Involved in research and teaching programmes and fund raising in the field of social sciences and natural resources (anthropology of law) for Wageningen University, and the African Studies Centre, Leiden. Focusing on (agro)pastoralism, agriculture, livelihoods, land tenure, natural resource management (drylands, forest, pastures, fisheries), interethnic relations, conflict, migration, climate change adaptation, agricultural decision-making in high-risk conditions, post-conflict land governance.
This paper seeks to advance our understanding of health policy agenda setting and formulation pro... more This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to ev...
Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five... more Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented. Ghana Demographic and Health Survey data (1988-2008) were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges. Since 1988, the annual average ra...
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 ...
... are expected given the same agro-ecological and socio-economic conditions (de SteenhuijsenPit... more ... are expected given the same agro-ecological and socio-economic conditions (de SteenhuijsenPiters 1995: ll). ... According to the Fulbe herds-men they again lost most of their cattle in the ... economy has suffered enormously from the fluctuations in cat-tle numbers (De Bruijn 1997 ...
ABSTRACT There are many concerns about the impact of the globalization and commodification of the... more ABSTRACT There are many concerns about the impact of the globalization and commodification of the Nile perch fisheries as a result of the export-led development of the sector: food and job insecurity, spread of HIV/AIDS and loss of morals in fishing communities, exploitation and unequal share of benefits, continued fishing illegalities, over investment and spread of theft and piracy. Moreover, a direct relationship between the commodification of Lake Victoria fisheries and the disappearance of traditional norms and values in fishing communities, particularly traditions and rituals in boat construction and launching, is evident.
ABSTRACT Management and leadership in complex health systems have been little addressed as contri... more ABSTRACT Management and leadership in complex health systems have been little addressed as contributors toward improving maternal and newborn health. Widespread perceptions of weak district-level management and leadership have encouraged capacity strengthening interventions with a predominant focus on individual rather than systemic capacities. However, both types of capacities matter. Greater understanding is required about how managerial decision making and policy implementation are influenced by the systems in which managers operate. This article presents an exploratory case study to understand the balance of top-down and bottom-up dynamics influencing district manager decision making in one district in the Ghanaian health system. Our study was theory driven, drawing on concepts of decision space, power, and trust from the literature. Data collection methods included document review, participant observation, and semistructured interviews. Using analysis that drew upon complex leadership theory, we found that contexts of hierarchical authority and resource uncertainty constrained district manager decision space. These constraints also gave rise to a leadership type oriented toward serving the bureaucratic functions of the health system (more top-down than bottom-up). The analysis of this case study showed that, as a result, district-level management and leadership were less responsive to maternal and newborn health service delivery challenges.
... economic differences in changing patterns of responses and the gradual changes in people'... more ... economic differences in changing patterns of responses and the gradual changes in people's 'habitus'. ... Global circulation models predict greater aridity in parts of the Sahel, implying that the ... of a household typology/stratification based on the analysis of local actors' responses ...
This paper seeks to advance our understanding of health policy agenda setting and formulation pro... more This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to ev...
Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five... more Following the adoption of the Millennium Development Goal 4 (MDG 4) in Ghana to reduce under-five mortality by two-thirds between 1990 and 2015, efforts were made towards its attainment. However, impacts and challenges of implemented intervention programs have not been examined to inform implementation of Sustainable Development Goal 3.2 (SDG 3.2) that seeks to end preventable deaths of newborns and children aged under-five. Thus, this study aimed to compare trends in neonatal, infant, and under-five mortality over two decades and to highlight the impacts and challenges of health policies and intervention programs implemented. Ghana Demographic and Health Survey data (1988-2008) were analyzed using trend analysis. Poisson regression analysis was applied to quantify the incidence rate ratio of the trends. Implemented health policies and intervention programs to reduce childhood mortality in Ghana were reviewed to identify their impact and challenges. Since 1988, the annual average ra...
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 ...
... are expected given the same agro-ecological and socio-economic conditions (de SteenhuijsenPit... more ... are expected given the same agro-ecological and socio-economic conditions (de SteenhuijsenPiters 1995: ll). ... According to the Fulbe herds-men they again lost most of their cattle in the ... economy has suffered enormously from the fluctuations in cat-tle numbers (De Bruijn 1997 ...
ABSTRACT There are many concerns about the impact of the globalization and commodification of the... more ABSTRACT There are many concerns about the impact of the globalization and commodification of the Nile perch fisheries as a result of the export-led development of the sector: food and job insecurity, spread of HIV/AIDS and loss of morals in fishing communities, exploitation and unequal share of benefits, continued fishing illegalities, over investment and spread of theft and piracy. Moreover, a direct relationship between the commodification of Lake Victoria fisheries and the disappearance of traditional norms and values in fishing communities, particularly traditions and rituals in boat construction and launching, is evident.
ABSTRACT Management and leadership in complex health systems have been little addressed as contri... more ABSTRACT Management and leadership in complex health systems have been little addressed as contributors toward improving maternal and newborn health. Widespread perceptions of weak district-level management and leadership have encouraged capacity strengthening interventions with a predominant focus on individual rather than systemic capacities. However, both types of capacities matter. Greater understanding is required about how managerial decision making and policy implementation are influenced by the systems in which managers operate. This article presents an exploratory case study to understand the balance of top-down and bottom-up dynamics influencing district manager decision making in one district in the Ghanaian health system. Our study was theory driven, drawing on concepts of decision space, power, and trust from the literature. Data collection methods included document review, participant observation, and semistructured interviews. Using analysis that drew upon complex leadership theory, we found that contexts of hierarchical authority and resource uncertainty constrained district manager decision space. These constraints also gave rise to a leadership type oriented toward serving the bureaucratic functions of the health system (more top-down than bottom-up). The analysis of this case study showed that, as a result, district-level management and leadership were less responsive to maternal and newborn health service delivery challenges.
... economic differences in changing patterns of responses and the gradual changes in people'... more ... economic differences in changing patterns of responses and the gradual changes in people's 'habitus'. ... Global circulation models predict greater aridity in parts of the Sahel, implying that the ... of a household typology/stratification based on the analysis of local actors' responses ...
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Papers by Han van Dijk