Bureaucratic Tools Research Articles

Organizational Formation for Priority Setting: Historical Perspectives and Thematic Analysis of India’s Health Technology Assessment Agency

ABSTRACT Countries pursuing universal health coverage must set priorities to determine which benefits to add to a national health program, but the roles that organizations play are less understood. This article investigates the case of the formation of an organization with a mandate for choice of technology for public health interventions and priorities, the Health Technology Assessment India. First, we narrate a chronology of agenda setting and adoption of national policy for organizational formation drawing on historical documentation, publicly available literature, and lived experiences from coauthors. Next, we conduct a thematic analysis that examines windows of opportunity, enabling factors, barriers and conditions, roles of stakeholders, messaging and framing, and specific administrative and bureaucratic tools that facilitated organization formation. This case study shows that organizational formation relied on the identification of multiple champions with sufficient seniority and political authority across a wide group of organizations, forming a coalition of broad base support, who were keen to advance health technology assessment policy development and organizational placement or formation. The champions in turn could use their roles for policy decisions that used private and public events to raise priority and commitment to the decisions, carefully considered organizational placement and formation, and developed the network of organizations for the generation of technical evidence and capacity building for health technology assessment, strengthened by international networks and organizations with financing, expertise, and policymaker relationships.

Impacts of accreditation on the performance of primary health care centres: A systematic review.

Evidence on the impacts of accreditation on primary health care (PHC) services is inconsistent. Thus, this study aimed to assess the impacts of accreditation on the performance of PHC centres. This study systematically reviewed articles published from 2000 to 2019 in the Web of Science, Scopus, ScienceDirect, Springer, PubMed and ProQuest. The following keywords were used: ((primary care OR primary health care) AND (accreditation) AND (impact OR effect OR output OR outcome OR influence OR result OR consequences)). The database search yielded a total of41256 articles, among which 30 articles were finally included in the review. Accreditation showed the most positive impacts on the quality, effectiveness, human resource management and strategic management of PHC services. Accreditation also positively affected safety, responsiveness, accessibility, customer satisfaction, documentation, leadership, efficiency and continuity of care. Few negative impacts were noted, including the possibility of accreditation being used as a bureaucratic tool, high cost of acquiring accreditation, difficulties in understanding the accreditation process, high staff turnover rate in accredited PHC centres and weak sustainability of some accreditation programmes. Given its numerous positive impacts, accreditation could be used to effectively improve the performance of PHC centres.

Diagnosing social ills: Theorising social determinants of health as a diagnostic category.

Medicine, as an institution and discipline, has embraced social determinants of health as a key influence on clinical practice and care. Beyond simply acknowledging their importance, most recent versions of the International Classification of Diseases explicitly codify social determinants as a viable diagnostic category. This diagnostic shift is noteworthy in the United States, where 'Z-codes' were introduced to facilitate the documentation of illiteracy, unemployment, poverty and other social factors impacting health. Z-codes hold promise in addressing patients' social needs, but there are likely consequences to medicalising social determinants. In turn, this article provides a critical appraisal of Z-codes, focussing on the role of diagnoses as both constructive and counterproductive sources of legitimacy, knowledge and responsibility in our collective understanding of health. Diagnosis codes for social determinants are powerful bureaucratic tools for framing and responding to psychosocial risks commensurate with biophysiological symptoms; however, they potentially reinforce beliefs about the centrality of individuals for addressing poor health at the population level. I contend that Z-codes demonstrate the limited capacity of diagnoses to capture the complex individual and social aetiology of health, and that sociology benefits from looking further 'upstream' to identify the structural forces constraining the scope and utility of diagnoses.

Who Counts as Family? How Standards Stratify Lives

Building on Max Weber’s observation that the state’s reliance on formal tools leads to governance for some and dehumanization for others, we investigate administrative standards as a social mechanism of stratification that sorts people into categories and allocates symbolic and financial resources. Specifically, we examine how at a time of increased family diversity, the state’s use of family standards at the end-of-life discounts certain people as kin. Based on ethnographic and documentary data about government’s implementation of family standards to identify next-of-kin and task them with the disposition of dead bodies, we find that the use of family standards leads to three outcomes: a formal fit between standard and family forms; a formal misfit between who is designated next-of-kin and who is willing to handle disposition, leading to bodies going unclaimed; and a formal refit, where people not officially designated as next-of-kin overcome formal barriers to disposition. Our analysis offers a conceptual framework to examine how administrative standards include and exclude people from social groups. These bureaucratic tools produce a standard-specific governable life for some, and a diverse range of oppositional effects varying from non-recognition to opportunism for the non-standardized.

The Criminal Registry in the German Empire: The ‘Cult of Previous Convictions’ and the Offender’s Right to Be Forgotten

Abstract In 1882 the criminal registry, a bureaucratic tool used to assemble information about the criminal biographies of German citizens, was implemented in all territories of the German Empire. This article demonstrates that the registry, evidence that states were accumulating ever more knowledge about the population, was from the beginning surrounded by critical reflection on its functioning. Worried about the scale of the work involved, in the interests of administrative efficiency bureaucrats wished the use of the registry to be curtailed. Prussian officials stressed that private parties should be denied access to the registry, while scholars pointed out that the registry was not intended to support forensic investigation. Journalists and worried citizens argued that the use of the registry in German courts was responsible for a culture of excessive suspicion. By portraying the emotional effects of the registry on German citizens, critics therefore sought to mobilize empathy for the ‘victims’ of the registry and started to demand a ‘right to be forgotten’. The Expungement Law of 1920 was designed as a solution to many of these problems and can be viewed as the endpoint of an important liberalizing process in German society. Yet, for many contemporaries the law was largely ineffective, for it did not combat social prejudices against citizens with a criminal record.

The Spectacle of Data: A Century of Fairs, Fiches, and Fantasies

Alongside the robots, rockets, kitchen appliances, and other technical wonders displayed at the great expositions and world’s fairs of the late-19th and early-20th centuries, visitors frequently found deceptively staid demonstrations of banal bureaucratic tools: cards, fiches, and files. Yet these technologies of information management were aestheticized and presented as integral to the generation and pursuit of the fairs’ ambitious ‘world projects’: global networks, universal intelligences, efficient cities, colonized galaxies. The small, moving parts of information functioned as critical tools for city- and world-building. In this article we begin with the 1964–5 World’s Fair, where bits and fragments of information fueled (or generated?) space-age visions, then trace those mid-century imaginaries back to the 1939–40 World’s Fair and a constellation of expos at the turn of the century, to see how the small, moving parts of information management ‘scale up’ to generate grand fantasies, and, at the same time, how they serve to index their own particular political and cultural milieux.

Bureaucratic Tools in (Gendered) Organizations: Performance Metrics and Gender Advisors in International Development

This article contributes to a growing conversation about the role of numbers in promoting gendered agendas in potentially contradictory ways. Drawing from interviews with gender advisors—the professionals tasked with mainstreaming gender in development projects—in an East African country, I begin from the paradox that gender advisors articulate a strong preference for qualitative data to best capture the lives of the women they aim to assist while voicing a need for quantitative metrics. I demonstrate that (women) gender advisors come to imagine metrics as expeditious bureaucratic tools able to inspire cooperation from otherwise reluctant (men) coworkers. I argue that development organizations are gendered in ways—acutely seen in how advisors struggle, are sidelined, and attempt to advance their goals with numbers—that lead to the utility of valuing quantitative metrics over qualitative ones. I establish two theoretical contributions: (1) Gendered organizations theory is essential to understanding the adoption and globalization of performance metrics, and (2) in an age of evidence-based decision making, the utility of quantified data to garner resources is heightened, rewarding those who adopt quantified knowledge production. I coin the term “the paradox of quantified utility” to describe how these material advantages encourage even skeptics to value quantitative metrics.

On the Material Semiotics of the Bates Stamp

Ethnographic studies of legal materiality and the bureaucratic mundanities of law often juxtapose their richly empirical approach to the material assemblages of law with the ‘grand talk’ and conceptual abstractions of law. This article considers the intersection of formal legal discourse and the mundanity of bureaucratic practice through an examination of two judicial opinions concerning the legal significance of the Bates number, a sequential digit inscribed onto documents produced in US pretrial discovery. Through this analysis, the article both illustrates the Bates stamp’s role in the material constitution of law, and offers a reminder that the stories law tells about its own materiality can offer insights into, and enact and extend, the sociolegal agency of bureaucratic tools.

Voices of youth: how Indigenous young people in urban Ontario experience plans of care

The plan of care is a document completed regularly for every child and youth in the care of Children’s Aid Society in Ontario. Using a mixed methods approach with a strong emphasis on Indigenous Methodologies, a key informant and two Indigenous young people who have been in care share their thoughts about how plans of care can be improved. The youth describe how their plan of care was impacted by the relationship with their worker and level of participation in goal setting. It is discussed that the plan of care presents as a standardized, bureaucratic tool that does not inherently reflect Indigenous culture. These findings lead to recommendations for change including greater opportunities for relationship-building between workers and youth, space for young people to participate in planning, integration of Indigenous culture in plans of care, and the need for reconciliation at the macro level.

Challenging portrait conventions: ‘Types’, masks and the series in South African portraiture

ABSTRACTHistorically, portraiture was perceived to faithfully portray the unique essence of the sitter, through the process of mimesis. This mimetic portrayal was also essential to the racial classification of South Africans under apartheid, when a tetrad of race was promulgated in the Population Registration Act of 1950 (Breckenridge 2014b:226). This article investigates the questioning of racial taxonomy in contemporary South African portraits. It argues that the notion of individual essence is questioned through rhetorical devices such as ‘types’, masks and the portrait series. Racial categories are questioned through ‘types’ in portraits by Keith Dietrich, Pieter Hugo, Anthea Pokroy and Frikkie Eksteen. Kendell Geers and Richardt Strydom employ the mask to efface individual essence, while foregrounding socio-political issues. The notion of the portrait series is discussed in relation to portraits by Marlene Dumas which, contrary to portraiture’s aim, highlights the collective over the individual. This article argues that the representation of the subject through ‘types’, masks and the portrait series challenges the totalitarian impetus to arrest the sitter’s essence in the portrait. The discussion commences with the exploration of the mimetic portrayal of the individual in the portrait, which became a bureaucratic tool of racial classification.

The Cynical Public: Claims about Science in the Discourse on Hydrofracking

This content analysis of newspaper articles and online social media from English-speaking sources on the topic of ‘fracking’ interrogates the use of scientific legitimacy in claims-makings and how public understandings of science develop through these media. In both forms of media, science is invoked in one sense as rational and objective to either neutralize or support emotionally-charged accounts and fears of hydraulic fracturing dangers. In another sense, however, science is viewed as a bureaucratic tool used at the will of government and business interests and easily corrupted to support ideological or interest-based positions. Claims regarding science typically follow ideological positions rather than the reverse - the ‘science’ that supports fracking as safe is called into question by those skeptical of fracking, while the anti-fracking position is designated as ‘anti-science’ by those who favor fracking. These strategies as they play out in the media serve to spread uncertainty, heighten cynicism, and undermine public confidence in science. An understanding of science as incomplete and cumulative, however, lends itself to the precautionary principle.

Try to Control Yourself: The Regulation of Public Drinking in Post-Prohibition Ontario, 1927-44 by Dan Malleck

Reviewed by: Try to Control Yourself: The Regulation of Public Drinking in Post-Prohibition Ontario, 1927-44 by Dan Malleck Christine Sismondo Malleck, Dan – Try to Control Yourself: The Regulation of Public Drinking in Post-Prohibition Ontario, 1927-44. Vancouver: UBC Press, 2013. Pp. 305. Like all perfectly-titled books, Dan Malleck’s Try to Control Yourself: The Regulation of Public Drinking in Post-Prohibition Ontario, 1927-44, summarizes his argument succinctly. In a nut, the end of Prohibition represented a new, more moderate phase in Ontario moral regulation, one in which the newly constructed “citizen-drinker” became a participant in a complex and highly bureaucratic negotiation between political power and the body. From 1916 to 1927, there was a total prohibition on alcohol in Ontario and, as such, until repeal, there was no legal public drinking and no “citizen-drinker.” In Malleck’s view, this period was a legislative excess, since there was no room for negotiation. Repeal, therefore, represented the scaling back of excess and a move towards a more moderate approach. In turn, the 1927 Liquor Control Act requested that the “citizen-drinker” be moderate, too, unlike the pre-prohibition [End Page 268] drinker, who has been characterized as intemperate. Malleck sees the 1927 LCA, which birthed the Liquor Control Board of Ontario, as evidence of “temperance” in government—a neat turn of phrase and concept that fits in well with his Foucauldian framework. Since it’s tempting to begin a study of public drinking in Ontario in 1934 (when licensed beverage rooms were first allowed), Malleck’s choice to delve into the transition period from 1927 to 1934 is especially revelatory. Purchasing alcohol was legal, but only with an individual permit. Through this bureaucratic tool, which could be revoked at the discretion of the Liquor Control Board, consumption could be tracked and, to some degree, controlled. Individuals that held both Standard Hotel licenses and liquor permits produced the most anxiety for the Board, since they were in prime position to break the law and profit from semi-public drinking. Many hotel owners and employees were caught selling alcohol to guests who held parties in private rooms or, occasionally, in the public spaces of the hotel. We might assume that the repercussions for violating the conditions of both licenses would be swift and harsh and that hoteliers risked losing their livelihood with every quick sale of liquor. Not so, says Malleck, whose research involved reading every LCBO Establishment File in six jurisdictions—Toronto, Ottawa, Niagara, Essex County, Waterloo County and Thunder Bay—and revealed a pattern of paternalism and leniency. One woman hotel-keeper caught selling liquor on New Year’s Eve 1929 was told to be a “good girl.” So, although the Liquor Control Board of Ontario (LCBO) is often portrayed as a tight regulatory agency, the control was primarily in the form of documentation and light reprimands, as opposed to strict enforcement. This is a significant departure from previous work that has interpreted the LCBO as an agency of tight social control. Malleck shows how liquor control was, instead, about disciplining subjects. From 1927 to 1934, pressure to allow beverage rooms in Ontario largely came from people who believed that making public drinking legal would give the economy a much-needed boost. Critics of the restrictive Liquor Control Act of 1927 argued that Ontario’s ban on bars and permit requirements made the province unattractive to American tourists, who were looking for a vacation from Prohibition. Four other provinces—British Columbia, Alberta, Manitoba and Quebec had more liberal public drinking laws and, as such, were more competitive tourist destinations. When America began seriously debating repeal of its federal prohibition on alcohol, Ontario opted to review its laws, too. Of course, it’s unlikely that many post-Prohibition Americans would have been enticed by Ontario’s sorry beverage rooms, since the restrictions were myriad and designed to make it as likely as possible that Ontarians would control themselves. Where many American states opted to allow cocktails, live music and saloon-style stand-up bars, Ontario’s beverage rooms could only serve small glasses of beer to seated patrons. These conditions, in addition to advertising and signage...

When Worlds Collide: Business Meets Bureaucracy in the Water Sector

Increasing water scarcity has attracted more businesses and their high-powered market tools to a sector that has been dominated historically by organizations operating under low-powered incentives. This paper compares business and bureaucratic institutions through three interfaces. The first compares bureaucratic tools – such as water footprinting and conservation technologies – to business tools that rely on prices and markets to change water consumption. The second explores how high-powered incentives within a low-powered institutional setting can result in harmful outcomes, as when regulations on bottled water, hydraulic fracturing, and food exports mismatch costs and benefits. The third discusses how changes in information make business tools for managing risk from floods and drought more appropriate than bureaucratic tools developed in a past of uncertainty. Institutions that allocate water with appropriate incentives – high-powered business incentives for economic uses and low-powered bureaucratic incentives for social uses – will maximize social wealth, but mismatches will increase negative spillovers and waste resources.

Moral Hazard, Discipline, and the Management of Terrorist Organizations

Terrorist groups repeatedly include operatives of varying commitment and often rely on a common set of security-reducing bureaucratic tools to manage these individuals. This is puzzling in that covert organizations are commonly thought to screen their operatives very carefully and pay a particularly heavy price for record keeping. The authors use terrorist memoirs and the internal correspondence of one particularly prominent group to highlight the organizational challenges terrorist groups face and use a game-theoretic model of moral hazard in a finitely sized organization to explain why record keeping and bureaucracy emerge in these groups. The model provides two novel results. First, in small heterogeneous organizations longer institutional memory can enhance organizational efficiency. Second, such organizations will use worse agents in equilibrium under certain conditions. The core logic is that in small organizations the punishment strategies that allow leaders to extract greater effort are credible only when operatives can identify and react to deviations from the leaders' equilibrium strategy. This dynamic creates incentives for record keeping and means that small organizations will periodically use problematic agents in equilibrium as part of a strategy that optimally motivates their best operatives.

Beyond Bureaucracies?

■ Can workers run socially responsible enterprises or are they doomed to bureaucratization and self-exploitation under the pressures of the prevailing socio-economic system? This article focuses on the empresas recuperadas (ERs), workers’ cooperatives established during Argentina’s 2001 social and economic crisis. Combining ethnography and a critical political economy of accounting, it provides a worker-centred approach to ‘corporate social responsibility’ (CSR), which recognizes the politico-cultural complexities of class and state formation as constitutive social processes. Responding to the effects of neoliberal restructuring, thousands of Argentine workers occupied, revived and operated bankrupt or abandoned companies, often using assembly-based decision-making. Challenging idealistic or deterministic approaches, the article identifies links between the everyday politics of profitability, wider processes of state formation and workers’ social understandings. It reveals that while some ERs used accounting as a bureaucratic tool of moral and political leadership that constrained social goals, others democratized their accounts to promote social responsibility centred on self-empowerment. My findings suggest the possibilities for qualitative innovations in political economy by demonstrating that objectivity in accounting needs grounding in intersubjectivity, in the ethnography of communication between subjects relating to a shared world. They support Marx’s theory of determination by identifying the practical possibilities for worker-run companies to control capital as a social relation and promote human-centred CSR through their accounting control, rather than simply imposing the usual productivity targets.

Paradoxes of High-Stakes Testing

Over the centuries and across nations, tests have been employed as bureaucratic tools for a variety of purposes. As far back as 200 BC, the Chinese used tests to help eliminate patronage and open access to the civil service. The Dead Sea scrolls describe the use of tests by the Qumran community to determine when a man was ready to become a formal member of the community. England, France, and Italy, among other nations, have used tests to ensure that students acquire certain skills and establish standards of performance. In fifteenthcentury Italy, tests were used to hold teachers accountable for student learning. Since then, policy-makers have used tests to hold students and schools accountable and allocate scarce resources.

The Incan Quipus

Quipus, knotted structures of woollen or cotton cords, were used as a bureaucratic tool in the Inca state. In the absense of a writing system, numerals and possibly other pieces of information were encoded on the quipus by tying knots into elaborately structured coloured cords. Though interpretation of the quipu contents is far from complete, some information on Inca mathematics can be deducted from the analysis of ancient specimen, especially when combined with the results of anthropological and linguistic research in contemporary Andean societies. In this paper, the quipus are introduced, their structure is explained, and some results on mathematical concepts of the Incas are presented based on a comparison of mathematical and anthropological literature on the subject.

Performance evaluation in the hotel industry

The job analysis, which is a basic foundation of the evaluation process, is not a bureaucratic tool, but the element of an effective leadership. Due to the variety of jobs, high turnover of employees, superiority of subjective factors, and a strong dependence of work activities on customers' demand, the job analysis in the hotel industry is rather necessary.

Healthy Cities and change: social movement or bureaucratic tool?

Healthy Cities is seen as a vision, project and movement. Its wide appeal leaves it open to losing touch with the core values envisaged by the origtnators of Healthy Cities. This paper considers the outcomes Healthy Cities should aim for in Australia and the processes by which they can be achieved It identifies the political ideology underlying the Ottawa Charter as social democratic and collectivist. Economic rationalism, individualism and misplaced professionalism are discussed as blocks to achieving Healthy Cities. It is suggested that professional workers seeking to promote health should operate within a 'health promotion winners' triangle' as many do currently. The paper concludes by arguing that Healthy Cities should ensure complacency does not permit a taken-for-granted economism, individualism and professionalism to dominate agendas for change and suggests ways in which collaborations with forces inside and outside bureaucracies may assist the processes of achieving healthier cities.

Artificial Negativity as a Bureaucratic Tool? Reply to Roe

Abstract Roe closes his half-hearted defense of affirmative action bureaucracies with a quote from Mannheim to the effect that “bureaucracy is the type of organization which renders all policy issues into administrative problems.” This must be his way of apologizing for his own reduction of the artificial negativity analysis of the changing character of advanced capitalism during its oligopolistic phase, i.e., following the New Deal/Welfare state reorganization of the socio-economic system between the early 1930s and the mid-1960s, to merely another relatively trivial elaboration of internal bureaucratic dynamics. Although an analysis of affirmative action bureaucracies as artificial negativity may help explain their dismal record of increasingly generating perplexing counterfinalities.