaceted 21st-century security challenges, such as terrorism, pandemics, illegal migration, and drug trafficking, permanently question the adequacy of both state and global organizations to guarantee general wellbeing, the rule of law, and the protection of human rights. In this sense, the United Nations (UN) has received the brunt of the criticism despite its growing responsibilities, the complexity of the threats, and its decision-making structure’s limitations. This paper examines the UN’s effectiveness in addressing Colombia’s major security challenges, suggesting that providing adequate assistance to build state capacity is key to reducing power vacuums that foster both deviant globalization and embryonic security challenges.

Business and Human Rights: How NGO Orientation toward Local Communities Shapes Access to Remedy

With respect to human rights, firms historically have incurred little government oversight domestically and internationally resulting in governance gaps. This has resulted in an emphasis and adoption of global governance structures as a mechanism for providing this much needed oversight. However, as we argue here, the emphasis on global governance structures overlooks opportunities for building state capacity and democratization by governing globally and not locally. In what follows, we offer another approach for dealing with the governance gaps of the existing approach to business and human rights and draw from unique empirical evidence to detail how domestic and international nongovernmental organizations (NGOs) operate to check corporate misbehavior. The empirical evidence indicates that NGOs classified as either community- or corporation-focused react differently in terms of shaping remedy solutions. Community focused organizations are more apt to help victims seek judicial and quasi-judicial mechanisms, thereby triggering positive effects to state capacity building and or entrenchment of democratization. Alternatively, corporate-focused NGOs are more likely to seek non-judicial outcomes that rarely result in material benefits for victims. We support our findings with case studies illustrating NGO activism and discerning its important implications for long-term capacity building and democratic institutional strength.

State Sponsorship of Religiously Motivated Terrorism: A Deadly Combination

ABSTRACT This study investigates the outcomes of suicide terrorism by examining the interaction between religious ideology and state sponsorship. Specifically, we are interested in how state sponsorship may facilitate religiously motivated terrorist groups to carry out suicide attacks. Religiously motivated terrorism groups are predisposed to the utilization of suicide terrorism because of the justification of unrestrained violence to achieve religious goals and the veneration of martyrdom. States will sponsor religiously motivated terrorist groups especially for the purposes of public goods provisions, increasing the state’s bargaining power and credibility, and as a way to export state ideology. The interaction between religion and state sponsorship ultimately facilitates suicide attacks as a low cost, yet highly visible and effective means for both the state and the terrorist group to achieve their goals. The results suggest that not only are religiously motivated terrorist groups more inclined to use suicide terrorism than other group types, but that this inclination is heightened when religiously motivated groups are state-sponsored. Consequently, states should seek to devote specific attention and resources to halting state-sponsors of religiously motivated terrorism and consider including building state capacity as part of a counterterrorism strategy.

The Weak State Trap

Development outcomes come in ‘clusters’ that seem difficult to exit. Using original data from Colombia, we present evidence of the interconnection between two critical political components: state weakness and clientelism. State weakness creates the right environment for clientelism to flourish. Clientelism sets in place a structure of incentives for politicians and citizens that is detrimental to building state capacity. We show that vote buying, as a measure of clientelism, and tax evasion, as a measure of state weakness, are highly correlated at the micro level. We also report evidence that both practices are widely accepted in society, a result consistent with a deeply entrenched relationship of mutually reinforcing influences. Finally, we propose a set of mechanisms that underlie the hypothesis that a weak state and widespread clientelism are part of a political equilibrium with multiple feedback loops. Our results suggest that state weakness is a trap that is likely hard to exit. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

The Impact of Aid Dynamics on State Effectiveness and Legitimacy

Efforts to build state capacity in developing countries are often predicated on the assumption that external partners can help states improve their effectiveness and earn legitimacy by providing aid for public service provision. In a theory-building exercise, this paper advances a typology of aid dynamics in order to afford a granular picture of how development assistance for public service provision interacts with internal governance processes in recipient countries. Developing a conjunctural conceptualization of aid dynamics, we articulate how the impact of foreign aid depends not just on how much money is involved but also on whether donors or recipient governments are more influential in designing and implementing aid programs. We illustrate the descriptive utility of this typology by applying it to our empirical research on aid in the health and education sectors in Cambodia, Laos, and Uganda. We also probe causal expectations emerging from the typology, anticipating that aid for public service delivery has distinct and separate effects on state effectiveness and legitimacy depending on the precise aid conjuncture through which it is conceived and delivered. We conclude with suggestions for further research on the impact of foreign aid on state–society relations through the lens of public service delivery.

The Challenge of Building State Capacity in the Land Administration in Rajasthan: Creating a Regulatory Administration in Land

The quality of land markets and tenurial rights in land are significantly dependent on the quality of land administration. In most countries, governments provide services that can be defined as land administration including land record management, land valuation and tenure protection. In India the government has attempted to improve land administration by undertaking programmes to computerise land and title records. However, several administrative and structural issues with the land administration system are adversely affecting the quality of land administration, of which the computerisation process is one subset. This paper analyses the state capacity constraints and structural mis-alignments in the land administration of the state of Rajasthan and proposes a shift to a regulatory state. We build on our analysis to argue that a shift to a regulatory state is necessitated by the paucity of human capital in the land administration. This paper examines the efficacy of the separation of core services to be provided by the state and other services that can be provided by regulated, private service providers. In doing so, this paper proposes a structural shift in the design of the land administration in Rajasthan.

Enforcing authoritarian rule over building state capacities: foreign military assistance in Guinea, Côte d’Ivoire and Upper Volta 1958–1974

ABSTRACT The decolonization of Africa coincided with intense Cold War competition. The opposing sides of the ideological divide were willing to invest considerable resources in expanding their influence to newly independent countries. International competition, hence, created opportunities for African presidents to attract significant resources from the external environment to increase their power. This article focuses on the impact of foreign military assistance on building the national militaries and political structures in francophone West Africa. It argues that military aid contributed to political systems where decision-making was concentrated to a few individuals and to the capital. The case studies demonstrate the difficulty of assessing the impact of military assistance, but also show that the main objective for granting or receiving countries was not to build a strong military. Granting countries wanted to gain influence and allies; receiving governments wanted to stay in power.

Building state capacity for welfare governance: The pathway and development of child welfare system and social work in China

ABSTRACT China’s dramatic socioeconomic transformation after the reform and opening up, coincided with changes in state-family relationship, has resulted in a large number of children at risk of care. In the past three decades, child welfare has been highly concerned by the government and society, and the child welfare system has substantially developed in the direction of establishing a moderately universal system. In this process, the development of child welfare and social work has shown a mutually reinforcing trend. This includes the professionalisation of child welfare services, the professional training of child welfare workers and the advancement of child welfare policies. The governance of child welfare is an essential component of national social governance. Its future development should be oriented towards a developmental and holistic approach of governance, and social work as an important institutional actor plays a critical role in promoting good governance of child welfare and beyond.