Local Councils Research Articles

A long way from Frome: improving connections between patients, local services and communities to reduce emergency admissions

BackgroundLow socio-economic status can lead to poor patient outcomes, exacerbated by lack of integration between health and social care and there is a demand for developing new models of working.AimTo improve connections between patients, local services and their communities to reduce unscheduled admissions.Design and settingA primary care cluster with areas of high deprivation, consisting of 11 general practices serving over 74,000 people.MethodA multi-disciplinary team with representatives from healthcare, local council and the third sector was formed to provide support for people with complex or social needs. A discharge liaison hub contacted patients following hospital discharge offering support, while cluster pharmacists led medicine reviews. Wellbeing Connectors were commissioned to act as a link to local wellbeing and social resources. Advance Care Planning was implemented to support personalised decision making.ResultsUnscheduled admissions in the over 75 age group decreased following the changes, equating to over 800 avoided monthly referrals to assessment units for the cluster. Over 2,500 patients have been reviewed by the MDT since its inception with referrals to social prescribing groups, physiotherapy and mental health teams; these patients are 20% less likely to contact their GP after their case is discussed. An improved sense of wellbeing was reported by 80% of patients supported by wellbeing connectors. Staff feel better able to meet patient needs and reported an increased joy in working.ConclusionImproved integration between health, social care and third sector has led to a reduction in admissions, improved patient wellbeing and has improved job satisfaction amongst staff.

Greed or Grievance? Linking Revenue Sharing Implementation to Unauthorised Resource Use and Conservation Support at Bwindi Impenetrable National Park

Revenue sharing is considered a major incentive to promote Community Based Approaches to conservation of protected areas. The sharing of revenue from Protected Area resources is supported by conservationists to promote strong partnerships between protected area management and local communities to address unauthorised resource use for better conservation outcomes. This is premised on the ability of the shared revenue to translate into people’s livelihood improvement and minimize their dependency on resources from protected areas. However, empirical realities indicate that the practice of the Revenue Sharing policy barely addresses the initial objectives of human livelihood improvement to gain support for conservation. This study examined the Revenue Sharing Implementation, Data was collected from 715 respondents who included Local community members (including the unauthorised resource users), staff from conservation organisations in Bwindi and local council leaders. Data was collected using household survey questionnaires, key informant interviews and Focus Group Discussion (FGD). Results showed that most beneficiaries of the Revenue Sharing policy were random community households not the unauthorized resource users. The revenue sharing projects allocated to community members were majorly livelihood projects compared to common good projects. Projects included; livestock, passion fruit growing, poultry, provision of land and water projects. Unauthorised resource use was largely motivated by the need for bush meat, minor timber forest products especially firewood, collection of basketry materials and medicinal plants. Protected area managers ought to consider greater involvement of poachers in Revenue Sharing activities. Reducing unauthorized resource use requires systematic but also a combination of factors to mitigate the most driving forces that compel community members to engage in unauthorized forest resource use

Meeting the Needs: Description and Evaluation of an Alcohol Related Brain Damage (ARBD) Residential Rehabilitation Service

ABSTRACT To describe and evaluate a cost-effective, integrated model of service provision for people with Alcohol Related Brain Damage (ARBD). Participants identified by three large acute hospitals as having ARBD and suitable for recovery and rehabilitation were offered a 12-week recovery-focussed program at a residential unit. The unit is a collaboration between an NHS board, the local council, and a 3rd sector organization Participants’ pre-admission and post-admission medical data was gathered to analyze the effectiveness of the unit’s program on Emergency Department (ED) attendance and inpatient bed use. Improvement in cognition was measured by comparing the ACE-III results for all participants at admission and just prior to discharge from the program. Thirty-one participants met the inclusion criteria. Paired t-tests revealed the 12-week program overall significantly reduced attendance at ED, use of in-patient beds after discharge, and improved cognitive functioning. This integrated model of service provision provides clear benefits to residents’ cognitive functioning and to the NHS by freeing up inpatient beds and ED capacity. Therefore, it should be considered by commissioners when addressing the needs of people with ARBD.

Sounding out solutions: using SONAR to connect participants with relevant healthcare resources.

This article outlines a scalable system developed by the All of Us Research Program's Genetic Counseling Resource to vet a large database of healthcare resources for supporting participants with health-related DNA results. After a literature review of established evaluation frameworks for health resources, we created SONAR, a 10-item framework and grading scale for health-related participant-facing resources. SONAR was used to review clinical resources that could be shared with participants during genetic counseling. Application of SONAR shortened resource approval time from 7 days to 1 day. About 256 resources were approved and 8 rejected through SONAR review. Most approved resources were relevant to participants nationwide (60.0%). The most common resource types were related to support groups (20%), cancer care (30.6%), and general educational resources (12.4%). All of Us genetic counselors provided 1161 approved resources during 3005 (38.6%) consults, mainly to local genetic counselors (29.9%), support groups (21.9%), and educational resources (21.0%). SONAR's systematic method simplifies resource vetting for healthcare providers, easing the burden of identifying and evaluating credible resources. Compiling these resources into a user-friendly database allows providers to share these resources efficiently, better equipping participants to complete follow up actions from health-related DNA results. The All of Us Genetic Counseling Resource connects participants receiving health-related DNA results with relevant follow-up resources on a high-volume, national level. This has been made possible by the creation of a novel resource database and validation system.

Educational Decentralisation and the Management of Public Primary Schools by Local Councils in Cameroon

Educational Decentralisation and the Management of Public Primary Schools by Local Councils in Cameroon

Local power play: the post-election repression and local governance

ABSTRACT We explore the aftermath of electoral defeats for incumbents in competitive authoritarian regimes, positing that they escalate repression in response. While prevailing research on competitive authoritarian regimes typically analyses incumbent repression at the national level, we focus on its effects on local political actors. Our argument centres on subnational variation in repression, influenced by the incumbent’s strength within the local city council. Specifically, incumbents tend to employ legislative blockage to hinder opposition mayors from efficiently delivering public goods when their party holds a majority of seats in the city council. We present original data on legislative proposals in city councils and employ a mixed-method approach to investigate this phenomenon. The 2019 local elections in İstanbul offer a unique opportunity to probe the dynamics of repression against the opposition at the local level. Our findings underscore that repression neutralizes emerging political leaders, thereby undermining municipal administration in the process.

Exploring the Paradoxical Nature of Digital Public Services: Experiences of UK Local Council Leaders

Exploring the Paradoxical Nature of Digital Public Services: Experiences of UK Local Council Leaders

Instrumental councillors? On the strategic interests that drive local councillors’ legitimacy perceptions of citizen participation

ABSTRACT Lately, municipalities in Western democracies have become increasingly more participatory. Local councillors have a fundamental role therein as they can either enable or block citizen participation. In that vein, their legitimacy perceptions towards different participatory arrangements seem key. This article analyses to what extent instrumental motivations steer these attitudes. Specifically, we distinguish between collective power (belonging to the governing majority or not) and individual influence (level of self-perceived political efficacy) as explanatory variables. Results based on a large-scale survey among local councillors in Flanders (Belgium) show that instrumental motivations indeed play a significant role: councillors with high levels of influence perceive traditional forms of decision-making (classic decision-making and consultative participation) as more legitimate. At the same time, majority councillors evaluate decisive forms of citizen participation as less legitimate than their colleagues in opposition. Additionally, feeling more powerful seems to be linked with an overall enthusiasm irrespective of participatory designs.

Evidence of Factors Hindering Establishment of Viable Rural Development Action in Eastern Cape Municipalities

Efforts aimed at assuaging rural areas in South Africa date back to the post-transition-to-democracy era in 1994. During this era, reforms and policy interventions aimed to enhance rural development, with a focus on economic growth within rural landscapes. The main argument in this article is that implementing viable rural development action requires a collaborative effort to address complex aspects of societal and economic transformation. The article draws from a study that examined factors hindering the successful establishment of viable rural development actions in the O.R. Tambo and Amahlathi District municipalities. Qualitative data were collected through in-depth interviews with 19 participants, including local economic development officers, entrepreneurs, NGOs, and councillors. The data were analysed using Atlas ti 9 software. The findings highlight several limitations in addressing local development actions, including malfunctioning leadership, climate change, criminal activity, limited access to reliable markets, and funding and skills deficits. To drive change, collaborative action platforms should be established to facilitate the sharing of traditional and innovative knowledge among rural communities and other non-state agents. Leveraging this knowledge and skills can lead to the adoption of best practices and new technologies. The article contributes to a body of knowledge that informs rural development policies and explores alternative ways of achieving development goals such as the infusion of best practices from exclusive top-down approaches to bottom-up approaches. Keywords: Viable rural development action, Economic growth, Bottom-up approach

Water Quality Assessment of Outdoor Public Swimming Pools in Ovia North East, Edo State, Nigeria

Poor water quality management practices of public swimming pools have raised concerns about the health safety of these recreational facilities. This study evaluated the physicochemical properties and bacteriological quality of four (4) outdoor swimming pools in Ovia North East, Local Council of Edo State, Nigeria. Results of physicochemical analysis showed that water temperature (25.75 - 26.38°C), pH (3.78 - 6.1), electrical conductivity (37.5 - 72.5 mg/L), total dissolved solids (14.58 - 38.43mg/L), turbidity (0.75 - 4NTU), dissolve oxygen (6.03 - 7.43mg/L), residual chlorine (0.03 - 0.13mg/L), alkalinity( 7 - 26.5mg/L), hardness (6 - 36mg/L), were within the World Health Organisation and Environmental Protection Agency stipulated maximum permissible limit for recreational waters except for pH and residual chlorine levels. The presence of pathogenic microorganisms in all the studied pools – total bacteria count (1 – 3 cfu/100mL), total coliform count (1 – 5 cfu/100 mL) and E. coli count (1 – 2 cfu/100 mL) predisposes the users of these facilities to microbial infection. The findings demonstrated that the swimming pools did not meet the required standards, particularly in terms of pH levels, residual chlorine, and microbial parameters. There is a need for ongoing monitoring of swimming pool water quality, improving bathers’ hygienic practices, raising awareness about the associated risks, and providing training for governmental inspectors

Assessing the Regional Socio-Economic Disparities, Evidence from Jordan

Objectives: Regional disparity in development among regions in developing countries is a common issue. Despite being a small, emerging economy, Jordan suffers from this problem. This study aims to identify and explore regional disparities in Jordan between 2010 and 2018 by integrating social and economic factors. Methods: A mixed-methods approach combining statistical analysis and Geographic Information Systems (GIS) techniques was employed to uncover the economic and social disparities in Jordan, and classify the governorates accordingly. This study presents the results of the Lorenz curve and the site quotient and shows the direct interactions between social disparities on economic disparities in Jordan. Results: The results indicated significant differences between the twelve governorates in Jordan. The capital city, Amman, possesses the highest share of social and economic factors in Jordan and is the only governorate with the highest economic growth. The second and third-ranking governorates in terms of ratios are Irbid and Zarqa. Conclusions: The study recommends implementing balanced and obligatory regional development plans, utilizing an integrated team of experts, decision-makers, investors, and local representatives. Emphasizing the importance of decentralization and empowering local councils in the governorates is crucial.

Community overview on the differential prevalence of Hepatitis E in two sub-counties in Kitgum District, Uganda: a mixed study design

BackgroundAn epidemic of Hepatitis E infection occurred in Kitgum district, northern Uganda in 2009. In that epidemic, more than 10,422 people were infected, and over 166 deaths were registered. Kitgum District Health Management Information Systems (HMIS) showed that Hepatitis E cases continued to occur in Mucwini more than in Kitgum Matidi sub-county despite instituting similar epidemic control measures in the two communities. The tenacity of the virus in Mucwini sub-county had remained unclear. This study aimed to assess communities’ views and perspectives on the differential prevalence of Hepatitis E in the two sub-counties of Kitgum Matidi and Mucwini in northern Uganda.MethodsA mixed study using qualitative and quantitative methods was used. Four Focus group discussions and six key informant interviews were conducted with the village health teams, local council chairpersons, health workers, and community members. These participants were chosen purposively because of their expertise and experience in community health services. Face-to-face interview guides were administered to obtain detailed information on factors associated with the differential occurrence of Hepatitis E in the two sub-counties. This study was approved by a local IRB and the Uganda National Council of Science and Technology (UNCS&T).ResultsThe most substantial findings were the differences in prevention and control practices in the two communities. Residents of Mucwini were less compliant with infection, prevention, and control guidelines, and disagreements between local councilors and village health teams in Mucwini over allowances led to poor implementation and non-adherence to guidelines on community control of the epidemic.ConclusionA differentially higher prevalence of Hepatitis E in Mucwini than in Kitgum Matidi resulted from poor personal and community hygiene and non-adherence to behavior change communication among residents of Mucwini than their counterparts in Kitgum Matidi. The authors recommend a more proactive approach to managing an epidemic by securing the willingness of the affected community to adopt appropriate infection prevention and control guidelines. In addition, disagreements among stakeholders should be resolved quickly so that all community members adhere to control measures.

From private to public and back? Kyoto's cityscape councils and the urban commons

AbstractScholarly and public debate on the urban commons is burgeoning, but building exteriors and the cityscape these constitute are surprisingly absent from it, despite their considerable significance for and impact on residents and visitors. After reflecting on the cityscape as a commons, the article turns to Kyoto, the former capital of Japan and acclaimed stronghold of history and tradition. Decades of conflict about the built environment led to a new building code in 2007 that continues to enjoy broad support. Details of building design, however, are now left to ‘local cityscape councils’, volunteer bodies that discuss construction plans with developers. Officially, local amateurs meet non‐local professionals here, but ethnographic fieldwork in 2019/20 revealed that both technical expertise and Kyoto ties are present on both sides. State representatives are also less absent than officially proclaimed. This case demonstrates that mixed management of the urban commons by the state and civil society can lead to amicable solutions that rise above vested interests, so that state involvement and ‘commoning’ should not be posited as mutually exclusive.

Specific Aspects of Efficiency of Local Council in the Uzbekistan

Specific Aspects of Efficiency of Local Council in the Uzbekistan

The missing economies of density and south Australian local government efficiency

ABSTRACT Sound theoretical grounds exist to assume that economies of density will have pervasive effects on municipal service provision. However, to date the available empirical literature offers inconsistent and confusing findings on the potential impact of density. Moreover, the extant empirical evidence of substantial density economies is unconvincing. This paper investigates this apparent contradiction by addressing (a) significant non-monotonicity in density economies, (b) confusion over density economies through its disparate impact on various municipal activities and (c) underlying differences in how density affects different types of local council. These questions are investigated employing multiple regression analysis using a panel data set covering all 68 South Australian local authorities over the seven-year period from 2014 to 2020. We find evidence of economies of density across the entire data set. We infer that the measurement of population density imposes constraints on identifying density economies and the empirical methodology employed.

Participatory Climate Action: Reflections on Community Diversity and the Role of External Experts

Academics have often contributed to designing, running, and evaluating participatory events with publics on climate action. Whilst climate assemblies are perhaps the most well-known of such events, there is also a proliferation of smaller and more local projects suggesting scope for reflection on the role of academic researchers in this evolving space. We deploy an experimental methodology that blends personal reflections with group discussion amongst the authors to help unpack the lessons learned from a project led by the local council, where we facilitated the involvement of local people in decision-making around climate action. Reflecting on our individual and academic positionalities, we question the extent to which we are well placed to build, maintain, and sustain trust, which requires spending time in place, continuity, and ceding power. As “outsiders” with “elite connotations,” our role as actors in this space is open for discussion. Indeed, our involvement could be perceived as a missed opportunity to retain more money and knowledge locally by ceding more responsibility to grassroots organisations. Our experience also suggests that framing public participation in terms of design and facilitation deficit is somewhat misleading. It is not just a process that needs to be attuned to diverse communities, but an ongoing relationship that needs certain enabling conditions to flourish, including conducive funding frameworks and a willingness to address incumbent power differentials between state and non-state actors.

Determinants of Backyard Livestock Farming amongst Households in Federal Capital Territory, Abuja, Nigeria

This study analysed the determinants of backyard livestock farming among households in Federal Capital Territory, Abuja, Nigeria. The sample size was 166 randomly selected from 6 towns in two local government councils in the FCT, Abuja. Primary and secondary data were used for the study and questionnaire and interview schedules were used to collect data from the respondents. Descriptive and inferential statistics were respectively used to analyse the objectives and hypotheses of the study. Results revealed that the average age, household size and farming experience of respondents was 43.01 years, 7 persons and 10.14 years respectively. Also revealed was the fact that female-dominated backyard livestock farming (76.51%), most (56.63%) of who were married and of secondary school educational level (51.81%). Most (71.69%) of them were into full-time farming and of Christian religion (59.64%). The majority (40.36%) of the farmers realized an annual income level of N100,001 - 200,000 and realized an average income of N194,578.31 on a per annum basis. Several benefits like provision of income (mean = 3.55), source of food to the family (mean = 3.40) and source of savings (mean = 2.87), amongst others were derived from backyard livestock farming. Most of the respondents were favourably disposed to the derived benefits derived from the farming practice even though they were confronted with some challenges like, lack of finance with a mean of 3.16, outbreak of pests and diseases (3.03) and theft (mean = 2.93), amongst others that plagued backyard livestock farming practice. However, socioeconomic variables such as respondents’ gender, age, marital status, education and farming experience were significant variables and related to the annual income earned from the backyard.

The relationship between local councillors’ representative style and their support for participatory democracy

The last few decades governments have operated in a challenging environment which increasingly calls for extended citizen participation. The aim of the article is to demonstrate that representative and participatory democracy are not two distinct realities, but that politicians’ opinions about their representative roles are associated with their attitudes about participatory democracy. To this end, the present paper links representative styles (partisan-delegate-trustee) with support for (1) the amount of citizen participation and (2) the type of citizen participation. Elected politicians traditionally perceive their representative roles either as ‘partisan’ (party-driven), ‘delegate’ (voter-driven) or ‘trustee’ (driven by their own judgement). We conducted a large-scale survey among Flemish (Belgium) local councillors ( N = 791). We show the biggest differences in support being between ‘delegates’ and ‘partisans’. The first group seems to be more receptive to (far-reaching) citizen participation and we explain that by their general orientation towards citizens.

Cultural stewardship in urban spaces: Reviving Indigenous knowledge for the restoration of nature

Abstract Relationships to nature are important for the health and well‐being of peoples globally and should be actively protected. Indigenous Māori people in Aotearoa New Zealand recognize this important relationship to nature through narratives of lineage and express this through concepts such as kaitiakitanga; a cultural place‐based practice of stewardship that intertwines relationships of responsibility between people, nature and culture. However, many Māori now live outside of tribal areas in urban settings, putting relationships with nature into question. We asked how urban Māori people practice kaitiakitanga, and what factors might predict flourishing relationships with nature. We surveyed 214 urban Māori who shared their perceptions of kaitiakitanga, cultural practices and restoration activities. The data were analysed by identifying qualitative themes and using linear mixed effect models. Māori who were exposed to kaitiakitanga as children were more likely to attend marae and family restoration activities, and less likely to attend events led by local councils. Pressingly, young people in urban areas were more at risk of losing cultural knowledge and opportunities to practice cultural practices in urban areas. Age, distance from tribal area and early exposure all affected decision‐making and expression of kaitiakitanga in urban areas. Knowledge associated with kaitiakitanga can create inclusive and effective urban restoration activities. We suggest that partnership between Māori groups including local marae, and local councils, may provide accessible, best practice urban restoration models that attract local Māori and act to support cultural knowledge, in turn encouraging diverse pathways to nature restoration to develop in urban areas. Likewise, such partnerships will ensure that Māori in cities are supported to express and maintain cultural knowledge and practice into the future. Read the free Plain Language Summary for this article on the Journal blog.

Women and Urbanisation in the Federal Capital Territory, Abuja, Nigeria

This study examines women's role in the urbanisation of the Federal Capital Territory (FCT), Abuja. From the standpoint of feminist theory, urbanisation is believed to create expanded opportunities for the general populace as well as for women, who typically face discrimination in rural economies. However, the initial FCT master plan ended up being distorted by the dynamics and complexities of Abuja's urbanisation and growth process over time, which is driven by political and economic realities. There are drawbacks to urbanisation in civilisations with strong sociocultural norms and values, such as the fact that women must endure various forms of gender inequality, discrimination, and exclusion, particularly in the political sphere, which present significant difficulties. This study makes use of secondary data to demonstrate how the FCT's 2003 reconstruction to its original Master Plan provided chances for active participation in which women were included for both native people and newcomers. In a similar vein, the Federal Capital Development Authority's (FCDA) and other local council offices, which hired indigenous people for their departments and agencies, significantly altered the way of life for women from being rural farmers to empowered workers. In order to address the issues facing women in the FCT, empowerment must be a multifaceted process that transforms the economic, political, social, psychological, and legal conditions of the weak (women). It must also aim to demolish cultural, traditional, and social norms that devalue, disempower, and dispossess women, with a primary goal of meeting their needs.