Multi-stakeholder Involvement Research Articles

Integrating Top-Down and Bottom-Up Adaptation Planning to Build Adaptive Capacity: A Structured Learning Approach

Climate adaptation planning provides an opportunity to enhance the adaptive capacity of stakeholders across multiple levels. However, reviews of standard top-down and bottom-up approaches indicate that the value of multistakeholder involvement is not fully recognized or incorporated into guidelines. Focusing on provinces in Indonesia and Papua New Guinea within the Coral Triangle region, we present a novel integrated top-down and bottom-up planning approach. Based on Participatory Systemic Inquiry the process involves three stages of workshops intentionally designed to promote social learning, knowledge exchange, empowerment and social networks among multilevel stakeholders. Stage 1 workshops engage government, nongovernment and science stakeholders at the provincial level to analyze sub-districts' vulnerability and design appropriate adaptation strategies. Stage 2 engages local government, non-government and community stakeholders within vulnerable sub-districts identified in Stage 1. Stage 3 combines Stage 1 and 2 stakeholders to refine adaptation strategies and design action plans for sub-districts. Evaluation demonstrated that different stakeholder groups' perceptions of community adaptation needs varied significantly, justifying the approach. In terms of adaptive capacity, the primary outcome for all stakeholder groups was innovative ideas, suggesting that social learning and knowledge exchange had occurred. Empowerment was a secondary outcome. We discuss how the approach could be further refined.

Analysing the sustainability of the physical rehabilitation sector in seven fragile countries through multi-stakeholder involvement using a participatory consensus tool

Background: Sustainability is identified by nearly all organisations working in global health as one of the key indicators for project evaluation. Though typically recognised as an essential component for good project management to ensure positive impact, it is rarely applied effectively in practical terms and there are very few practical methods or tools to support implementation and monitoring of sustainable interventions. Further, despite efforts of stakeholders at all levels, the rehabilitation sector is not usually at the top of policy-makers’ agendas, which often results in limited to no funding and makes the task of building sustainability even more challenging at field level.

Analysing temporal changes and sustainability of rainfed 'Aus rice' production systems

An evaluation is needed to monitor the progress of sustainable agricultural development. This study jointly evaluates the temporal changes and sustainability of Aus rice production systems in Bangladesh. First, based on the literature review and synthesis, this study found that: 1) although the cultivation area of high yielding varieties (HYVs) increased over the last four decades, the total production of Aus rice gradually decreased; 2) the major drivers responsible for such changes are low yield of Aus rice, lack of available and appropriate HYVs, higher productivity concern of growers and the negligence of government intervention. Second, a set of 12 indicators was developed, employing a participative multi–stakeholder involvement. Data for this study were gathered through a questionnaire survey, covering 280 farm households and key informant interview as well as informal discussion with stakeholders. By applying data screening tests, multivariate analyses and the three main steps (e.g., normalisation) of index development, a composite indicator was constructed. Results demonstrated that less than half of Aus growers were sustainable in terms of environmental integrity, economic resilience, social development and good governance. The path analysis of determinants of contributory indicator revealed that five significant indicators for promoting sustainable Aus rice production exist, namely increasing land productivity and marketing facility, social and human capital formation and availability of extension services. The major policy implications of the findings of the study are outlined.

What is a new drug worth? An innovative model for performance-based pricing

This article focuses on a novel method to derive prices for new pharmaceuticals by making price a function of drug performance. We briefly review current models for determining price for a new product and discuss alternatives that have historically been favoured by various funding bodies. The progressive approach to drug pricing, proposed herein, may better address the views and concerns of multiple stakeholders in a developed healthcare system by acknowledging and incorporating input from disparate parties via comprehensive and successive negotiation stages. In proposing a valid construct for performance-based pricing, the following model seeks to achieve several crucial objectives: earlier and wider access to new treatments; improved transparency in drug pricing; multi-stakeholder involvement through phased pricing negotiations; recognition of innovative product performance and latent changes in value; an earlier and more predictable return for developers without sacrificing total return on investment (ROI); more involved and informed risk sharing by the end-user.

200th ENMC International Workshop “European Reference Networks: Recommendations and Criteria in the Neuromuscular field”, 18–20 October 2013, Naarden, the Netherlands

200th ENMC International Workshop “European Reference Networks: Recommendations and Criteria in the Neuromuscular field”, 18–20 October 2013, Naarden, the Netherlands

Review of Sustainable Agriculture: Promotion, Its Challenges and Opportunities in Japan

Agricultural ecosystems are the largest managed ecosystem in the world. The sustainable development of agriculture is significant to the reversion of dramatic loss of biological diversity in the world. Globally Important Agricultural Heritage Systems (GIAHS) project launched by Food and Agriculture Organization (FAO) of the United Nations is among the global efforts to conserve and dynamically manage the specific agricultural knowledge system and landscapes. Ministry of Agriculture, Forestry and Fisheries (MAFF), Japan stressed the environmental concern of conventional farming practices in Japan in 1992. Noto Peninsula and Sado City were designated as two new GIAHS pilot sites in Japan as part of local level initiative to preserve the traditional agricultural systems in 2011. This paper reviewed the development process of sustainable farming in Japan and analyzed the challenges and new possibilities to its further extension. The current situation of various sustainable farming practices: such as farming with reduced input of chemical fertilizers and pesticides to conserve rich biodiversity, and organic farming, were reviewed. Emphasis was given to the sustainable farming practices in Hokuriku region, in particular, Ishikawa Prefecture and Sado City in Niigata Prefecture. Based on the recent official documents, reports and research papers, policy implication was brought forward. The challenges of sustainable farming practices and market valuation of sustainable farming products were analyzed. It was concluded that the environmental concerns of farmers and consumers are key to extend the sustainable farming practice in Japan. Conversion to bottom up policy making process paying attention to farmers' interest with involvement of multi stakeholders including government, researchers and private sectors is effective for sustainable farming extension.

Implementing sustainable tourism: A multi-stakeholder involvement management framework

Within the extensive body of literature on sustainable tourism (ST), its successful implementation is an emerging and important theme. The lack of or ineffective stakeholder participation is a major obstacle to ST realisation and there is little clarity as to how best to resolve this problem. This paper presents the findings of a purposive UK-based case study that evaluated stakeholder involvement in the implementation of ST. Using over fifty stakeholders' accounts drawn from eight primary stakeholder groups, a ‘multi-stakeholder involvement management’ (MSIM) framework was developed. The MSIM framework consists of three strategic levels: attraction, integration and management of stakeholder involvement. Six stages are embedded within the three levels: scene-setting, recognition of stakeholder involvement capacity, stakeholder relationship management, pursuit of achievable objectives, influencing implementation capacity and monitoring stakeholder involvement. These are supported by the overarching notion of ‘hand-holding’ and key actions [e.g. managing stakeholder adaptability] that enhance stakeholder involvement in ST.

Sustainability Issues in Water Management

In the 1992 Rio World Summit on Environment and Development/UNCED), water resources are indicated to remain at the core of sustainable development and, thus, they are to be managed and developed on a sustainable basis. Sustainability is a philosophical concept and thus difficult to measure. Yet, we need to describe it on rather precise terms to assess whether our water management practices are sustainable and to ensure sustainability in decision making for management. To this end, a number of sustainability criteria have been defined, based on quantifiable measures, without overlooking immeasurable aspects of sustainable development. This paper considers economic, social and environmental dimensions of sustainability as the basic criteria to be pursued in evaluating how effective our water management plans are in achieving sustainability. On the other hand, actual case studies are needed to test the usefulness of selected criteria by using computer-based interactive optimization and simulation models with associated databases embedded into a decision support system (DSS). The study herein intends to present such a case study based on economic, social and environmental criteria to assess sustainability in management of the Gediz River Basin in Turkey. Various management scenarios developed for the basin are evaluated within a DSS while ensuring multi-stakeholder involvement in defining the three sustainability criteria. The case study is a result of the analyses carried out in SMART (Sustainable Management of Scarce Resources in the Coastal Zone) and OPTIMA (Optimization for Sustainable Water Resources Management) projects funded respectively by the 5th and 6th Framework Programmes of the European Union.

Global progress and potentially effective policy responses to reduce maternal mortality

Reducing maternal mortality within significant margins is a global imperative that reflects attainment of development goals. Progress in reducing maternal mortality, in particular among countries with notably high maternal mortality ratios (MMRs), has been substantially slower than the Millennium Development Goal target of an annual rate of 5.5% decline. The latest UN maternal mortality estimates show a reduction in MMR in a number of countries between 1990 and 2008. Understanding the factors associated with progress in countries that have reduced maternal mortality provides other countries and development partners with opportunities to consider and implement policies and interventions that could help accelerate progress. This paper reviews 6 countries that have demonstrated marked progress. The policies that have been effective include innovative financing measures; investment in human resources both in terms of strengthening pre-service education and emphasizing in-service training for healthcare providers; strengthening obstetric care by enhancing infrastructure and upgrading equipment, as well as improving quality of services; and investing in the broader determinants of maternal mortality, particularly family planning and women's education and socioeconomic empowerment. This range of actions, which includes a combination of facility and community-based approaches, provides a list of potentially effective strategies that could be considered when developing programs in other countries with slower progress. Strong political will and multistakeholder involvement and interventions are key in the development and implementation of these policies and actions.

Modeling mitigation strategies for toxic cyanobacteria blooms in shallow and eutrophic Lake Kasumigaura, Japan

This paper explores mitigation scenarios for toxic cyanobacteria blooms in Lake Kasumigaura is located about 60–90 km northeast of Tokyo, in the southeast of Ibaraki Prefecture, Japan. Dominant species of cyanobacteria (Microcystis aeruginosa, Microcystis viridis and Microcystis ichthyoblabe) produce highly potent toxins as (Microcystin-(Leucine + Arginine, MC-LR), Microcystin-(Arginine + Arginine, MC-RR) and Microcystin-(Tyrosine + Arginine, MC-YR) in the Lake. Toxin production is generally the result of two major factors-natural processes and human interferences. Both factors have an extreme influence on the generation of cyanobacteria toxins within lake ecosystems. To address these factors, we propose two concepts for mitigation. The first concept is intended for examining the natural process of toxin production behavior within the lake and the second concept is used for evaluating inflow of wastes and nutrients from human activities that form toxins. Our research aims to combine both strategies to mitigate impacts of toxins, by examining trends of cyanobacteria nutrient sources, buoyancy regulations that influence bloom formation, and the environmental conditions that spur blooms. This study proposes a simple IMPACT (Integrating Mitigation Policies for Aquatic Cyanobacteria Toxin) model for diminution strategies of harmful algal blooms and their toxins. A mixed-methods approach is employed, nested within the Environmental Systems Analysis (ESA) tools e.g. scenario analysis and stakeholder analysis. The quality of the lake is assessed through a combination of observation and field study analysis. The findings suggest that successful mitigation of cyanobacteria toxins is highly dependent on multi-functional, multi-stakeholder involvement, and relevant intergovernmental policy. Without integrating approaches among different stakeholders, diverse socioeconomic activists, local-national policymakers and effective policy measures, prevention of cyanobacteria toxin production within lakes becomes extremely complex and difficult. The proposed IMPACT model could be a decision framework for identifying suitable policies that mitigate cyanobacteria impacts.

Stakeholders’ Influence and Contribution to Social Standards Development: The Case of Multiple Stakeholder Approach to ISO 26000 Development

We present an empirical investigation on how multiple stakeholders can influence and contribute to a standard development process. Based on the analysis of comments submitted by stakeholders developing ISO 26000 standard for social responsibility, we found no significant differences between the ratio of accepted and non-accepted comments among various stakeholder groups; however, we conclude that industry is the most influential stakeholder due to the volume of the comments. We also present a set of processes that stakeholders follow to influence and contribute to standards development, namely to (1) eliminate issues that are controversial and undesirable; (2) link and integrate the standard into a network of other documents and ISO standards; (3) seek consensus by highlighting areas for further dialogue or by addressing their exclusion from the standards development, (4) reinforce issues that are important; and (5) improve the content of the new standard. In conclusion, we provide a set of propositions about multi-stakeholder standards development and compare multi-stakeholder involvement in standards developed through a new committee established in existing standards setting organization [i.e., Committees within the International Organization for Standardization (ISO)] and through new standards setting organizations established for one specific task (i.e., Forest Stewardship Council). We envisage that our study will be a useful platform to monitor and evaluate future developments of ISO 26000 and other multi-stakeholder standards.

Basin Water Resources Management in Unite States and Its Enlightenment to China

In order to provide some useful lessons to basin water resources management practice, this paper summarized the successful experience of the two modes of basin water resources management in the United States; one is the mode of the bureau of river basin water resources management represented in Tennessee, and the other is the mode of the committee of river basin water resources management represented in Delaware. The result shows that the improvement in legislation and management and coordination capacity and the increase in multi-stakeholder involvement is the key issue in the water resources management

International social-related accountability standards: Using ANT towards a multi-stakeholder analysis

This article illustrates and critically discusses how organizations manage, interact with, and involve stakeholders in social-related international accountability standards through the theoretical lens of actor-network theory. Theorizations on international accountability standards have largely focused on opportunities and problems related to their adoption from a macro-economic or governance perspective. The role of stakeholders and related management practices remain overlooked, with little evidence-based understanding of the interaction between internal and external organizational actors in multi-stakeholder involvement processes. Although overall generally relational approach to conceptualizing stakeholders is not new, this research focuses on the case of a well-known human-resource corporation and the way it involves stakeholders in a social-related accountability standard. The results reveal that gaining stakeholder involvement is a social innovation process supported by a strong network of stakeholders whose interests and agendas are taken into serious consideration by the corporation. The strength and the sustainability of the network established between the company and its stakeholders are subsequently dependent on the way the corporation translates its own interests and those of the stakeholders into common goals.

EPODE approach for childhood obesity prevention: methods, progress and international development

SummaryChildhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. ‘Ensemble Prévenons l'ObésitéDes Enfants’ (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity.At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input – drawing on the evidence-base – together with evaluation of the programme.Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge.

Approach to Environmental, Health and Safety Issues of Nanotechnology in Japan

In environmental, health, and safety issues of nanotechnology (nanoEHS), at present, risk assessment and management of nanomaterials to protect workers, consumers, and the environment is the most urgent. Workers have the highest possibility of being exposed to nanomaterials in workplaces, where nanomaterials may be inhaled or enter the body through dermal exposure. Several kinds of in-vivo tests have been done to assess the hazards of nanomaterials, mainly in terms of immunity response and carcinogenicity. Most advanced countries agree that it is important to manage the risks of nanomaterials with using the existing framework for chemical substances as much as possible to minimize risks, product of hazard and exposure. Research papers on the hazards of nanomaterials have been increasing, but there have been comparatively little scientific data related to exposuremeasurement. The Japanese government and national research institutes have been proactively committed to this issue since 2004. In addition to supporting several domestic projects, the Japanese government proactively joined international bodies such as the OECD Working Party on Manufactured Nanomaterials and ISO TC-229. Still, much more scientific data in appropriate studies and more discussion by appropriate participants are needed although funding is limited. To improve the situation, proposals have included (1) promoting basic research on nanoEHS, (2) increasing opportunities for scientific discussion on nanoEHS, (3) working continuously to construct and maintain databases on nanoEHS, (4) promoting the involvement of multistakeholders in nanoEHS, and (5) having ministries working cooperatively and efficiently on nanoEHS.

Multi-stakeholder involvement and urban green space performance

This study aimed to identify the main factors influencing urban green space performance. Therefore, a conceptual framework on the relations of multi-stakeholder involvement (MSI) and the performance was conducted by a mixed-method approach. The study covered all urban green space projects (UGSPs) published in international journals as its population which were obtained from three main databases: ISI Web of Knowledge, Scopus and Picarta. Using a few combinations of keywords, 29 relevant journals were identified, which included 42 UGSPs as the main units of analysis in this study. A content analysis was used to determine the contribution of MSI to the performance of urban green space. The main internal (state, private, society, planning/design, implementation, maintenance, input for management, and financial support) and external (regulation, good leadership and financial support) MSI indicators were further identified. The findings showed that the main indicators that significantly influence urban green space performance are ‘state, society, implementation and regulation’. The study concluded that the state plays a critical role in the UGSPs' performance although it is not the only actor. The influential role of the state and society should also be considered since most of green space projects are non-profit oriented. ‘Society’ involvement also contributes to the performance and ‘regulation’ is also needed as a legal basis for green space development and management. To validate the conceptual framework and mixed-method approach developed here, it is recommended that more studies should be conducted to compare the relationship of the MSI and the UGSPs' performance in different categories.

Participative environmental management and social capital in Poland

Eastern European countries, such as Poland, often illustrate social capital studies. Upon entering the European Union, social capital in Poland was seen as a problem in implementing new regulations, par- ticularly in the field of environmental policy. Equally important, environmental issues often present a high degree of complexity - and European legislation requires multi-stakeholder involvement in decision-making processes. Thus, the dilemma: on the one hand, there is a demand to engage and consult many actors; on the other hand, the actors function in administrative culture with a ubiquitous top-down approach taken by institutional decision makers. This paper attempts to address the problem from the perspective of social capital theory. An overview of ad- ministrative culture and examples of decision-making processes shows the way decisions are currently made. We also propose a way to achieve more participative environmental management. it plays in environmental management. The current situation in Poland and the way it a ects the environmental conser- vation sector is also discussed. We conclude with solutions tailored to the Polish conditions, and designed to increase bottom-up initiatives.

New Modes of Governance and Democratic Accountability

AbstractThis article raises the question of the link between new modes of governance and democratic accountability. Our definition of new modes of governance as modes refers to public policy-making that includes private actors and/or public policy-making by public actors that takes place outside legislative arenas, and which focuses on delimited sectoral or functional areas. We identify three different ways in which new modes of governance can be subjected to democratic control: parliamentary control, multi-stakeholder involvement and control through the public sphere and civil society at large. Building on a number of the illustrative insights from various empirical projects, we find that, in our cases at least, new modes of governance did not have a negative effect on existing patterns of democratic accountability. At the same time, neither multi-stakeholder policies nor the participation of civil society guarantee democratic accountability in the strict sense. We provide some evidence to the effect that, if institutionally linked to democratically elected governmental bodies – meaning, in this context, the European Parliament – it is more likely that negative externalities deriving from public policy-making in functionally segmented arenas of the European Union's multilevel polity will be dealt with in a more systematic way.

Developing a Policy-Relevant Research Agenda for the Patient-Centered Medical Home: A Focus on Outcomes

BackgroundThe Patient-Centered Medical Home (PCMH) is a widely endorsed model of delivery system reform that emphasizes primary care. Pilot demonstration projects are underway in many states, sponsored by Medicare, Medicaid, major health plans and multi-payer coalitions.MethodsIn this paper we consider the development of a long-term policy-relevant research agenda on outcomes of the PCMH. We provide an overview of potential measures of PCMH impact, identify measurement challenges and recommend areas for further study. Although the PCMH should not be expected to solve every problem in the health care system, developing a research agenda for measuring outcomes of delivery system innovations such as the PCMH should be considered in the context of the larger effort to improve the US health care system, with the ultimate goal to improve population health.ResultsAs a framework for our discussion, we have chosen the Institute of Medicine’s six specific aims for 21st century health care: (1) safe, (2) effective, (3) patient-centered, (4) timely, (5) efficient and (6) equitable. In addition, we include potential areas of PCMH outcomes that do not easily fall under this framework and consider unintended consequences.ConclusionMulti-stakeholder involvement will be essential in developing a long-term policy-relevant research agenda for outcomes of the PCMH.

Sustainability of vector control strategies in the Gran Chaco Region: current challenges and possible approaches.

Sustainability has become a focal point of the international agenda. At the heart of its range of distribution in the Gran Chaco Region, the elimination of Triatoma infestans has failed, even in areas subject to intensive professional vector control efforts. Chagas disease control programs traditionally have been composed of two divorced entities: a vector control program in charge of routine field operations (bug detection and insecticide spraying) and a disease control program in charge of screening blood donors, diagnosis, etiologic treatment and providing medical care to chronic patients. The challenge of sustainable suppression of bug infestation and Trypanosoma cruzi transmission can be met through integrated disease management, in which vector control is combined with active case detection and treatment to increase impact, cost-effectiveness and public acceptance in resource-limited settings. Multi-stakeholder involvement may add sustainability and resilience to the surveillance system. Chagas vector control and disease management must remain a regional effort within the frame of sustainable development rather than being viewed exclusively as a matter of health pertinent to the health sector. Sustained and continuous coordination between governments, agencies, control programs, academia and the affected communities is critical.