Policy Commitments Research Articles

The politics of universal health system reform in the context of COVID-19

Abstract Background Implementing universalism is more a political than a technical project. With this in mind, Ireland devised a ten-year plan through political consensus to deliver universal healthcare - Sláintecare. The COVID-19 pandemic occurred early in its implementation. Methods This is qualitative research drawing on international literature on universal health system reform in the context of COVID-19 as well as the politics of health reform. The overall research programme is co-produced with the Irish health system. A timeline and analysis of the reform journey is drawn from documentary analysis of key policy documents, parliamentary reports and key informant interviews. Results Despite a policy commitment since 2005, universal healthcare implementation only became government policy in Ireland 2018. While whole system reform and implementation progress has been slow, the COVID-19 health system response boosted aspects of universalism and reform. All COVID-related services during the pandemic were universal, free at the point of delivery, as are most new services introduced since 2021. Despite the political consensus holding through a change government and the pandemic, and significant additional investment in the public health system, there remain many obstacles to reform. These include different stakeholder understanding of implementing universalism in Ireland especially in the context of COVID-19, how best to implement universal healthcare and the politics of delivering reform. Conclusions Contrary to other countries’ experience during COVID, Ireland pursued its policy aim of delivering universalism and expanded services provided universally, free at the point of delivery, with a focus on enhanced community care. The universalism applied to COVID-related prevention and care, new women’s health and chronic disease management services. Despite progress, government has yet to legislate for a universal entitlement to care and obstacles to reform implementation remain.

The Challenges and Opportunities of NEP-2020 in the Reference of Inclusive Education in India: An Overview

The National Education Policy (NEP) 2020 provides a transformative vision for India's education system by emphasizing inclusive education and offering equal learning opportunities for children from varied socio economic, cultural and ability backgrounds. This paper looks at the challenges and opportunities given by NEP 2020 for promoting inclusive education in India. Infrastructure deficiencies, insufficient teacher preparation, and social biases are major hurdles, but policy-driven changes, technological integration, and financial support mechanisms present potential. This report gives an overview of the challenges and opportunities for implementing inclusive education in light of NEP 2020. Poor infrastructure, a lack of specialized teacher training and entrenched social attitudes about disability and marginalization all impede progress. However, opportunities arise as a result of policy-driven efforts, growing use of information and communication technology (ICT), and financing provisions aimed at fostering more equal learning settings. The research emphasizes the need of teacher capacity building, community participation, and long-term policy commitment in overcoming these challenges and realizing NEP 2020's inclusive vision. According to the findings, successful policy implementation requires stakeholder engagement to establish a more inclusive and easier to able education system in India.

Higher education and public good in England

AbstractIn the Anglophone jurisdictions, higher education policy is over-determined by economic policy and subjected to neoliberal regulation based on quasi-market competition between corporatised institutions, regulated by performative comparisons, tuition fees, and outputs imagined as commodities. England installed marketisation in successive policy changes between the Thatcher government’s introduction of commercial fees for international students in 1979 and the full-fee market for domestic students, supported by subsidised income-contingent loans, in 2012. Policy commitment to public good outcomes (the collective and non-pecuniary individual benefits of higher education) was largely emptied out, leaving only attenuated proxies such as widening participation and research impact. Responsibility for public good outcomes was transferred from government to institutions. Following a discussion of Anglophone concepts of ‘public’ and an overview of key policy reports from 1963–2019, the paper reports on qualitative research into approaches to higher education and public good in England. There were 24 semi-structured interviews, with middle and senior manager-leaders in two universities and policy professionals. Nearly all advocated a broad public good role, in contrast to policy in England, and provided examples of public outcomes in higher education. However, these concepts lacked clarity, while at the same time the shaping effects of the market were sharply understood.

The Principle of Righteousness and the Chosŏn–Ming and ROK–ROC Security Commitments*

This study addresses the question of why some decision‐makers and political elites in Chosŏn and the Republic of Korea (ROK) remained committed to the Ming Dynasty and the Republic of China (ROC) when the latter had declined in power. Based on the social psychological literature on righteousness, we explore this relationship through the lens of spontaneous and binding mechanisms. The former refers to voluntary help after reciprocity has been internalized as a duty, and the latter suggests that although individuals are reluctant to help, the fear of violating righteousness motivates continued commitment. Using the most‐different case design, this study finds supporting evidence from both the Chosŏn and the ROK periods. Specifically, Chosŏn loyalist officials insisted on aiding the weakened Ming and dethroned the rationalist King, Gwanghaegun. Moreover, those Korean elites who lived through the Korean Independence Movement and the Korean War emphasized diplomatic ties with the ROC even after the ROC lost its UN seat in 1971. By integrating social psychology and constructivism literature, the findings illuminate how the norms of righteousness shape decision‐makers' foreign policy and alliance commitment preferences.

Can Mindful Politics Be Meaningful Politics? Socially Engaged Buddhism as a Political Project within a Liberal Political Order

Throughout the Western political world, and particularly in the United States, contemporary Buddhist political thought has largely become synonymous with the movement of mindful politics, also known as Socially Engaged Buddhism. Focusing primarily on issues of social, economic, and environmental justice, mindful politics has found a natural ally in Western left-wing and progressive movements to the degree that Buddhist political thought in the United States is now seemingly indistinguishable from these Western political positions as a practical matter. While the practical alliance of Socially Engaged Buddhism and progressivism is well established, what is less clear is what the movement of mindful politics brings to this relationship beyond its Buddhist veneer. By basing its political project on the secularization of Buddhist compassion (karuṇā), mindful politics fails in creating a political project which can be compelling to those outside of the confines of Buddhist religious belief and practice. While the mindful politics movement and contemporary liberal progressivism share an overlap in policy commitments, the religious roots of Buddhist mindful politics ultimately preclude it from properly aligning with the pluralistic requirements of the prevailing liberal political order. This article will examine the foundations of Socially Engaged Buddhism and explore the standing of the possibility of Socially Engaged Buddhism as the foundation for a political project within the confines of a liberal political order.

Avoiding siloed approaches: Integrating psychological insights into sustainable farming.

This study enhances our understanding of the psychological factors influencing farmers' adoption of sustainable farming practices, specifically those related to achieving NetZero emissions. It achieves this by integrating various psychological theories with practical farming methods within the context of Behavioral-Adoption and Purpose-Driven contexts. The research consisted of two studies. Study 1 employed Exploratory Factor Analysis (EFA) to analyze responses from 438 UK farmers regarding their attitudes toward a series of Net Zero policy commitments, drawing on psychological theories including the Unified Theory of Acceptance and Use of Technology, the Theory of Planned Behavior, the Prototype Willingness Model, Implementation Intentions, Self-Determination Theory, Eudaimonia, and the Integrated Model of Health Literacy. The findings revealed a new Integrated Motivation Model for Sustainable Farming that comprises seven factors: Agricultural Commitment and Stewardship, Sustainable Farming Readiness and Confidence, Sustainable Incentive Engagement and Acceptance, Climate Adaptation Competence and Confidence, Net Zero Accountability and Reporting Commitment, Community Influence and Commitment in Sustainable Farming, and Innovation and Technological Competence. Study 2 validated these factors through the development of a 21-item Integrated Motivation Model for Sustainable Farming scale and use of Confirmatory Factor Analysis (CFA) to confirm the 7-factor structure using a subsample of 418 UK farmers from Study 1 and an additional 230 US farmers. Furthermore, Study 2 tested the concurrent validity of the new scale by demonstrating significant associations with reported sustainable farming behaviors. These findings underscore the complex interplay of motivational, cognitive, and social processes influencing sustainable farming practices. The integrated psychological model developed through this research provides parsimonious and valuable insights for policymakers to foster sustainable practices in farming effectively. The confirmation of this model across farming populations enhances its generalizability and potential to guide targeted interventions aimed at achieving behavioral change in pursuit of Net Zero targets in agriculture.

Amendments to Vietnam Labor Law after Two Years of Implementing European-Vietnam Free Trade Agreement

The article presents the labor policy commitments in the Free Trade Agreement between Vietnam and the European Union (EVFTA), analyzes the progress in amending the law related to Vietnamese labor according to the signed commitments, identify limitations and propose some solutions for effectively implementing the commitments in the EVFTA Agreement.

Assessing insurer guarantee cover and risk retention toward SDG 3: a structure-break down-and-out call valuation

The paper develops a down-and-out call option to evaluate the equity of a life insurer. The COVID-19 pandemic challenges captured by the premature feature of the down-and-out call option are also identified as structural breaks incorporated into the contingent claim option. Hedging, shown by the guarantee cover ratio, reflects the insurer’s ability to meet policy commitments. Reinsurance, indicated by the risk retention ratio, distributes insurance risk between the insurer and reinsurer. The insurer engages in those practices aligned with Sustainable Development Goal 3 (SDG 3: good health and well-being). The main findings are as follows. The COVID-19 pandemic harms policyholder protection and deviates from SDG 3 due to financial instability. However, strategic hedging, reinsurance, and government capital injections enhance policy assurances, achieving SDG 3 by increasing payments to policyholders and improving financial stability. Moreover, the risk retention ratio increases during severe COVID-19 periods but decreases with more government capital injections, which can substitute for risk retention. Policy implications suggest that policymakers can mitigate crisis impacts on insurer capacity to fulfill commitments, thereby enhancing life insurance stability and well-being aligned with SDG 3.

Alliances and Civil War Intervention

Abstract Governments have a number of structural advantages over rebel groups in civil wars, one of which is their greater ability to make credible international commitments. Governments can use foreign policy commitments to incentivize other states to provide them military support or deny support to their rebel groups. We analyze international intervention in civil conflicts between 1975 and 2017 and find that some kinds of alliances are associated with pro-government intervention, but all alliances are not equal. Alliances with consultation commitments are associated with interventions that provide materiel, training, intelligence, and/or other forms of non-troop support, while defense pacts are associated with both troop and non-troop support. Members of nonaggression and neutrality pacts are not more likely to intervene to support the government but are less likely to provide support to anti-government forces. We argue that alliances are not simply proxies for common interests; they sometimes involve specific bargains designed to aid a government in defeating rebels. Our evidence suggests that these agreements are successful at incentivizing the intended behavior. Governments use international security policy to protect the status quo domestically as well as internationally, and this affects our understanding both of civil wars and of alliance politics.

Unconventional policies in state-dependent liquidity traps

We characterize optimal unconventional monetary and fiscal-financial policies against supply- and demand-driven liquidity traps within a tractable New Keynesian model featuring a cash-in-advance constraint and a monetary policy cost channel. Deposit subsidies circumvent the inflation-output trade-off arising from stagflationary shocks and supply-driven liquidity traps by enabling negative nominal interest rates. Additionally, deposit taxes facilitate modest interest rate hikes to escape demand-driven deflationary traps. Notably, discretionary and commitment policies with deposit taxes / subsidies deliver virtually equivalent welfare gains, rendering time-inconsistent forward guidance schedules unnecessary. We also derive robust and implementable optimal policy rules when the sources of shocks are unknown.

Inclusion of people with disabilities in Chilean health policy: a policy analysis

BackgroundAround 18% of the population in Chile has disabilities. Evidence shows that this population has greater healthcare needs, yet they face barriers to accessing healthcare due to health system failures. This paper aims to assess the inclusion of people with disabilities in health policy documents and to explore the perceptions of key national stakeholders regarding the policy context, policy processes, and actors involved.MethodsA policy content analysis was conducted of 12 health policy documents using the EquiFrame framework, adapted to assess disability inclusion. Documents were reviewed and rated on their quality of commitment against 21 core concepts of human rights in the framework. Key national stakeholders (n = 15) were interviewed, and data were thematically analysed under the Walt and Gilson Policy Analysis Triangle, using NVivo R1.ResultsCore human rights concepts of disability were mentioned at least once in nearly all health policy documents (92%). However, 50% had poor policy commitments for disability. Across policies, Prevention of health conditions was the main human rights concept reflected, while Privacy of information was the least referenced concept. Participants described a fragmented disability movement and health policy, related to a dominant biomedical model of disability. It appeared that disability was not prioritized in the health policy agenda, due to ineffective mainstreaming of disability by the Government and the limited influence and engagement of civil society in policy processes. Moreover, the limited existing policy framework on disability inclusion is not being implemented effectively. This implementation gap was attributed to lack of financing, leadership, and human resources, coupled with low monitoring of disability inclusion.ConclusionsImprovements are needed in both the development and implementation of disability-inclusive health policies in Chile, to support the achievement of the right to healthcare for people with disabilities and ensuring that the health system truly “leaves no one behind”.

Climate Policy Performance Bonds: Holding Governments Accountable for their Climate Policy Commitments

Climate Policy Performance Bonds: Holding Governments Accountable for their Climate Policy Commitments

Equality, Diversity and Inclusion within Ireland’s Police Service, An Garda Síochána: Bridging the Gap between Commitments and Reality

Abstract The Black Lives Matter movement highlighted the importance of equality, diversity and inclusion (EDI) in a policing context. Using the Irish police service, An Garda Síochána, as a case study, this article critically evaluates efforts to promote EDI within a policing organization that has been characterized as resistant to change. It focuses primarily on the implementation of relevant recommendations contained in the landmark 2018 Report of the Commission on the Future of Policing in Ireland. It demonstrates that while building a culture that respects and promotes EDI within any organization is a challenging process, it can be even more difficult in policing organizations due to police sub-culture. It submits that laws, policies and commitments, while necessary, are insufficient of themselves to achieve transformative change. Strong and committed leadership is also required, as well as measures to recruit and retain a diverse workforce at all levels, sufficient resourcing for EDI initiatives, EDI training that accords with international best practice, efforts to improve relationships with marginalized communities, measures to combat hate crime and racial profiling, effective mechanisms for collecting EDI data and evaluating EDI policies, and a robust governance, oversight and accountability framework. While identifying and welcoming measures undertaken to date by An Garda Síochána to convert EDI policy commitments into reality, the article also highlights areas where improvements are necessary. Finally, aligning with several theorists of police sub-culture, the article concludes that any efforts to promote EDI within An Garda Síochána will need to be accompanied by efforts to combat structural inequality in wider society.

Voluntary optimisation of antimicrobial consumption in swine and poultry production in Thailand: a policy analysis.

Antimicrobial resistance (AMR) is a global health concern with significant implications on economies and health security, affecting humans, animals, food, and the environment. To tackle this issue, promoting responsible antimicrobial use in livestock production has emerged as a crucial intervention. In 2018, Thailand introduced the Voluntary Optimization of Antimicrobial Consumption (VOAC) programme, with the objective to encourage responsible antimicrobial use practises. This study aimed to analyse the context, content, process and actors of the VOAC programme. A qualitative method including document reviews and key informant interviews were applied. In-depth interviews were conducted with 18 key informants who are key stakeholders from public and private sectors involved in the policy formulation, design of policy contents and implementation of VOAC: policy makers or officers responsible for animal health (n = 12), animal producers (n = 2), animal product traders or retailers (n = 2), and farm veterinarians (n = 2). Interview transcripts were validated by informants for accuracy, and triangulated with document review findings. Deductive approach was applied for data analysis and interpretation based on Walt and Gilson's policy analysis framework. The VOAC farm certification comprises of Raised Without Antibiotics (RWA) and Reducing Antibiotic Use (RAU), both aiming to combat AMR in food animals. Global and national factors, including increased public awareness, policy commitments, export requirements from the European Union, and international organisation advocacies, influenced the development of the programme led by the Department of Livestock Development (DLD), under the Ministry of Agriculture and Cooperatives. Collaboration with the private sector facilitated policy clarity, with implementation primarily executed through regional, provincial, and district livestock officers. Integration of the programme with the pre-existing Good Agriculture Practise certification system enabled cost-effective implementation without additional resources. In 2022, DLD official data reported 214 RWA farms (112 pig and 102 broiler), and 230 RAU farms (83 pig and 147 broiler). Incentives for farms to participate in the programme include improving corporate image and demonstrating corporate responsibility addressing AMR in food products. Recommendations include optimising certification strategies, increasing consumer awareness of RWA and RAU products and strengthening monitoring and evaluation systems.

Conservation and human rights: The public commitments of international conservation organizations

AbstractTo ensure the protection of both people and nature, conservation practitioners have a responsibility to integrate human rights considerations into their conservation policies and practices. Here, we (i) develop a human rights‐based scoring framework for international conservation organization (NGO) policy commitments and (ii) use this to conduct a gap analysis of policy commitments for nine NGOs, which collectively contribute approximately $1.86 billion USD annually to the global conservation budget.While progress has been made, critical gaps remain in commitments to certain rights and recognizing local groups' rights and knowledge, particularly around social development and decent work, recognitional equity, and commitments to implement human rights‐based approach principles. Given the influence of these organizations in global public discourse, more comprehensive public commitments to human rights will likely increase compliance with international law, drive organizational change, and help rebuild trust with vulnerable communities.

Form and functioning: contextualising the start of the Global Financing Facility policy processes in Burkina Faso

ABSTRACT Background Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally. Objective This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso. Methods We conducted an exploratory qualitative policy analysis. Data collection included document review (N = 74) and in-depth semi-structured interviews (N = 23). Data were analysed based on the components of the health policy triangle. Results There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective. Conclusions Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.

Is it possible to broaden women's inclusive rights by improving their participation in the labor market? A new perspective at the global level

PurposeThe objectives of this study are twofold: (1) to investigate whether the increase in FLFP enriches women's inclusive rights (economic, social, and political), (2) whether the effect of FLFP on inclusive rights is different across different economics (developed vs developing).Design/methodology/approachThe study utilizes panel data encompassing 188 countries spanning the years 1981–2011. Discrete choice models, namely ordered probit and ordered logit, are employed, while also controlling for observable heterogeneity across countries, including factors such as inflation, income inequality, education, and human rights.FindingsWe find a positive association between FLFP and all aspects of women's rights (economic, social, and political). The results related to developed and underdeveloped countries are robust for women's political rights; however, the effect of FLFP on women's social and economic rights is insignificant for developing countries.Originality/valueThe need for continuous policy commitment to gender equality may be needed to bring about equality of inclusive rights (economic, social, and political rights) and to fulfill the sustainable development goals (SDGs). Therefore, the current study particularly adds value in existing research by investigating (empirically) the link between FLFP and different dimensions of women's inclusive rights.

Agricultural Commodity Markets in Pakistan: Analysis of Issues

EXECUTIVE SUMMARY Agriculture markets in Pakistan are still primarily based on a colonial-era model and have not modernised with changing times. This has increased unnecessary costs in the supply chains that put growers and end-consumers at a disadvantage. Additionally, price and supply volatility causes insecurity for policy-makers as information about prices, supply and demand is not structured, timely or reliable. For decades, agricultural markets have functioned without government focus on innovation. Recent initiatives from various federal and provincial agencies provide hope that this vital area can now finally be addressed. Numerous constraints need to be resolved to bring meaningful change to the ecosystem. The process must start with a fresh policy look and commitment to adopt modern themes. This policy process can be supported by technology and successful lessons from other countries as well as developments in other sectors within the country. There is a need to develop a certain level of coordination between various federal and provincial agencies. The increasingly fragmented nature of agriculture markets might be useful for some stakeholders as they can innovate according to their needs but it leaves most of the sector at a continually suboptimal level. The lack of progress in modernising core markets has also made it difficult for some innovative solutions to succeed. A rapid assessment of the current environment, key constraints and recommendations for possible development areas is presented in this report.

Believe me when I say green! Heterogeneous expectations and climate policy uncertainty

We develop a dynamic model where heterogeneous firms take investment decisions depending on their beliefs on future carbon prices. A policy-maker announces a forward-looking carbon price schedule but can decide to default on its plans if perceived transition risks are high. We show that weak policy commitment, especially when combined with ambitious mitigation announcements, can trap the economy into a vicious circle of credibility loss, carbon-intensive investments and increasing risk perceptions, ultimately leading to a failure of the transition. The presence of behavioural frictions and heterogeneity - both in capital investment choices and in the assessment of the policy-maker's credibility - has strong non-linear effects on the transition dynamics and the emergence of ‘high-carbon traps’. We identify analytical conditions leading to a successful transition and provide a numerical application for the EU economy.

A rapid mixed-methods assessment of Libya’s primary care system

BackgroundLibya has experienced decades of violent conflict that have severely disrupted health service delivery. The Government of National Unity is committed to rebuilding a resilient health system built on a platform of strong primary care.AimCommissioned by the government, we set out to perform a rapid assessment of the system as it stands and identify areas for improvement.Design and settingWe used a rapid applied policy explanatory-sequential mixed-methods design, working with Libyan data and Libyan policymakers, with supporting interview data from other primary care policymakers working across the Middle East and North Africa region.MethodWe used the Primary Health Care Performance Initiative framework to structure our assessment. Review of policy documents and secondary analysis of WHO and World Bank survey data informed a series of targeted policymaker interviews. We used deductive framework analysis to synthesise our findings.ResultsWe identified 11 key documents and six key policymakers to interview. Libya has strong policy commitments to providing good quality primary care, and a high number of health staff and facilities. Access to services and trust in providers is high. However, a third of facilities are non-operational; there is a marked skew towards axillary and administrative staff; and structural challenges with financing, logistics, and standards has led to highly variable provision of care.ConclusionIn reforming the primary care system, the government should consolidate leadership, clarify governance structures and systems, and focus on setting national standards for human resources for health, facilities, stocks, and clinical care.