Policy Programs Research Articles

Health system reform and path-dependency: how ideas constrained change in South Africa’s national health insurance policy process

Path-dependency theory says that complex systems, such as health systems, are shaped by prior conditions and decisions, and are resistant to change. As a result, major policy changes, such as health system reform, are often only possible in policy windows—moments of transition or contextual crisis that re-balance social power dynamics and enable the consideration of new policy ideas. However, even in policy windows there can be resistance to change. In this paper, we consider the role of ideas in constraining change. We draw on political science theory on the dynamic relationship between foreground ideas (policy programmes and frames) and background ideas (deeply held collective cognitive and normative beliefs) to better understand how ideas exert influence independently of the contextual conditions that give rise to them or the actors that espouse them. To do so, we examine two apparent policy windows in the South African National Health Insurance policy process. The analysis reveals how ideas can become institutionalised in organisations and procedures (such as policy instruments or provider networks), and in intangible cultural norms—becoming hegemonic and uncontested ideas that shape the attitudes and perspectives of policy actors. In this way, ideas operate as independent variables, constraining change across policy windows. While health policy analysts increasingly recognise the influence of ideational variables in policy processes, they tend to conceptualise ideas as tools actors wield to drive change. This analysis reveals the importance of considering ideas (values, norms, and beliefs) as persistent features of the policy-making context that constrain actors.

Social Processes of Public Sector Collaborations in Kenya: Unpacking Challenges of Realising Joint Actions in Public Administration

AbstractSocial processes behind the success or failure of collaborative implementation frameworks in African public administration contexts are under-researched. This paper addresses this gap by paying particular attention to trust attributes in collaborative implementation arrangements in Kenya. It shows how implementation challenges of policy programs and interventions may be linked to these interventions’ social characteristics in the public sector. The paper draws on a threefold approach of mutual trust and administrative data on public sector collaborative implementation arrangements for Kenyan anti-corruption policy like the Kenya Leadership Integrity Forum. Findings show that despite increased efforts to realise joint actions in public sector collaborative arrangements, they remain primarily symbolic and hierarchical and feature loose social cohesion among actors, producing challenges bordering on deficiencies in social processes of implementation. These include politicised aloofness or lack of commitment, unclear governance structures, coordination deficiencies, inter-agency conflicts, layered fragmentations, and overlapping competencies among different agencies. The paper recommends identifying and nurturing socially sensitive strategies embedded in mutual trust, like informal knowledge-sharing channels, to address primarily mandated public sector collaboration challenges in Kenya. Such efforts should consider systematic training and incentivising public managers to think outside inward-looking organisational cultures, allowing them to devise sustainable collaborative implementation approaches (promote open innovation) for policy programs, particularly anti-corruption policy.

Reflections on the Kerala Public Health Act 2023: A response to Dr Karpagam's commentary.

In this response, we seek to analyse and rebut the observations of Karpagam S using an understanding of the Kerala Health system and the general purpose of the Kerala Public Health Act (KPHA). The KPHA was crafted with a greater focus on a one-health and preventive approach. It does not seek to interfere in an individual's preferred choice of treatment, except in the case of public health emergencies. KPHA is not a standalone document, but a supporting tool to the existing Kerala Health Policy and various other health policies and programmes instrumental in improving the health and quality of life of the people of the State. The KPHA is intended to be an enforcement tool for legal provisions to ensure welfare maximisation of the society at large, and thus detailed discussions regarding actions to be taken beyond these legal provisions do not fall within the purview of the Act.

An Interview with APPLE Lecture Speaker Dr. Ross Perlin

On April 26th, 2024, the Studies in Applied Linguistics and TESOL (SALT) journal interviewed Dr. Ross Perlin, an invited speaker for the 2024 APPLE Lecture Series hosted by the Applied Linguistics and TESOL program at Teachers College, Columbia University. Dr. Ross Perlin is a linguist, writer, and translator focused on exploring and supporting linguistic diversity. His book Language City: The Fight to Preserve Endangered Mother Tongues in New York was just released by Grove in the US and the UK. Since 2013, he has been co-director of the Endangered Language Alliance in New York, managing research projects on mapmaking, documentation, policy, and public programming for urban linguistic diversity. He also teaches linguistics at Columbia. His writing has appeared in the New York Times, The Guardian, Harpers, and elsewhere. His first book, Intern Nation: How to Earn Nothing and Learn Little in a Brave New Economy, ignited national conversation about unpaid work. He has an MA in language documentation and description from the University of London (SOAS) and a PhD in linguistics from the University of Bern.

Analysis of Policy Implementation of the Food Program in Rural Areas

In order to reduce poverty rates, the Ministry of Social Affairs through the Basic Food Program aims to reduce the burden on KPM expenditures by fulfilling part of their food needs as well as reducing poverty. Implementation of this policy was also held in Purisemanding Village, Jombang Regency. However, it is not yet known how far the Basic Food Program has been implemented in these rural areas. The aim of this research is to analyze the implementation of the Basic Food Program in rural areas, especially in Purisemanding Village. This research uses research methods descriptive with a qualitative approach. By using data analysis techniques developed by Miles & Huberman. The research focus refers to Matland's (1995) theory, namelyPolicy Accuracy, Implementation Accuracy, Target Accuracy, and Environmental Accuracy. The results of the research conclude that the accuracy of the Basic Food Program policy has been implemented well but has not been able to reduce the poverty rate, the accuracy of implementation has been carried out well by the policy implementing agency, however the accuracy of the target has been good but has not been implemented optimally, especially in terms of infrastructure, and environmental accuracy is also lacking. carried out optimally, especially for the external environment.

스마트폰 과의존 관련 국내 연구 동향

Objectives The purpose of this study is to analyze trends in research on smartphone overdependence published in Korea and then suggest directions for future research. Methods For this purpose, we selected 254 papers published in academic journals from 2016 to the end of November 2023 with martphones overdependence as the keywords. For data analysis, the data were classified by publication year, research method, academic field, academic organization, and related variables. Results The results of this study are as follows. First, Research on smartphones overdependence first began in 2016 and increased rapidly from 2020. Second, As for research methods, The research method was predominantly quantitative research. Third, The academic field with the most papers published was social science. The largest number of papers were published in [The Journal of Humanities and Social science(HSS21)], published by the The Journal Of Humanities and Social Sciences 21·Asia Culture Academy of Incorporated Association. Fourth, As for trends by variable related to smartphone overdependence, personal factor variables were the most studied, and sub-variables such as self-esteem, life satisfaction, happiness, depression, and mindset were confirmed. Conclusions Based on these results, The problem of dependence on smartphones was confirmed as a social and environmental phenomenon that occurs in all age groups from infancy to old age. This suggested the development of a smartphone overdependence prevention program and finding policies and plans for controlled use.

Prevalence and Impact of Refractive Errors in School-Aged Children: A Cross-Sectional

This cross-sectional study aims to determine the prevalence and patterns of refractive errors among 700 schoolchildren aged 5-15 years in Al-Manara School, Tobruk, Libya. A comprehensive ophthalmic examination will be conducted to assess visual acuity and identify refractive errors. Academic performance will be evaluated by reviewing school records, including grades and standardized test scores. The impact of refractive errors on quality of life will be measured using a validated pediatric vision-related quality of life questionnaire. The study seeks to provide data on the burden of refractive errors and their effects on learning and daily living in this population. We hypothesize that uncorrected refractive errors will be associated with poorer academic achievement and reduced quality of life compared to peers without vision impairment. This research can highlight the need for regular vision screening and provision of spectacles for schoolchildren in Libya. Findings may guide education policy and school health programs to address this treatable cause of impaired classroom performance. The large sample size will allow for analysis of prevalence stratified by key demographics and characterization of the patterns of refractive errors in this geographic setting.

Implementasi Kebijakan Program Gotong Royong (Studi di Kecamatan Bukit Kecil Kota Palembang)

This study discusses the implementation of the gotong royong program policy in Bukit Kecil Sub-district, Palembang City, South Sumatra Province. Keeping the environment clean is very important in an effort to maintain health and prevent disease. The gotong royong program is one way to increase public awareness in maintaining environmental cleanliness. The principle of gotong royong reflects collaboration between residents in maintaining the cleanliness and aesthetics of the environment where they live. In the theoretical foundation, this study refers to Edward III's theory to understand the process of public policy implementation and the factors that influence it. This theory helps understand communication, disposition, and implementation decisions in the context of the gotong royong program. The research technique used is qualitative, where the main data is collected through interviews with Mr. Untung Sobirin, who serves as the Head of General Services in Bukit Kecil Sub-district. Additional information was obtained from analyzing related literature as secondary data. The results showed that the implementation of gotong royong was conducted every Sunday morning with active participation from the community, local government, and echelon 2 officials. The socialization of the gotong royong program is considered successful, although there are still obstacles such as the indifference of some residents. The availability of waste disposal sites (TPS) reflects a commitment to keeping the environment clean.

Policy Brief Optimizing the First Thousand Days of Life (1000 HPK) Policy Program as an Effort to Prevent Stunting in Indonesia: Literature Review

Introduction: 1000 HPK is a food insecure group which includes pregnant women, breastfeeding mothers and children under two years old. Thus, nutrition program policies are the focus of the 1000 HPK group in efforts to prevent stunting. Objective: The aim of this research was to carry out a literature review to determine the Policy Brief for Optimizing the First Thousand Days of Life (1000 HPK) Policy Program as an Effort to Prevent Stunting in Indonesia. Method: This research looked for journals used in the literature review, journals used in the literature review were obtained through international journal provider databases such as Google Scholar, PubMed, and Scince Direct. Researchers wrote appropriate keywords, namely 1000 HPK, stunting, and Policy Brief. Result: After conducting literature, the researcher obtained five articles that were relevant to the research topic, namely about 1000 HPK, stunting, and Policy Brief. Based on indicators, the 1000 HPK program has not yet reached the target in Indonesia, which is caused by the availability of human resources and infrastructure in implementing the 1000 HPK program at the Community Health Center which is still inadequate. Conclusion: Presidential Regulation number 42 of 2013 concerning the National Movement to Improve Nutrition was issued to support efforts to increase stakeholder participation and awareness in a planned and coordinated manner to accelerate nutritional improvements in the first 1000 days of life (1000 HPK) in efforts to accelerate nutritional improvements in the first 1000 days of life (1000 HPK) prevent stunting.

Barriers and Facilitators for Implementing Shared Decision Making in Differentiated Antiretroviral Therapy Service in Northwest Ethiopia: Implications for Policy and Practice

Background. Shared decision making (SDM) for patients enrolling in differentiated antiretroviral therapy (DART) is crucial. Empirical evidence is lacking regarding factors promoting or hindering SDM implementation in DART provision in Ethiopia. Hence, this study aimed to explore the barriers and facilitators to implementing SDM for patients enrolled in DART in Northwest Ethiopia. Methods. A qualitative descriptive study using semi-structured interviews among 17 patients and 15 providers at health facilities providing DART service was conducted. The MAXQDA version 20 software was used for inductive coding. Interviews were analyzed using thematic analysis. Results. Ten themes emerged at 4 levels related to SDM in the provision of DART: patient, provider, organizational, and health system. At the patient level, 1) trust in providers (facilitator) and 2) patient’s level of education (barrier) emerged as themes. At the provider level, 3) lack of familiarity with DART models (barrier) and 4) patient-provider relationship (barrier and facilitator) were emerged themes. At the organizational level, 5) workload (barrier) and 6) resources (barrier and facilitator) emerged as themes. At the health system level, 7) availability of DART models (facilitator), 8) not involving providers while initiating DART models (barrier), 9) other providers’ involvement (facilitator), and 10) presence of other implementing partners (barrier) emerged as themes. Conclusions. Numerous barriers and facilitators influence the implementation of SDM in the provision of DART. Based on these findings, the following steps are recommended. Providing access to patient decision aids shall be in place to assist patients in making decisions about their preferred DART models. Health care workers shall be trained, and patients shall be given education to enhance the SDM process. Policy makers and program managers shall consider the resource context (training and size of human resources and convenience of rooms) for the delivery of ART service to have an appropriate implementation of SDM in clinical practice. Highlights Shared decision making in DART is influenced by various barriers and facilitators present at the patient, provider, organizational, and health system levels. Patients need education, and health care staff need regular training to improve SDM in DART service provision. Patient access to decision support tools that aid in the selection of the preferred DART model in health facilities is critical. Policy makers and program managers shall consider the availability of adequate and trained human resources as well as provide adequate space and private rooms for SDM in the implementation of DART.

DESAIN PEMBELAJARAN PENDIDIKAN AGAMA ISLAM TERINTEGRASI PROFIL PELAJAR RAHMATAN LIL ‘ALAMIN DI MADRASAH ALIYAH NEGERI 1 TAPIN

This study aims to describe the implementation of an integrated learning design student profile of rahmatan lil 'alamin which is one of the programs of the independent curriculum policy in madrasah. The student profile of rahmatan lil 'alamin is a characteristic of madrasah that distinguishes it from the implementation of an independent curriculum in schools under the auspices of the Ministry of Education and Culture. The profile of Pancasila students and rahmatan lil 'alamin is an inseparable whole. With the profile of students in the projects launched in the independent curriculum, it is hoped that madrasahs can explore the potential of each student and direct learning to be more optimal according to the needs and character of each diverse student

Artefacts of disaster risk reduction: conceptualizing bottom-up initiatives of climate action in informal settlements

PurposeDisaster risk reduction is of prime importance in informal settlements in the Global South, where several forms of vulnerability coexist. Policy and official programmes, however, rarely respond to the needs and expectations of citizens and local leaders living in these settlements. Even though these agents constantly attempt to reduce risks in their own way, we know very little about their activities, motivations and effective impact on risk reduction. Here we seek to conceptualize bottom-up initiatives to better grasp their origins, limitations and success.Design/methodology/approachThrough a four-year action-research project in Colombia, Cuba and Chile, we theorize about the production of change by local agents. Through detailed case studies we explored the activism of 17 local leaders. Through narrative analysis we studied their motivations and explanations. Finally, by documenting 22 initiatives, we revealed effective changes in space.FindingsIn the face of risk and disasters, residents and leaders in informal settings engaged in symbolic, physical and social spaces of interaction. Their actions were guided by trust, emotions, time cycles and activism. Local agency was justified by narratives about risk and climate change that differ from those of authorities and scholars.Research limitations/implicationsThere is still limited understanding of bottom-up initiatives in informal settings. It is crucial to conceptualize their origins, limitations and success. The focus on three specific countries necessitates further research for broader applicability and understanding.Practical implicationsA better comprehension of bottom-up actions is crucial for informing policies and programmes aimed at reducing risk in informal settings. Stakeholders must recognize the political, social and cultural roles of these actions for more impactful climate action.Originality/valueWe borrow Simon’s concept of “artefact” to introduce the notion of “Artefacts of Disaster Risk Reduction”, providing insights into the multifaceted nature of bottom-up initiatives. We also emphasize the simultaneous political and phenomenological character of these actions, contributing to a deeper understanding of their origins and impact.

Regionale Disparitäten in der Transformation: Braucht es ein Update der deutschen Regionalpolitik?

Abstract The green transition will affect different places in diverse ways, as place specific and contextual factors, such as pre-existing industrial specialisations, shape how transitions unfold in various territories. In the absence of a place-sensitive approach to decarbonisation, regional disparities are likely to intensify. This may make those who will be potentially hard hit reluctant to support policies necessary for reducing GHG-emissions. Research shows that populist parties that have been the most vocal opponents of climate policies in many countries can capitalize on this sentiment. Thus, investigating how both economic and political costs of the transition will be distributed regionally is key to crafting policies that make a just transition possible. By drawing on the findings of Südekum and Rademacher (2024), the text at hand discusses how the costs of the green transition are likely to be distributed among regions in Germany and what to do about it. It calls for a proactive approach to regional policy and outlines how Germany’s most important regional policy programme can be updated.

Implementasi Kebijakan Pembuatan Kartu Tanda Penduduk Elektronik di Dinas Kependudukan dan Catatan Sipil Kabupaten Malinau

The implementation of the electronic identity card (KTP-el) is part of an effort to accelerate and support the accuracy of the population data base in the district/city, province and national population data base. This research aims to analyze the implementation of the electronic identity card policy at the Population and Civil Registration Office of Malinau Regency and analyze the factors that support and hinder the implementation of the electronic identity card policy program at the Population and Civil Registration Office of Malinau Regency. This research was conducted using descriptive qualitative methods. The results showed that the Implementation of the Electronic Identity Card (KTP-el) Policy at the Population and Civil Registration Office of Malinau Regency has gone well. However, there are still obstacles in the process of recording and printing KTP-el that need to be overcome. There needs to be additional training and technical guidance to improve the knowledge of the apparatus in carrying out the system and policies that have been set.

Multidimensional energy poverty in Colombia: A department-level review from 2018 to 2022

This article aims to measure energy poverty in Colombia in its thirty-two departments and its capital city from 2018 to 2022, using a composite approach. To achieve this, a Multidimensional Energy Poverty Index (MEPI) was designed, according to the methodology proposed by Nussbaumer et al. (2012; 2013) [1,2]. Twenty-eight variables were used, which were distributed across seven dimensions, and recorded by the National Quality of Life Survey (ECV, Spanish acronym), administered by the National Administrative Department of Statistics (DANE) of Colombia. In addition, a nested weighting method was used to assign weights within the index. Subjective weights were given to the dimensions, and an entropy method was used for each of the component variables. The results show that energy poverty has an increasing trend in Colombia throughout the period, especially in the municipal capitals. There are significant differences between urban and rural areas in all territories, and the departments located in the most remote areas of the country have a higher energy poverty. This is consistent with the low population density, as well as with off-grid areas. The results obtained will allow decision makers to conduct a preliminary evaluation of the management and effects of the specific public policy programs and plans that have been implemented in the different territories of the country.

Evaluation of the policy program for strengthening local food commodities for sustainable food security in papua

Achieving sustainable food security in Papua remains a significant challenge due to the region's heavy reliance on imported food. The policy program aimed at bolstering local food commodities is designed to promote self-sufficiency and ensure long-term food sustainability. This study evaluates the policy program focused on strengthening local food commodities in Papua, specifically targeting sago, sweet potatoes, and maize. The objective is to assess the program's effectiveness in boosting local food production and its overall contribution to sustainable food security. The research methodology integrates both qualitative and quantitative approaches, incorporating secondary data analysis from government reports, field surveys of local farmers, and in-depth interviews with key stakeholders to gain a holistic perspective. The data analysis techniques included thematic analysis for qualitative data, ensuring detailed insights, and statistical methods for quantitative data to provide robust findings. The results indicate that the policy program has increased local food commodity production by 30% over the past five years. However, significant challenges remain, including inadequate infrastructure, limited market access, and insufficient support services for farmers, which hinder the full optimization of the program's benefits. The policy initiative has positively impacted food production and sustainable food security in Papua. For long-term success, it is crucial to improve infrastructure, expand market access, and provide continuous support and training for local farmers. This will ensure the gains achieved by the policy program are maintained and further developed, leading to a more resilient local food system in Papua

Implementation of Merdeka Belajar Kampus Merdeka Program in Improving the Quality of Education in Indonesia

The existence of the Ministry of Education and Culture policy related to Merdeka Belajar Kampus Merdeka Program (MBKM) is the right effort in creating a generation that has soft skills and hard skills, and is qualified in aspects of leadership and personality. The MBKM program was launched in 2020 as a new breakthrough for the Ministry of Education and Culture to increase the flexibility of Indonesia's higher education system. MBKM provides greater autonomy for universities and students in designing study programs through student exchange schemes, partner internships, to research or field projects.MBKM is one of the policies of the Minister of Education and Culture, Nadiem Makariem. One of the programs of this MBKM policy is the Right to Study Three Semesters Outside the Study Program. The focus of this study is to analyze the implementation of MBKM comprehensively in improving the quality of education in Indonesia, so that it can be useful for formulating strategies for improvement and development of MBKM policies in the future. The research method used is a literature study of the material or research that has been done. From the results of the study, it can be seen that the implementation of MBKM helps students in their self-development, in addition, additional skills and student academic achievement also increase.

Academic Entitlement among Filipino College Students: Exploring the Influence of Narcissism, Locus of Control, and Family Functioning

Academic entitlement (AE) denotes an expectation of academic success without corresponding effort, reflecting an entitlement mentality prevalent among students. This study focuses on assessing AE prevalence among Filipino undergraduate students in the Cavite region and its association with key predictors: narcissism, internal and external locus of control, and family functioning. The researcher collected data online from 500 undergraduate students using established measurement scales like the Narcissistic Personality Inventory-16, Internal-External Locus of Control Short Scale-4, McMaster Family Assessment Device, and Academic Entitlement Scale. The relationships among these variables were examined by employing path analysis via the SMART PLS computer application. The analyses reveal that narcissism and external locus of control significantly contribute to AE, highlighting the influence of inflated self-perceptions and reliance on external factors in shaping entitlement attitudes. Conversely, internal locus of control and family functioning show no significant association with AE in this context. Beyond academia, the findings suggest broader implications for the educational landscape in the Philippines. Unchecked AE poses risks to educational quality and student progress, demanding proactive measures. In conclusion, the study emphasizes the need for ongoing exploration of AE within the Philippine context, accompanied by policy recommendations and program interventions to address its impact effectively.

Contemporary Anglophone Plays on Montenegrin Stages in the Post-Pandemic Era

This paper explores the reception and impact of nine contemporary Anglophone plays in Montenegro during the post-pandemic era. Analysing data from theatre archives, reviews, and interviews, the study examines the selection, production, and reception of these plays in the context of Montenegro’s political, social, economic, and cultural landscape. The research highlights a sustained interest in both classic and modern-day Anglophone playwrights and delves into complex societal challenges, providing a backdrop for understanding the theatre’s role in addressing these issues. The adapted plays, which explore global concerns and existential themes, contribute to a dialogue with Montenegrin society and challenge accepted norms. The absence of COVID-related plays is discussed, revealing programming policies and priorities. Ultimately, this paper explores how theatre continues to be a vital platform for critique and engagement with contemporary issues, reaffirming its role as a space for dialogue and collective therapy.

A Nation-Wide Survey of Program Directors at a Large Health Care Organization: Prevalence and Perceptions of Resident Wellness Activities.

This study evaluated wellness programs in a large hospital network to determine residency program directors' (PDs) perspectives on their wellness programs' state, including wellness prioritization, frequency of wellness activities, and wellness' influence on decision-making across organizational levels. In 2021, 211 PDs were sent surveys on program policies, program implementation frequency, perceptions of the administration's ability to prioritize wellness, funding sources, and perceptions of resident wellness' impact on decision-making. Among 211 contacted programs, 148 surveys were completed (70.1%). The majority reported having wellness programs, committees, and funding. Fewer than 25% reported having a chief wellness officer. PDs perceived that fellow colleagues in their institution linked wellness to markers of institutional success to a greater extent than other available options (ie, Accreditation Council for Graduate Medical Education [ACGME] requirements, budgetary concerns, resident input, core faculty priorities, and education quality). Financial well-being was perceived as least connected to wellness. Perceptions of wellness were rated across 3 organizational levels: program, institution, and organization. Across all levels, ACGME requirements (31.0%-32.8%) and budgetary/financial concerns (21.9%-37.0%) were perceived as having the most significant influence on overall decision-making, whereas resident wellness was rated lower in influence (8.0%-12.2%). Most programs allowed residents to attend mental health appointments without using paid time off (87.9%) and while on duty (83.1%). The frequency of wellness activities varied greatly across programs. PDs reported challenges making resident self-care and personal development a priority and perceived resident wellness as having limited importance to decision-making at higher levels.