Devolution Of Governance Research Articles

The views of family physicians on National Health Insurance in Gauteng Province, South Africa.

Universal health coverage (UHC) improves national health outcomes while addressing social inequalities in access to quality healthcare services. The district health system (DHS) is critical to the success of UHC in South Africa through the National Health Insurance (NHI) scheme. Family physicians (FPs), as champions of primary care, are central to the DHS operation and implementation of NHI. This was a qualitative exploratory study that used semi-structured interviews to explore FPs views and engagement on NHI policy and implementation in their districts. Ten FPs were included through purposive sampling. Most of the FPs interviewed were not engaged in either policy formulation or strategic planning. The NHI bill was seen as a theoretical ideology that lacked any clear plan. Family physicians expressed several concerns around corruption in governmental structures that could play out in NHI implementation. Family physicians felt unsupported within their district structures and disempowered to engage in rollout strategies. The FPs were able to provide useful solutions to health system challenges because of the design of their training programmes, as well as their experience at the primary care level. Healthcare governance in South Africa remains located in national and provincial structures. Devolution of governance to the DHS is required if NHI implementation is to succeed. The FPs need to be engaged in NHI strategies, to translate plans into actionable objectives at the primary care level.Contribution:This study highlights the need to involve FPs as key actors in implementing NHI strategies at a decentralised DHS governance level.

Going down the local: the challenges of place-based net zero governance

Place-based decarbonisation is emerging as a significant element in the UK government’s net zero agenda, specifically through central government devolution deals. Such localised governance has the potential to reap social and economic benefits for communities whilst also potentially delivering on net zero goals. However, pre-existing institutional constraints and unresolved tensions remain, such as the uneven distribution of initiatives across areas and the fiscal limitations within local authorities. These could potentially exacerbate regional inequality rather than promote a just transition. This report characterises the current governance regimes and challenges to net zero delivery in four parts of the Midlands: Coventry, Nottingham, Leicester and Staffordshire. It highlights variation in local-scale action and identifies the constraints to multi-scalar governance for net zero. It recommends cultivating policy innovation, particularly to align planning with the net zero transition and identifies the potential role of regulatory sandboxes to this end as well as community ownership.

Water policy, politics, and practice: The case of Kitui County, Kenya

The devolution of governance to county level in Kenya provides a window for innovation in water policy and practice, critical to improving water security in rural areas where almost half of households lack basic water services. In rural Kitui County, Kenya, a number of projects supported by different funders have served as policy experiments over the past 10 years. We apply an action-oriented knowledge framework to explore the kinds of knowledge that have been produced in the course of these interventions and reflect on what kinds of knowledge are contributing to institutional change and how they are contributing to sustainability in the rural water sector. Actionable recommendations for the further development of county-level water policy include: First, ensure local ownership of the policy-making process whilst enabling appropriate technical and legal support; second, take long timeframes of institutional change into account in donor programming; third, establish water, sanitation and hygiene forums bringing diverse actors within the sector together to build cohesion, facilitate knowledge exchange, enable collaborative learning, and deliver collective action.

Does devolution influence the choice and quality of public (vs private) health care?

Government decentralisation also called ‘government devolution’ (GD) can provide an alternative to the ‘build in’ accountability mechanism of markets by influencing both the choice as well as the perceived quality of public versus private health care. To test this hypothesis, this paper exploits the gradual decentralisation of the political stewardship of the Spanish National Health System (NHS) using a difference-in-differences design. We find that GD (abandoning centralised governance) increases the choice and quality of (measured by the preference for, perceptions of, and satisfaction with) public health care (NHS) compared to private health care. Consistently, we also find that the GD reduces the uptake of private health insurance among higher income and education groups. These effects are mainly driven by improvements in health care quality as well as policy innovation and diffusion.

Interventions and intersections: institutional environment and local level autonomy in LEADER. A comparative study

In 2010, when hope emerged that the new conservative government would improve the governance of the LEADER Programme, the Naturama Alliance, a co-operative network of seven Hungarian LAGs, issued a Declaration that summarised procedural issues to be addressed by a revision[1]. After introducing the alliance, the first chapter was entitled “Decentralisation and Autonomy”, indicating the direction of the desired shift towards a more autonomous operation. The LEADER Programme is scrutinised in this article from the point of view of autonomy and local democracy, exploring to what extent these are linked with or distinct from higher level governance transformations towards decentralisation or recentralisation.
 Theoretical approaches derived from rural and government studies are interpreted in the first sections of the paper, exploring the debate regarding the correlation of autonomy and local democracy and the way it is manifested in LEADER. Most authors regard LEADER as a promoter of local democracy and identify a positive correlation between democracy and an enhanced local autonomy. However, a consensus among scholars also seems to be unfolding from these studies suggesting that the scope of ‘LEADER democracy’ is mostly narrow, restricting participation to more resourceful social groups due both to the ‘thematic filters’ of the Local Development Strategy and to ‘procedural filters’, such as capacities allocated to the staff for animation and assistance to overcome difficulties of application.
 The empirical research background of this article is provided by two case studies, which were conducted in 2018-2019, one in England (Northumberland Uplands) and one in Hungary (Balaton Uplands), two states with complex recent histories and trajectories in terms of devolution of governance to lower levels and local autonomy. The secondary interpretation of these case studies focuses on the degree of participation and autonomy of LAGs. The analysis reveals that the degree of autonomy (and to some extent of participation) declined in both countries in the last iteration compared to the 2007-13 programming cycle. It has also been uncovered that rather than the ‘post transition’, recentralised Hungarian context, it was the British institutional system and governance tradition that permitted more top-down intervention and less autonomy for the LAGs.
 
 
 [1] A NATURAMA Szövetség Akciócsoportjainak javaslatai az UMVP III. IV. tengelye intézkedéseinek
 hatékonyabb megvalósítása érdekében. [Suggestions of the NATURAMA Alliance for the more effective implementation of III-IV axes of the RDP], 2010.
 http://leadercontact.com/images/stories/https___leaderkontakt.pdf

Investing in Public Health Infrastructure to Address the Complexities of Homelessness.

Homelessness is now recognized as a significant public health problem in North America and throughout advanced economies of the world. The causes of homelessness are complex but the lack of affordable housing, unemployment, poverty, addiction, and mental illness all contribute to the risk for homelessness. We argue that homelessness is increasingly exacerbated by system-wide infrastructure failures occurring at the municipal, state, and federal government levels and whose catastrophic impacts on population health and the response to the COVID-19 pandemic are the consequence of the decades-long devolution of government and neglect to invest in public infrastructure, including a modern public health system.

A Critical Evaluation of New Localism and Neighbourhood Planning of the UK from a Social and Spatial Equity Perspective: Neighbourhood Planning of Highgate as a Case Study

The devolution of governance to communities is an integral aspect of the state strategy of localism. This paper critically evaluates New Localism and neighbourhood planning from a social and spatial equity aspect, mainly on whether or not this agenda can contribute to fairness especially equal participation, whether people can equally benefit from this agenda and whether the needed spatial housings and amenities are provided. The neighbourhood planning of Highgate will be regarded as a case study.

An Overview of Food and Nutrition Security Situation of Kenya

Achieving food and nutrition security remains a challenge for Kenya, despite International bodies providing long-term active support in order to achieve it. Low technological capability, inefficient production systems, inconsistent economic growth, increasing population and lately climate variability, affect food production, leading to either stagnation or only modest gains in food and nutrition security in Kenya. Nevertheless, food and nutrition security continues to improve, albeit at a slow pace. The major drivers of the improvements are political stability, ambitious economic planning, the quest for higher agricultural productivity, improving educational achievement, sanitation and health. To accelerate the process, Kenya embraced Vision 2030, devolution of governance and resources to County Governments, and lately, the Big 4 Agenda. This overview examines the status of food and nutrition security in Kenya including the prospects and the challenges faced. The analysis provides specific recommendations for achieving it. These include investment in agriculture, decelerating population growth, using adaptive research to solve farmer-problems, improving the management of farmer-organizations and formation of cooperatives.

‘The Best‐Laid Schemes o’ Mice an’ Men’? Proposals, Planning, Defeat, and Legacy, of Devolution in the 1970s*

AbstractThe question of whether devolved assemblies should be established for Scotland and Wales dominated considerable parliamentary time in the 1970s and became a key pillar of the Labour government's legislative agenda after the two 1974 general elections. The main building blocks of the government's devolution proposals for Scotland and Wales were in place from 1975 with the publication of the white paper, Our Changing Democracy, which outlined proposals for a primary lawmaking assembly for Scotland and a Scottish executive, operating under a ‘conferred powers model of devolution’. For Wales, the assembly was to be a body corporate (with no split between executive and assembly) exercising only executive functions and able only to pass secondary legislation. With some important modifications (including crucially the requirement for a referendum, which was then further amended to require a Yes tally equating to 40% of the electorates in both nations), these proposals were eventually incorporated into law as the Scotland and Wales Acts 1978.While the political debates surrounding devolution in this period are well known, less attention has been paid to the practical plans undertaken by the civil service for devolution to become a reality. Considerable time was spent drawing up, from an early stage, detailed preparations for devolution, particularly in Scotland. In Wales, planning was more tentative, yet, none the less, was taken seriously by the Welsh Office. These plans never materialised in the way envisaged, with neither Welsh nor Scottish devolution able to pass the referendum thresholds put in place. However, as this article also demonstrates, both the Scotland and Wales Acts had a constitutional legacy when devolution became reality under New Labour in the late 1990s.

Adaptive Governance and sub-national Climate Change Policy: A comparative analysis of Khyber Pukhtunkhawa and Punjab Provinces in Pakistan

This study explores the adaptive governance and effective implementation of climate policies at the subnational level in a developing country context. We focused on Pakistan as our central case as it is considered one of the most vulnerable countries to climate change and has also gone through a recent governance devolution process. This study is conduced to investigate climate governance at subnational level in Pakistan by looking at the province of Punjab and Khyber Pukhtunkhawah (KPK). We employ the Ostrom’s Institutional Analysis and Development (IAD) Framework for this study. The framework as methodology is important to uncover the complexity of adaptive governance at subnational level after devolution and transformation of environmental institutions in Pakistan. Different aspects of governance such as engagement of local actors, activism of political leadership, awareness campaigns, and capacity building are the notable initiatives in the provinces. The study identifies the differences of initiatives in these provinces are manifest in subnational climate change policy differentiation, research capacity and institutional maturity. The study finds that the provincial government of the KPK follows more participatory and decentralized approach while Punjab is more centralized. The IAD framework provided an effective means of understanding these complex differences in outcome and scale.

Outcomes of gear and closure subsidies in artisanal coral reef fisheries

AbstractThe outcomes of subsidizing natural and fishing capital were studied in nearshore coral reef fisheries initiated by the devolution of governance and management from national to county governments. One county promoted a net subsidy program of preferred mesh sizes with a distinct purchase and distribution date, while the other supported the ongoing maintenance of fisheries closures. This provoked a BACI design where standard fisheries statistics were measured 3 years prior to and 2.5 years after the net subsidy, or the life expectancy of these nets. Only ~50% of the purchased nets were utilized, indicating a replacement rather than addition of capital and low need. For example, net fishing effort did not change and there was an overall demographic change in gear use away from traps toward lower cost spearguns. Net subsidized fisheries displayed a 9% increase in the mean length of captured fish but also a decline in catch‐per‐unit effort (CPUE) and personal incomes and no change in prices, yields, and per area incomes. In contrast, the fisheries surrounding closures displayed increased fishing effort and a 4% decline in fish lengths but increased CPUE, yield, incomes, and per area revenues. The net cost of maintaining closures was less than the gear subsidy purchase. Significant time × treatment interactions in all indicators support the conclusion that gear subsidies, apart from larger fish sizes, worsened the fisheries, while closures improved it. Increased recruitment rather than growth of fish appeared to be the mechanism for improvement.

Economic marginalization and community capacity: How does industry closure in a small town affect perceptions of place?

Neoliberal economic reform has undermined industries in rural and ‘blue collar’ towns exacerbating uneven development and population decline. In response to calls to examine the variegated and often conflicting experiences of neoliberalism, we interrogate the community effects of industry closure in a small town in the South Island of New Zealand. Adopting a mixed methods study, qualitative interviews with affected residents describe decades of economic decline culminating in job loss from the remaining major employer. Job losses compromised a sense of shared identity and social interaction in a town where declining amenities provided few opportunities to practice incidental, public forms of citizenship. Analysis of the survey data indicated that one year on from the partial-closure of the major industry, a statistically significant, relative decline in community capacity was observed in the study community. This research provides evidence that a community's confidence in their self-management is directly impacted by economic context. This is the first study we are aware of that has (a) quantified changes in community capacity over time and (b) identified that industry decline has had a short-term, negative effect on community capacity. These findings suggest the devolution of governance to the local level may be less effective in times of economic flux.

Working the Spaces in between: A Case Study of a Boundary‐Spanning Model to Help Facilitate Cross‐Sectoral Policy Work

AbstractSince the 1990s, ‘joined‐up government,’ ‘whole‐of‐government,’ and ‘horizontal governance’ approaches have emerged in many industrialized countries, resulting in the devolution of government functions to diverse policy networks. From these shifts, complex systems of networked actors have emerged, involved in designing, implementation, and influencing policy. Arguably, networked approaches to policy may solve some problems. However, as with all paradigm shifts, new problems have emerged. Specifically, skill and knowledge gaps have opened up, reflecting the need for new collaborative and networked relationships that can increase the capabilities and agility to work in these ways. In response to these gaps, we developed the Power to Persuade initiative. Power to Persuade is an annual symposium and online forum, aimed at deepening knowledge and awareness of current problems faced by policy networks, and providing the skills and knowledge to overcome them. In this paper, we discuss how Power to Persuade works within the spaces in between as a vehicle for relationship building and better policy.

INFLUENCE OF SACCOS IN ENTREPRENEURIAL CAPACITY DEVELOPMENT IN DAGORETTI SOUTH CONSTITUENCY, KENYA

Purpose: The main objective of this study is to find out the influence of SACCOs in entrepreneurial capacity development in Dagoretti South constituency, Nairobi, Kenya. To successfully achieve the study objective the research was guided by the following specific objectives: - To establish the extent to which disbursed credit by SACCOs help in entrepreneurial capacity development in Dagoretti South constituency; To determine the extent to which deposits/share capital help in entrepreneurial capacity development in Dagoretti South constituency; To find out how SACCOs investment portfolios help in entrepreneurial capacity development in Dagoretti South constituency. To find out how information dissemination helps in entrepreneurial capacity development in Dagoretti South constituencyMethodology: The study employed a descriptive survey research design to find out the role of SACCOs in entrepreneurial development in Dagoretti constituency. The study adopted a census study. A questionnaire was used as primary data collection instruments. The collected data was examined and checked for completeness and comprehensibility. The data was then summarized, coded and tabulated with the help of the Statistical Package for Social Sciences (SPSS 17.0) Data presentation was done by the use of pie charts, bar charts and graphs, percentages and frequency tables.Results: With all the independent variables having p < 0.05, this indicates that there is a significant relationship among all the four variables with the influence of SACCOs in entrepreneurial capacity development in Dagoreti South constituency. From the results, a unit % increase in Access to Loans would result to 44% decrease in share capital. Additionally, a unit % increase in entrepreneurship education would result to 36% increase on the influence of SACCOs in entrepreneurial capacity development in Dagoretti South constituency. Having the composite mean as 3.68053 and the standard deviation as 0.4768, meant that the respondents agreed that Access to Loans, Share capital, and Entrepreneurship education had a significant influence on SACCOs in influencing entrepreneurial capacity development in Dagoretti South constituency.Recommendation: With the Kenya government steering towards industrialization in her vision 2030, entrepreneurship training should be the first gear towards this direction. Many countries have prospered as a result of constructing and embracing entrepreneurial culture among their population. SACCOs are a good starting point especially in rural-urban areas where government devolution tentacles have started to spread.SACCOs should strive to maximize on the earnings to build the institutional capital. This institutional capital ensures the permanence and growth of the SACCOs even in turbulent economic times. In fact, it would help the SACCOs to grow and, remain economically and financially viable. Such growth should be enhanced by effective financial practices not to mention entrepreneurial training.

Assessing the capacity for public value creation within leadership theories: Raising the argument

In recent years, public administration has been targeted by multiple reform efforts. In multiple instances, such initiatives have been ideologically couched in public-choice perspectives and entrenched beliefs that government is the problem. One unavoidable consequence of this continued bout of criticism is the fact that government currently has a noticeably decreased capacity of boosting creation of public value. Within this context, there certainly is an important need for approaches that would counterbalance the loss of public value induced by market fundamentalism. This article suggests that leadership, as a concept of theory and practice, due to its partial immunity to the private-public dichotomy, can provide a pragmatic avenue for nurturing public interest and public value within the devolution of governance, a declining trust in government and a diminished governmental capacity to propagate the creation of public value. While this article critically examines and assesses the capacity of different leadership perspectives in terms of creating and maximizing public value, its primary scope is not the provision of definite answers but rather the instigation of a much necessary discussion.

The Welsh Blood Service - 70 years of continuous change.

The National Blood Transfusion Service (NBTS) in England and Wales was established as a single entity in 1946 and operated as such for almost half a century. During those 50 years, the blood service in Wales, as in the rest of the UK, saw many technological and operational changes. The automation of donation testing, the introduction of successive layers of microbiological screening, the creation of the Tissue Typing Laboratory (later renamed the Welsh Transplantation and Immunogenetics Laboratory) and the development of information technology brought - over a relatively long period - highly significant improvements to an organisation that had begun life as an Emergency Medical Service. Differing funding and reporting arrangements for the Welsh and English blood services made little difference in practice, but the devolution of government following the 1997 referendum in Wales would have a profound influence. Four years before the Government of Wales Act (1998) was passed through the UK parliament, the National Blood Authority (NBA) assumed executive control of the English blood services but not the blood service in Wales. The Scottish National Blood Transfusion Service and the Northern Ireland Blood Transfusion Service had been created as independent organisations in 1946; thus, the scene was set for diversification between the four independent blood services, each operating in different political environments with different funding streams. The creation of the UK Blood Services Forum and its Joint Professional Advisory Committee in 1999 has, however, ensured consistency in professional matters. The blood transfusion service in Wales, in its new headquarters in Talbot Green, became known as the Welsh Blood Service (WBS), or Gwasanaeth Gwaed Cymru in Welsh, reporting for most of its life to the Velindre NHS Trust, part of NHS Wales. Considerable changes would impact the WBS in the 21st century. Social changes would mean that the role of recruitment and marketing would become ever more important, although the impact of this was lessened somewhat by a decreasing demand for blood following the Better Blood Transfusion initiatives. The Medicines and Healthcare Products Regulatory Agency found new powers and impetus after the so-called EU Blood Directive was transposed into British law, and the inspection regime became significantly more onerous, requiring more resources to be put in this area. A strategic review found that some parts of the service required extensive modernisation, such as the information technology system in use and the deployment of staff on the blood collection teams, and these matters were attended to. The review also prompted the Welsh Government to consider the question of blood supply to and blood collection in North Wales, which had been the remit of the Liverpool Centre since the establishment of the NBTS in 1946. The Welsh Government duly announced the creation of an all-Wales Blood Service, and finally, in May 2016, 70 years after its creation, the WBS took over responsibility for blood collection and blood provision in the whole of Wales.

Bridging the Gap: Hong Kong Senior Civil Servants and the 1966 Riots

ABSTRACTThe 1966 Hong Kong riots were the trigger for wide-ranging changes in relationships between the government and the public which shaped the political future of the colony. However, it is not immediately clear why a relatively small-scale disturbance which was quickly contained should have had such a considerable impact. The explanation, it is argued, lies in a confluence of factors. The riots were the first to be specifically concerned with events in Hong Kong rather than in China and therefore required attention to local causes; urban councillors were demanding more electoral representation and devolution of government functions to the Council; the Commission of Inquiry into the riots held public meetings raising political awareness; and reforming senior civil servants saw the riots as an opportunity for change. Because there was antipathy within government towards elections and to any devolution of functions, the recommendations of the Commission of Inquiry were given priority, resulting in administrative rather than public policy or electoral solutions, a decision which retarded the development of democracy.

Devolution, Evolution, Revolution … Democracy? What's Really Happening to English Local Governance?

AbstractThe Cities and Local Government Devolution Bill 2015–2016[HL] was introduced into the House of Lords as Bill No. 1 in the 2015–2016 parliamentary session. The Bill forms a critical element of the government's high‐profile policy of devolving powers and responsibilities to local areas within England. The transition from first‐generation ‘city deals’ to second‐generation ‘devolution deals’ within five years provides a sense of the pace and development of the reform agenda but there is also a strong sense that something is missing. ‘Missing’ in the sense of an understanding of the specific type of devolution on offer, ‘missing’ in the sense of how an explosion of bilateral new ‘deals’ will be offset against the obvious risks of fragmentation and complexity, and ‘missing’—most importantly—in relation to the democratic roots that might be put in place to counterbalance the economic thrust and make the reform agenda sustainable. It is in exactly this context that this article argues that the full potential of the current devolution agenda will only be realised when the Conservative government fulfils its September 2014 commitment to wider civic engagement about how England is governed.

Limits of Devolution: Localism, Economics and Post‐democracy

AbstractThis article challenges the narrowly founded but untroubled consensus about the alleged benefits of the Conservative government's devolution programme. It suggests that too much attention has been paid to purported benefits and too little regard to the potential risks, and draws attention to international evidence that suggests that the distribution of the benefits of devolution is crucially dependent on its design. It critically examines the case for the currently offered model of devolution and finds the underpinning economic model and limited forms of democratic accountability are likely to produce regressive social outcomes and the reinforcement of existing local elites. It calls for a wider public debate and fuller democratic scrutiny of the model of devolution on offer.

The law is not enough: Seeking the theoretical ‘frontier of urban justice’ via legal tools

This commentary examines the conceptual limits of urban justice through the use of legal tools, both generally and in actually existing neoliberal urban contexts. Our interest emerges from previous research on social service siting in a region with legal tools that seem exceptionally friendly to spatial justice due to limits on exclusionary zoning. Conceptually, such powerful legal levers might be expected to mitigate the generally observed tendency towards revanchism in contexts of urban government devolution. However, even given exceptional legal accommodations, we found a spatially concentrated service landscape, mirroring neoliberal market-led framings of ‘highest and best use’. Using this prior research as a point of departure, we highlight related findings in the broader literature on the use of the law by urban social justice activists. We argue that even maximally powerful legal protections for justice-oriented actors cannot blunt systematic spatio-political dynamics that lead marketised states towards revanchist outcomes. We call for future research which more explicitly charts the specific frontiers of the potential of the law as a tool for social justice.