Loss Of Political Support Research Articles

'Community health workers are unable to work because they don't have supervisors' - mid-level providers' experiences of a CHW program in rural South Africa.

The World Health Organization has called for more than 4 million community health workers (CHWs) globally; yet there are gaps in the evidence of CHWs' impact where studies have not had consistent results. South Africa is currently investing in CHW programs. However, there are significant concerns about the implementation and effectiveness of the program. We interviewed mid-level supervisors involved in eight rural clinics in a deeply rural South African municipality to identify the strengths and weaknesses of the CHW programs currently being implemented. Half of these clinics were part of a program providing enhanced supervision to CHWs, and the remainder were operating as usual. We hypothesized that stakeholders would provide valuable insights on how to improve the implementation of CHW programs. Fourteen interviews with supervisors from three levels of clinic and non-governmental organizations were conducted. Interviews were transcribed and translated from isiXhosa to English, and thematically analysed using ATLAS.ti. Two overarching themes emerged: challenges at the national CHW program level (loss of political support, inadequacy of supervision and access to resources, human resource considerations); and experiences of the enhanced-supervision model provided (engagement and buy-in, link between CHW program and healthcare facilities, improvements through the intervention). Our findings suggest that CHWs operate largely unsupported, with limited access to training, equipment and supervision. The enhanced-supervision intervention appeared to mitigate some of these shortfalls. To make CHW programs efficient, we need to recruit CHWs based on social and administrative competence (rather than network referrals), provide improved higher quality training, provide more resources, especially equipment and transport, and ensure that CHWs receive supportive supervision that goes beyond simply administrative supervision. Furthermore, our findings suggest that the intervention in this study has somewhat mitigated these challenges through a package of supportive supervision and additional resources, highlighting the importance of stakeholder engagement and buy-in. It is clear that the governmental CHW program has many challenges - a number of which were temporarily mitigated by the intervention tested in this research's parent study. A list of recommendations for practice was developed from this work. First, contracts and reimbursements are important for CHW motivation, and are seen as essential prerequisites for CHW program success. Second, CHWs and other stakeholders must be involved in the design and implementation of the CHW program. Third, good-quality training and refresher trainings for CHWs is critical. Fourth, access to equipment such as scales is needed. Fifth, transport is critical in rural areas to access patients in remote areas. Lastly, supportive supervision was described as of upmost importance. CHWs have the potential to provide invaluable support in communities, and in rural communities in particular - but they need to operate in a functional supportive system. More resources need to be allocated to training, equipment and supportive supervision.

N.P. van Wyk Louw se opvattings oor taalbewegings en die behoud van Afrikaans

Die digter N.P. van Wyk Louw het hom in verskeie opstelle en praatjies uitgelaat oor klein volke en tale, taalbewegings, taalstryde en nasionalisme en die voortbestaan van Afrikaans. In hierdie artikel word op grond van sy siening van taalbewegings en sy opvattings oor nasionalisme gelet op die faktore wat bydra tot die welslae van 'n taalbeweging. Hy betoog met voorbeelde dat 'n taalbeweging slegs kan begin wanneer histories bewuste intellektuele bekommerd is oor die taal en die taalgemeenskap en planne maak om die taal te behou en die gemeenskap op te hef. 'n Taalbeweging het 'n kans op welslae wanneer dit 'n "staatkundige stut" kan bekom en dus nie polities so magteloos is dat dit nie regeringsbesluite kan beïnvloed nie. Volgens Louw is 'n taalbeweging se kans op welslae die beste wanneer die beweging dit kan regkry om die strewe na die bevordering van die taal te verbind met die bemagtiging van die minder bevoorregte lede van die gemeenskap. Hy illustreer laasgenoemde stelling met 'n oortuigende verwysing na die vordering van Afrikaans in die eerste helfte van die twintigste eeu. Sonder om na enige taal te verwys meen hy ook dat dit noodlottige gevolge vir 'n klein gemeenskap kan hê om in 'n meertalige land onregverdig teenoor ander groepe op te tree.

The flight of Carthach (Mochuda) from Rahan to Lismore: lineage and identity in early medieval Ireland

This paper explores the different ways in which the career of Carthach – Carthagus in Latin, also known as Mochuda or Mo‐Chutu – was remembered in both Latin and Irish accounts, in particular his expulsion from Rahan, where he was abbot for forty years, and his re‐establishing that community at Lismore, where he died c.637. It argues that the Life of Carthach legitimizes his foundation at Lismore, by celebrating its initial establishment at Rahan, and by connecting him through a chain of prophecies to Íte, Brendan, Comgall, and above all Colum Cille. In this Life, Patrick is never mentioned, quite unlike the Life of Declán, which claimed Ardmore as the original bishopric of the Déise region. Carthach's expulsion from Rahan, provoked by loss of political support from local princes, took place just as other abbots of the region were hesitating to adopt the Roman date of Easter, in the manner of much of southern Ireland. Carthach, part of a group sympathetic to Gregory the Great and Roman practice, was perceived by his admirers as being connected to a line of saints that helped define the particular identity of the church at Lismore.

The Choice Revolution: Privatization of Swedish Welfare Services in the 1990s

Abstract During the 1990s, the Swedish welfare state was declared by some to be in a “crisis”, due to both financial strain and loss of political support. Others have argued that the spending cuts and reforms undertaken during this period did slow down the previous increase in social spending, but left the system basically intact. The main argument put forward in this article is that the Swedish welfare state has been and is still undergoing a transforming process whereby it risks losing one of its main characteristics, namely the belief in and institutional support for social egalitarianism. During the 1990s, the public welfare service sector opened up to competing private actors. As a result, the share of private provision grew, both within the health‐care and primary education systems as well as within social service provision. This resulted in a socially segregating dynamic, prompted by the introduction of “consumer choice”. As will be shown in the article, the gradual privatization and market‐orientation of the welfare services undermine previous Swedish notions of a “people's home”, where uniform, high‐quality services are provided by the state to all citizens, regardless of income, social background or cultural orientation.

The Sad Demise of Skill-Based Pay in the Virginia Department of Transportation

The Virginia Department of Transportation attempted to use skill-based pay (SBP) to trigger the development of both multiskilled, self-managing work teams and a high-involvement work culture. A case study determined that this “new pay” intervention did not achieve intended goals. Two related, internal dynamics negatively affected the change effort: untimely systems redesign between SBP and agency subsystems and nonexistent strategic visioning to articulate where managers would “fit” in a high-involvement culture. These incongruencies led to loss of political support in the Virginia legislature, which ended the Virginia Department of Transportation SBP innovation. The study suggests that public agencies using SBP as a catalyst for institutional transformation must (a) be prepared for simultaneous systems redesign to support the SBP intervention, (b) address the job security needs of managers, and (c) produce successful outcomes to maintain political support throughout implementation and diffusion.

Fiscal expansion and political instability in the Iberic-Latin region

Recent research by public choice-oriented economists and political scientists points to a negative relation between fiscal expansion and voter support for the incumbents. Real per capita federal spending is negatively associated with the vote for the incumbent party's candidate in American presidential elections (Niskanen, 1979). There is a negative relation between increases in the percent of Gross National Product spent by the central government and incumbent party reelection to the White House and the British parliament (Cuzain and Heggen, 1984, 1985). Furthermore, the incumbent party's vote in American gubernatorial elections varies inversely with increases in the ratio of state general revenues to state personal income between elections (Peltzman, 1987). Fiscal expansion is also associated with the overthrow of Latin American governments (Cuzin, 1986). Fiscally expansionist Latin American regimes whether civilian governments or military juntas tend to be overthrown, while democracies and dictatorships practicing fiscal restraint usually survive. Together, these findings suggest that fiscal expansion costs the incumbent party a loss of political support, resulting in its being voted out or forced out of office. Since the stability of any government depends partly on support for the incumbents, it is hypothesized that, ceteris paribus, fiscal expansion is a cause of political instability. According to this hypothesis, fiscal expansion has a boomerang effect on the incumbents, increasing the likelihood that the party will lose executive office either by election or coup. The purpose of this paper is twofold. One is to bring additional empirical

British Higher Education under Pressure: Politics, Budgets and Demography and the Acceleration of Ideas for Change

To the British higher education community the period since 1979 has seemed to be characterised by severe external pressure, generated by a loss of political support, reduced budgets and the threat of a demographic-led decline in student numbers. These pressures have appeared to dominate public discussion of higher education, but underneath the smoke of battle new ideas and structures are emerging. Whether these are the best ideas or the most effective new structures it is too early to say but it is difficult to deny that these pressures have accelerated the long dormant processes of change in British higher education. One does not have to be a supporter of present government policies towards higher education and only the very smallest minority of the higher education community will admit to that to concede that the various external pressures have opened up higher education to new initiatives in an unexpected way.