Drawing on an analysis of the implementation of Ethiopia’s Productive Safety Net Programme (PSNP)... more Drawing on an analysis of the implementation of Ethiopia’s Productive Safety Net Programme (PSNP) in the Somali periphery, we consider how the programme is promoted as an ‘innovative’ social protection programme that links food security with development projects. Underpinning its ‘innovative’ role is a community-based approach, focusing upon the institutions, values and capacities of a community. Taking the case of the nomadic pastoralists in Ethiopia’s Somali region, we consider the role of clans as the ‘dominant’ grassroot socio-political organizations. Our analysis, drawing on ethnographic fieldwork shows how in the implementation of PSNP the mobilization and (re)deployment of clanship values and rules create legible and governable Somali pastoral subjects. This is in line with the Ethiopian state’s conception of ‘improvement’ and ‘modern’ way of life based on sedentary-based development and governance. We illustrate how clan leaders unwittingly (re)organize their clan (leadershi...
Immobility in the context of climate change and environmental risks is understudied, particularly... more Immobility in the context of climate change and environmental risks is understudied, particularly its relation to gender. In this article, we further understanding of immobility to include the gendered influences on potential of people to decide non-movement, decipher meanings that are attached with it and explore how it relates to mobility. We analyse emotions of women and men with different mobility experiences, reflecting their ideas of home, risk perceptions and construction of identity that are informed by gender and central to understanding immobility. Through ethnographic data collected in Bangladesh, we look into details of gendered ways of experiencing immobility where male and female attitudes to staying are distinctly different, yet intersect in many ways. Our data reveal how social and cultural context (patriarchy, social norms, cultural values and shared beliefs) and personal emotions (feelings of belonging, attachment, loyalty, modesty) regulate people’s actions on imm...
Redressing land dispossession in the aftermath of violent conflicts is daunting and complex. Whil... more Redressing land dispossession in the aftermath of violent conflicts is daunting and complex. While land dispute resolution and restitution are expected to promote return migration, this outcome is contingent upon the changing social, economic and political conditions under which return takes place. Drawing on qualitative data from Makamba Province in southern Burundi, this case study highlights the politically and historically shaped challenges underlying the resolution of competing and overlapping claims on land following protracted displacement. These include the undocumented and fluid nature of customary land rights, institutional and legal pluralism and shifting land governance relations. This paper emphasises the centrality of the state in regulating returnees’ land dispute resolution and restitution processes. Violent conflicts and forced migration have enabled the state to expand its control over customary land tenure. The gradual exclusion or replacement of local authorities...
Background and Objectives This paper analyses why and how conflicts occur and their influence on ... more Background and Objectives This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists ' motivation in the provision of maternal and neonatal health care in a special-ist hospital. Methodology The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethics Statement Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms
Providers' adherence to case management protocols can affect quality of care. However, how an... more Providers' adherence to case management protocols can affect quality of care. However, how and why protocols are adhered to by frontline health workers in low- and middle-income countries is not always clear. This study explored midwives' adherence to national postnatal care protocols in two public hospitals in Southern Ghana using an ethnographic study design. Ninety participant observations and 88 conversations were conducted over a 20-months period, and two group interviews held with the midwives in the two hospitals. Data was analysed using a grounded theory approach. Findings: Midwives collectively decided when to adhere, modify or totally ignore postnatal care protocols. Adherence often occurred if required resources (equipment, tools, supplies) were available. Modification occurred when midwives felt that strict adherence could have negative implications for patients and they could be seen as acting 'unprofessionally'. Ignoring or modifying protocols also occurred when midwives were uncertain of the patient's health condition; basic supplies, logistics and infrastructure needed for adherence were unavailable or inappropriate; or midwives felt they might expose themselves or their clients to physical, psychological, emotional, financial or social harm. Regardless of the reasons that midwives felt justified to ignore or modify postnatal care protocols, it appeared in many instances to lead to the provision of care of suboptimal quality. Conclusion and recommendations: Providing clinical decision-making protocols is not enough to improve mother and new born care quality and outcomes. Faced with constraining conditions of work, providers are likely to modify guidelines as part of coping behaviour. Addressing constraining conditions of work must accompany guidelines. This includes adequate risks protection for health workers and clients; and resolution of deficits in essential equipment, infrastructure, supplies and staffing.
The dry-salted trade of Nile perch or kayabo is important for many along the shores of Lake Victo... more The dry-salted trade of Nile perch or kayabo is important for many along the shores of Lake Victoria. The kayabo trade started in the 1990s and has been increasingly restructured due to changing regional and global trade relationships. This shift has led to the emergence of hierarchical trading relations, which create an exploitative network in which powerful middlemen control the access of trade for women from the Democratic Republic of Congo (DRC) and marginalizes the Tanzanian women, changing the organization from a poly-centric to a more centralized trade organization in the hands of a small group of powerful business men. We show in this paper that whereas the women traders from the DRC manoeuvred themselves in positions from which they could manipulate the network through bribery and conniving to derive substantial capital gains from the kayabo trade, their Tanzanian counterparts however are excluded from the decision-making processes, access to fish resources, financial capit...
Why issues get on the policy agenda, move into policy formulation and implementation while others... more Why issues get on the policy agenda, move into policy formulation and implementation while others drop off in the process is an important field of enquiry to inform public social policy development and implementation. This paper seeks to advance our understanding of health policy agenda setting, formulation and implementation processes in Ghana, a lower middle income country by exploring how and why less than three months into the implementation of a pilot prior to national scale up; primary care maternal services that were part of the basket of services in a primary care per capita national health insurance scheme provider payment system dropped off the agenda. We used a case study design to systematically reconstruct the decisions and actions surrounding the rise and fall of primary care maternal health services from the capitation policy. Data was collected from July 2012 and August 2014 through in-depth interviews, observations and document review. The data was analysed drawing ...
Drawing on an analysis of the implementation of Ethiopia’s Productive Safety Net Programme (PSNP)... more Drawing on an analysis of the implementation of Ethiopia’s Productive Safety Net Programme (PSNP) in the Somali periphery, we consider how the programme is promoted as an ‘innovative’ social protection programme that links food security with development projects. Underpinning its ‘innovative’ role is a community-based approach, focusing upon the institutions, values and capacities of a community. Taking the case of the nomadic pastoralists in Ethiopia’s Somali region, we consider the role of clans as the ‘dominant’ grassroot socio-political organizations. Our analysis, drawing on ethnographic fieldwork shows how in the implementation of PSNP the mobilization and (re)deployment of clanship values and rules create legible and governable Somali pastoral subjects. This is in line with the Ethiopian state’s conception of ‘improvement’ and ‘modern’ way of life based on sedentary-based development and governance. We illustrate how clan leaders unwittingly (re)organize their clan (leadershi...
Immobility in the context of climate change and environmental risks is understudied, particularly... more Immobility in the context of climate change and environmental risks is understudied, particularly its relation to gender. In this article, we further understanding of immobility to include the gendered influences on potential of people to decide non-movement, decipher meanings that are attached with it and explore how it relates to mobility. We analyse emotions of women and men with different mobility experiences, reflecting their ideas of home, risk perceptions and construction of identity that are informed by gender and central to understanding immobility. Through ethnographic data collected in Bangladesh, we look into details of gendered ways of experiencing immobility where male and female attitudes to staying are distinctly different, yet intersect in many ways. Our data reveal how social and cultural context (patriarchy, social norms, cultural values and shared beliefs) and personal emotions (feelings of belonging, attachment, loyalty, modesty) regulate people’s actions on imm...
Redressing land dispossession in the aftermath of violent conflicts is daunting and complex. Whil... more Redressing land dispossession in the aftermath of violent conflicts is daunting and complex. While land dispute resolution and restitution are expected to promote return migration, this outcome is contingent upon the changing social, economic and political conditions under which return takes place. Drawing on qualitative data from Makamba Province in southern Burundi, this case study highlights the politically and historically shaped challenges underlying the resolution of competing and overlapping claims on land following protracted displacement. These include the undocumented and fluid nature of customary land rights, institutional and legal pluralism and shifting land governance relations. This paper emphasises the centrality of the state in regulating returnees’ land dispute resolution and restitution processes. Violent conflicts and forced migration have enabled the state to expand its control over customary land tenure. The gradual exclusion or replacement of local authorities...
Background and Objectives This paper analyses why and how conflicts occur and their influence on ... more Background and Objectives This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists ' motivation in the provision of maternal and neonatal health care in a special-ist hospital. Methodology The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethics Statement Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms
Providers' adherence to case management protocols can affect quality of care. However, how an... more Providers' adherence to case management protocols can affect quality of care. However, how and why protocols are adhered to by frontline health workers in low- and middle-income countries is not always clear. This study explored midwives' adherence to national postnatal care protocols in two public hospitals in Southern Ghana using an ethnographic study design. Ninety participant observations and 88 conversations were conducted over a 20-months period, and two group interviews held with the midwives in the two hospitals. Data was analysed using a grounded theory approach. Findings: Midwives collectively decided when to adhere, modify or totally ignore postnatal care protocols. Adherence often occurred if required resources (equipment, tools, supplies) were available. Modification occurred when midwives felt that strict adherence could have negative implications for patients and they could be seen as acting 'unprofessionally'. Ignoring or modifying protocols also occurred when midwives were uncertain of the patient's health condition; basic supplies, logistics and infrastructure needed for adherence were unavailable or inappropriate; or midwives felt they might expose themselves or their clients to physical, psychological, emotional, financial or social harm. Regardless of the reasons that midwives felt justified to ignore or modify postnatal care protocols, it appeared in many instances to lead to the provision of care of suboptimal quality. Conclusion and recommendations: Providing clinical decision-making protocols is not enough to improve mother and new born care quality and outcomes. Faced with constraining conditions of work, providers are likely to modify guidelines as part of coping behaviour. Addressing constraining conditions of work must accompany guidelines. This includes adequate risks protection for health workers and clients; and resolution of deficits in essential equipment, infrastructure, supplies and staffing.
The dry-salted trade of Nile perch or kayabo is important for many along the shores of Lake Victo... more The dry-salted trade of Nile perch or kayabo is important for many along the shores of Lake Victoria. The kayabo trade started in the 1990s and has been increasingly restructured due to changing regional and global trade relationships. This shift has led to the emergence of hierarchical trading relations, which create an exploitative network in which powerful middlemen control the access of trade for women from the Democratic Republic of Congo (DRC) and marginalizes the Tanzanian women, changing the organization from a poly-centric to a more centralized trade organization in the hands of a small group of powerful business men. We show in this paper that whereas the women traders from the DRC manoeuvred themselves in positions from which they could manipulate the network through bribery and conniving to derive substantial capital gains from the kayabo trade, their Tanzanian counterparts however are excluded from the decision-making processes, access to fish resources, financial capit...
Why issues get on the policy agenda, move into policy formulation and implementation while others... more Why issues get on the policy agenda, move into policy formulation and implementation while others drop off in the process is an important field of enquiry to inform public social policy development and implementation. This paper seeks to advance our understanding of health policy agenda setting, formulation and implementation processes in Ghana, a lower middle income country by exploring how and why less than three months into the implementation of a pilot prior to national scale up; primary care maternal services that were part of the basket of services in a primary care per capita national health insurance scheme provider payment system dropped off the agenda. We used a case study design to systematically reconstruct the decisions and actions surrounding the rise and fall of primary care maternal health services from the capitation policy. Data was collected from July 2012 and August 2014 through in-depth interviews, observations and document review. The data was analysed drawing ...
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