Social Service Delivery Systems Research Articles

임신갈등 지원정책 연구

This study proposes the implementation of a comprehensive social policy system in Germany that safeguards women's reproductive rights and children's rights to birth. This system comprises a birth notification system, a protected birth system, a pregnancy conflict counseling system, and related service delivery mechanisms. A comparative case study was conducted to explain the support social services and family policy system for women in pregnancy conflict situations, focusing on a pregnancy conflict counseling center in Germany. Following the revision of the Criminal Law in 1992, the German government began to partially legalize abortion and introduce pregnancy conflict counseling centers. This research found that the German government has supported women in pregnancy conflict situations through child-centered cash benefits and family policy programs aimed at promoting work-life balance. Our research underscores the need to establish a social service delivery system that acknowledges women as the primary stakeholders in childbirth. Additionally, this study proposes revisions to laws related to abortion penalties and the establishment of a comprehensive family policy system.

Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

Financial Toxicity: A Barrier to Achieving Health Equity in Cancer Care

Applying network analysis to assess the development and sustainability of multi-sector coalitions.

Accountable Communities of Health (ACH) models have been popularized through Center for Medicare and Medicaid Innovation (CMMI) grants, including the State Innovation Model (SIM), to encourage the development of community-based coalitions across medical, public health, and social service delivery systems. These models enhance care coordination for patients and are better equipped to address Social Determinants of Health (SDH) needs. Network data was collected from participating organizations in seven ACH sites established across Iowa. The application of network analysis quantitatively characterized the relational context of the interorganizational, cross-sector networks which are foundational to achieving the ACH goal of systematic, comprehensive care. Our analysis primarily used logistic network regression modeling (LNRM) to identify network structures and characteristics of organizations that facilitate or impede sustainable connections. Our findings suggest that the ACH was effective at stimulating sustainable connections across sectors and disparate positions of centrality in the network. Factors associated with sustainable connections between organizations included the strength of relationships and the type of collaboration, namely data sharing and resource sharing. Leadership roles designated by the ACH structure were associated with stimulating connections during the grant, but not with sustainment. Network measures of density and transitivity, which peaked during the grant period (compared to pre- and post-grant networks), further implied possible attrition of the ACH intervention effects without incentive to maintain collaborations. Multi-sector care coordination networks were established, but our findings suggest depreciation of ACH intervention momentum and structure without incentive to maintain collaborations beyond the three-year duration of the grant. Sustainability could be bolstered and ACH goals actualized with reliable long-term funding.

«ПЕРЕОЦІНКА ДОГЛЯДУ»: ВИКЛИКИ СУЧАСНОЇ ЕКОНОМІКИ ТУРБОТИ

Care and nursing are considered important achievements of civilizational social development. The central place of concern in the smooth functioning of society is indisputable. The topical issues of the development of the economy of care as a sphere of the economy that is responsible for providing the necessary social services and assistance in the process of population reproduction are studied. The essence of the formation of formal and informal care practices, their relevance during the Kovid-19 pandemic is determined. The directions of theoretical researches of care economy are substantiated. Characteristic features of the sphere of care in Ukraine and the world are revealed. It is stated that most of the care work continues to be provided free of charge to family and friends, at home and in the community. In a post-industrial society, the social service delivery system has been affected by the global care economy, acquiring the characteristics of a “structured care industry”. However, care work continues to be “blackened” (often passed on to marginalized groups, women, precariats, temporary migrant workers, etc.). Care work, both paid and unpaid, contributes to well-being, social development and economic growth. Unfortunately, the costs of assistance are uneven among social groups. The care economy, however, is not confined to families and communities; it encompasses many private and public enterprises that provide health, education and social services. In addition, the Covid-19 pandemic has demonstrated the importance of the care sector for both human health and strengthening national economies by highlighting aspects of interdisciplinary participation in the joint care of practitioners, social workers, clients / patients and their relatives. Aspects of interdisciplinary participation in the joint care of practitioners, social workers, clients/patients and their relatives are disclosed. The experience of the countries of the world in the institutionalization of informal care is summarized. Emphasizes the importance of evaluating policies to protect unpaid family caregivers and the country's overall role in protecting paid social workers, including paraprofessionals.

International fieldwork: a mirroring of the expectations and experiences of social work students

ABSTRACT International fieldwork is a significant element of the internationalization of the social work profession. This paper describes the expectations and experiences of social work students engaged in international field education. There are different models practised by universities for international exchanges and fieldwork. This paper focuses on the reciprocal agreements between universities to facilitate student fieldwork. The qualitative study presented here recruited participants from Australia, USA and India, who travelled internationally for their fieldwork. The findings highlight the expectations and experiences the students had during each phase of the international fieldwork and the learning, specifically with issues of cross-cultural practices, social work service delivery systems, setting specific requirements, adaptations and challenges found across the three themes of preparation and planning; undertaking placement; concluding and re-presenting fieldwork. The paper concludes by considering the implications of the findings and how these relate to international fieldwork pedagogy, supervision and models of international placements.

A phenomenological reflection on women's lived experience of giving in circumstances of material scarcity.

There is a robust body of research that examines problems women with criminal-legal system involvement face, the support they need, how they get it, from whom, and how they use it. Rarely do we pause to consider what resources such women already have, the support they give, or what those experiences teach us about how to support them. In this study, my purpose was to reflect on the phenomenon of giving as experienced by women who have few material resources and whose lives have been disrupted by repeat incarcerations. I analyzed four lived experience descriptions of giving from interviews conducted in 2016-2017 with 10 women who had significant histories of criminal-legal system involvement, unstable housing, and little or no income. Using concepts from hermeneutic phenomenology and the practice of phenomenological study described by Max Van Manen, I analyzed giving wholistically, selectively, and in detail. I discerned that the women's experience of giving was relationally structured as exchange, with both past and future aspects. In selective and detailed analysis, themes of "taking in" and "being there" and a gem or essential feature of automaticity/personhood presented themselves. Women found meaning, value, and a sense of belonging in giving to others even when they struggled to meet their own needs. The findings suggest potential directions for nursing practice, research, and advocacy, including work to recognize, build on, and remunerate women's affiliative care-giving and support-while also putting pressure on community health and social services delivery systems to better serve those in need.

Examination of the effects of COVID-19 on the psychosocial life and the sources of social support of people with rare diseases in Turkey

ABSTRACT The study aims to examine the effects of the COVID-19 on the psychosocial life and the sources of social support of people with rare diseases in Turkey. The research was conducted with 178 rare disease patients. The sociodemographic questionnaire, The Fear of COVID-19 scale, General Health Survey-12, and the Multidimensional Scale of Perceived Social Support were used. The Fear of COVID-19 Scale average score is 20.20 ± 6.11, General Health Survey-12 average score is 5.82 ± 1.77, and the Multidimensional Scale of Perceived Social Support average score is 52.84 ± 14.23. There is a positive correlation between ages and scores on The Fear of COVID-19 Scale (r = .221, p˂.001). There is a negative correlation between the participant’s scores on the Multidimensional Perceived Social Support Scale and the General Health Survey-12 (r = -,265, p˂.001). It is suggested to develop social service delivery systems to support people with rare diseases.]

Interprofessional collaboration and barriers among health and social workers caring for older adults: a Philippine case study

BackgroundThere is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice.MethodsA case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Overall, 174 health and social workers consented to participate in this study. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis using NVivo 12® was used to identify and categorize relevant thematic codes.ResultsInterprofessional geriatric care provided by health and social workers was observed to be currently limited to ad hoc communications typically addressing only administrative concerns. This limitation is imposed by a confluence of barriers such as personal values and beliefs, organizational resource constraints, and a silo system care culture which practitioners say negatively influences care delivery. This in turn results in inability of care providers to access adequate care information, as well as delays and renders inaccessible available care provided to vulnerable older adults. Uncoordinated care of older adults also led to reported inefficient duplication and overlap of interventions.ConclusionGeriatric care workers fear such barriers may aggravate the increasing unmet needs of older adults. In order to address these potential negative outcomes, establishing a clear and committed system of governance that includes IPC is perceived as necessary to install a cohesive service delivery mechanism and provide holistic care for older adults. Future studies are needed to measure the effects of identified barriers on the potential of IPC to facilitate an integrated health and social service delivery system for the improvement of quality of life of older adults in the Philippines.

Ukrainian

Th is article is devoted to the issues of formation and functioning of innovative social work practices in Ukraine. Its purpose is to highlight the best examples of innovative social work practices for vulnerable groups in the country and to analyze the possibilities for their further application. Th e relevance of the study, on the one hand, is conditioned by the humanization of approaches to building relationships between the individual and the social protection system, the appearance at the state level of the requirements for the quality of social services, which are refl ected in the activities of social services, creating certain new models of work with socially vulnerable groups of citizens, and on the other hand it is conditioned by the severity and unresolvedness of a number of social problems related to the social protection of vulnerable populations. Such general scientifi c methods as generalization and analogies logical analysis are used for realization of the purpose. Innovative prac- tices are practices in the fi eld of social work practices for vulnerable groups, which have emerged as new ways of meeting the urgent needs of social service clients and aiming to achieve the most eff ective result both in solving the problems of individuals in need and social problems in general. Th e author proposes the algorithm for the formation of innovative social work practice, which covers all stages from the identifi cation of the need for such practice to the beginning of the functioning of an innovative practice. It is found that case management and integrated social services are the most widespread among innovative practices in the fi eld of social work in Ukraine. Th e article analyzes the specifi cs of both innovative practices and identifies and justifies the ways of their further development. Both practices have proven their eff ectiveness and fl exibility in solving specifi c social problems, and therefore the possibilities of their application (including in the newly created territorial communities) are expected to be expand in the future. Combined, these practices are able to ensure the high effi ciency of the domestic social service delivery system.

Integrated transitional care for older patients discharged from hospital and ED

Abstract Background Care integration through high level care continuation for older patients discharged from the hospital may secure positive health outcomes and reduce subsequent emergency visits. Integrated transitional care is, however, challenged by fragmented care delivery systems. We explored integrated transitional care from the delivery system perspective in three Nordic cities (Copenhagen, Stockholm and Tampere) to compare levels of integration of social and health service delivery systems and care paths for older patients discharged from hospital. Methods Information on organizational structure and care integration was obtained from administrative documents, legislation and statistics, webpages of the cities, and empirical studies. Based on the material we outlined the degree of integration at different levels and mapped the possible care paths for older patients discharged from the hospital for each city. Results All three cities are characterized by fragmented care systems for older patients based on financially and organizationally independent institutions. Sweden and Denmark, however, have introduced legislation to steer the integration of services between the local and regional level actors. However, older patients still have complex care paths after discharge from hospital care. Conclusions The fragmented care systems for older patients consisting of independent institutions across local and regional levels may impede integrated transitional care. Alternative care settings for older people with different needs could be an asset, but they can also form a hurdle for care continuation if the responsibilities and liaison between these sites are not clear. Key messages The fragmented organisation of care systems for older patients may impede integrated transitional care. The care facilities for older patients after discharge is targeted to accommodate the complex and varying needs, but pose challenges for continuity of care.

LGBT OLDER ADULTS AND THEIR PETS IN SOUTHERN APPALACHIA: RESULTS OF QUALITATIVE RESEARCH AND FUTURE RESEARCH DIRECTIONS

This session reports on older LGBT adults’ perspectives of roles that pets played in relation to older adults’ aging-in-place experiences. The goal of this study is to advance understanding of the role of pets in the lives of older LGBT adults living in rural communities. The qualitative study used individual, semi-structured interviews with 11 older adults residing in rural Appalachia. Individuals were recruited using purposive sampling techniques, including recruitment through LGBT friendly service providers, a lesbian listserv, and snowball sampling. The majority of respondents reported that pets played a role in social support and some in social capital. One respondent described a utilitarian relationship with animals that is important to understanding the roles animals may play in rural communities in terms of "belongingness". After reviewing study findings, we will provide recommendations for including information about pets in formal social service delivery systems and conclude with implications for future research.

The impact of transition from British to Chinese rule on social service delivery systems in Hong Kong

One of the consequences of the transition from British to Chinese rule in Hong Kong has been the development of parallel social service delivery systems. On the one hand, the welfare bureaucracy is characterised by contractual relationships between the government and nonprofit organisations and is shaped by western ideas associated with new public management. On the other hand, the political machine is composed of locally elected representatives, community-based organisations (CBOs) and local residents and reflects traits of Chinese communism. This article investigates the interactions and strategies adopted by actors in these two systems in their attempt to control the delivery of social services. Crucially, it explores how these two systems interact and the impact on policy implementation. Evidence shows that CBOs provide a critical brokering role between elected political officials, the public and nonprofit organisations that is critical to maintaining the functionality of Hong Kong’s parallel social service delivery systems.

Issues and Tasks for Reorganization of Social Service Delivery System under the Moon Administration - Focusing on publicity and decentralization

Issues and Tasks for Reorganization of Social Service Delivery System under the Moon Administration - Focusing on publicity and decentralization

네트워크 거버넌스 유형과 효과성에 대한 연구: 남양주시 사회복지전달체계를 중심으로

본 논문은 남양주시 사회복지전달체계를 대상으로 네트워크 거버넌스 유형의 구조적 속성이 협력의 효과성에 미친 영향을 분석하는 데 목적이 있다. 거버넌스에 대한 기존의 연구들은 네트워크 유형을 구분하거나 효과성을 분석하는 연구들이 분절적으로 이루어지는 한계를 나타내었다. 이에, 본 논문은 Milward와 Provan의 네트워크 논의를 바탕으로 남양주 내 공공･민간 조직들을 대상으로 네트워크 유형을 구분하는 한편, 연계망 내 조직 간 협력의 밀도와 강도가 협력의 경험과 성과인식에 미치는 영향을 확인하였다. 이를 위해, 남양주의 91개 조직을 대상으로 2017년에 실시한 설문조사를 바탕으로 네트워크 분석과 위계적 선형분석을 활용하였다. 분석 결과, 남양주의 사회복지 전달체계는 소수의 중재자를 중심으로 한 주도조직 중심 네트워크 유형으로 확인되었다. 네트워크 내 조직들은 많은 협력을 할수록 경험과 성과에 긍정적인 인식을 보였으나, 높은 수준의 협력은 오히려 부정적인 인식으로 이어졌으며 중재자인 희망케어센터를 통할 때 긍정적으로 영향을 미쳤다. 부정적 인식의 원인을 파악하기 위해 추가적으로 인터뷰를 실시한 결과, 중재자를 제외한 민간 조직들 간의 약한 관계(weak tie)와 최근의 행정개편으로 인한 중재자 수의 증가가 협력에 대한 부정적 인식으로 이어지는 매커니즘 또한 확인할 수 있었다.

Explaining reforms: post-New Public Management myths or political realities? Social housing delivery in England and France

This article examines the assumption that recent reforms in social and public services can be understood as a transition from New Public Management to post-New Public Management. English and French social housing delivery are selected as two cases in which to test out this assumption, for ostensibly these delivery structures share significant cross-national, post-NPM similarities – a movement towards a more ‘enabling’ or steering role for central government, the creation of coordinating agencies, ‘decentralization’ initiatives, the extensive use of public–private arrangements to finance social housing and the involvement of a wide range of extra- and semi-governmental organizations. However, further investigation reveals that these reforms of delivery structures have not been predominantly driven by an unfolding post-NPM managerial or governance logic as the thesis assumes. Rather the reforms have been driven by the partisan electoral and ideological goals of central government policymakers within the context of institutional legacies and entrenched social values. Points for practitioners New Public Management and post-New Public Management have become the conventional wisdom on administrative reforms particularly in a comparative context. This article argues that these ideas reflect an impoverished understanding of public administration given that they assume that change occurs predominantly through the unfolding of managerial and/or governance logics. These logics exclude the critical role of the political parties and other socio-political factors, such as urban unrest, in driving change. This Anglo-French analysis of social housing delivery demonstrates the significance of these political factors in how policymakers define social problems, re-design and implement social housing service delivery systems.

사회서비스 공급체계의 최근의 연구 동향

사회서비스의 공급체계에 대한 연구는 매우 제한적이며 학문적 연구 성과는 사회서비스 제공현장의 확장속도를 충분하게 따라가지 못하고 있다. 연구는 현재의 사회서비스 공급체계에 대한 연구의 현황을 확인하고 새로운 연구와 정책방향을 모색하고자 하였다. 분석논문은 총 79편으로 구성되었으며 분석틀은 분석차원, 분석기준 그리고 분석내용으로 구분을 하여 빈도와 교차분석을 하였다. 연구는 다음과 같이 정리할 수 있다. 첫째, 사회서비스 공급체계의 품질관련 평가 모델이나 품질 인증에 대한 적극적인 연구가 필요한 시점임을 확인하였다. 둘째, 사회서비스 관련 연구의 확대를 위해 사회서비스 예산에 대한 중앙정부와 지방정부의 규모, 개별 사회서비스 제공기관의 관련 자료 등의 공개가 필요함을 보여주었다. 셋째, 사회서비스 공급체계 연구 확대를 위해 사회서비스 예산 배분, 인구 특성, 형평성 그리고 지역 정보 등을 활용한 사회서비스 수요에 대한 예측 관련 연구가 필요함을 보여주었다. 마지막으로 공급과잉에 의한 서비스의 질의 감소 현실을 고려하여 개별 사회서비스 공급 기관의 진입 규정에 관한 연구도 필요함을 알 수 있었다. Academic research of the social service delivery system is very limited. This paper checked on the status of research on current social service delivery system in order to explore new research and policy directions. Analysis study consisted of 79 pieces and the framework was divided into dimensional analysis, content analysis and analytical standards. Research on the papers of social service delivery systems showed from the initial stage of the policy discussion to the phase of the individual services. Summarizing the study is as follows. First, This studies confirmed that at this time the quality studies on social service delivery system is needed. Second, this indicates that right now, the government budget of social services and the data relating to social service agencies will be opened to the public for the expansion of social services studies. Third, to expand social services delivery systems research, it showed that social services demand forecasting research such as budget allocation, population characteristics, equality of public service and local information is needed. Finally, since the quality of service is reduced by the oversupply, the discussion of the entry regulations of social service providers is required.

Understanding Service Contracting and Its Impact on NGO Development in China

The Chinese government and human service NPOs are joining the bandwagon of service contracting with enthusiasm. Although this new policy endeavor has attracted much interest, empirical studies are scant. Drawing from interviews with 14 nonprofit organizations and two government officials conducted in 2012 and 2014, along with abundant secondary data, this paper analyzes the impact of China’s service contracting on the following: the social service delivery system, the promotion of NGOs development, and the nature of government-nonprofit relationship. The study found that service contracting has positive impacts on NGOs, such as facilitating their fundraising through sharing the government’s legitimacy. However, the majority of contract funding went to organizations that have a close government connection. We argue that the future of China’s service contracting is determined by the Chinese government’s primary political agenda, which is social control.

"The Pain of Exile": What Social Workers Need to Know about Burmese Refugees.

Refugees from Burma have comprised the largest group of refugees resettling in the United States over the past decade, with nearly 90,000 people, and 19 percent of the total refugee population. However, very little literature exists that describes the cultural context and displacement experiences of this population. This article addresses that gap in the literature by examining historical, social, political, and cultural dimensions relevant to social work practice with Burmese refugees. Practice with Burmese refugees should be informed by knowledge of refugee policy, refugee resettlement, and social services delivery systems; the Burmese historical and political context; the community's specific strengths, needs, and cultural diversity; and human rights and social justice issues. Strong community partnerships between social workers and indigenous community leaders, between resettlement agencies and ethnic community-based organizations, and between different Burmese refugee groups are important to meeting short- and long-term social services needs and fostering successful adaptation and community integration.

Local Government Reform: Is It a Key to a Functional Decentralized Government in Zambia

The decentralization reform process in Zambia has raised citizen expectations towards their participation in local democracy and development. However, a sense of mistrust has arisen among most citizens about the performance of the local governments in Zambia. Local governments are widely criticized and blamed for poor service delivery, even those functions to be performed by central Government. Proponents of decentralization agenda have argued that local government is the frontline of local democracy and development by which citizens must have the greatest opportunity to be engaged actively and directly in decisions affecting their well-being. Opponents of decentralization have contested that with the current institutional capacity of most local governments in Zambia, decentralization by whatever form is an exercise in futility because the local governments have not recovered from the hangover of the one party state system of local government. It is evident that decentralization is a key policy issue for Zambia though is not the panacea for local democracy and local development. Across the globe, many local governments are becoming more responsible for the social service delivery system. Opinion differs as to the type of decentralization reforms and is a matter in which citizens’ appears so skeptic because of the perceived pitfalls of decentralization. However, the dominant view is that the decentralization process is good for citizens’ participation as it enhances local democracy and local development. Of course it is not the answer to resolving the many challenges of institutional reforms because decentralization is a process and not end itself.

A Study on the Social Care Service Delivery System for Older People: Focusing on the Perspectives of Public Sector Employees and Private Service Providers

A Study on the Social Care Service Delivery System for Older People: Focusing on the Perspectives of Public Sector Employees and Private Service Providers