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1. Moving on Up: Multilevel Monitoring and Advocacy for Health Rights

Author:
Abrehet Gebremedhin
Publication Date:
01-2023
Content Type:
Working Paper
Institution:
Accountability Research Center (ARC), American University
Abstract:
Multilevel approaches to monitoring and advocacy are often used by international development practitioners, particularly in civil society, in efforts to hold governments—from the national to the local—to account for policy implementation. However, such approaches are not yet well understood or identified by many scholars in the social accountability field. This evidence review addresses this gap through a cross-case comparison of multilevel approaches in ten health rights programs across Africa, Asia, and Latin America. It draws on published evaluations, working papers, and peer-reviewed journal articles, as well as insights shared by implementers and researchers. Cases were selected to illustrate health rights initiatives that included monitoring or advocacy activity at a minimum of two different levels: local health facility, district, regional, provincial or national. Four significant findings emerge from this review of evidence: Vertical integration is a relatively common feature of multilevel monitoring and advocacy in these ten cases and is most likely to take place at the lower ends of the health system. However, it is largely implicit, and often not articulated in project design or theories of change. Horizontal organizing—the coordination of civil society action across districts or geographies—is a less visible feature of multilevel approaches to health rights programming than vertical integration. Despite the multilevel nature of health monitoring and advocacy in these ten cases, less than half reported working at the regional or provincial level, indicating a ‘missing middle’ between local and national activity. Escalation—the process by which citizens’ unaddressed claims move upwards to those with greater decision- making powers—is an important mechanism for accountability and one way in which vertical integration can happen. However, escalation is not clearly articulated in much of the gray literature, and therefore merits further research. The findings from this evidence review have implications for strategy, including: the importance of explicitly identifying multilevel tactics for monitoring and advocacy; theorizing the process by which unaddressed claims can be addressed, particularly moving up beyond the local level; emphasizing the importance of the ‘middle’ and ensuring regional and provincial decision-making is leveraged; and looking to link vertical integration with opportunities for horizontal organizing.
Topic:
Civil Society, Health, Accountability, Advocacy, and Monitoring
Political Geography:
Africa, Asia, and Latin America

2. Planetary Health: Reflections from Asia

Author:
Margareth Sembiring
Publication Date:
06-2022
Content Type:
Working Paper
Institution:
Centre for Non-Traditional Security Studies, S. Rajaratnam School of International Studies
Abstract:
Planetary Health is a concept that advocates the care of the planet for human own survivability. It underscores the health implications of environmental degradation brought about by human activities and development progress, and calls for a systemic approach that considers and addresses socio-environmental trade-offs of certain policy and/or economic objectives. In view of multiple crises that have been happening in recent years – from the COVID-19 pandemic to the war in Ukraine – which have further negatively affected the environment, understanding how Planetary Health can be applied to address continuing environmental decline is critical. Planetary Health is a relatively new term in Asia. Drawing from the discussions in the 6th NTS-Asia Consortium Annual Conference in April 2022, this NTS Insight maps the different ways Indonesia, India, Bangladesh, Japan, and China engage Planetary Health in their specific contexts. The interpretations of the concept are likely to influence the trajectory of its implementation.
Topic:
Health, International Cooperation, Recovery, Pandemic, and COVID-19
Political Geography:
Asia

3. China’s Improvised Mask Diplomacy in Chile

Author:
Urdinez. Francisco
Publication Date:
04-2021
Content Type:
Working Paper
Institution:
Carnegie Endowment for International Peace
Abstract:
During the pandemic, Chinese medical and equipment supplies to Chile have come mostly from a diverse cast of Chinese players with local experience in Chile. They adapted to Chile’s unique system of emergency and disaster management. China has become a global power, but there is too little debate about how this has happened and what it means. Many argue that China exports its developmental model and imposes it on other countries. But Chinese players also extend their influence by working through local actors and institutions while adapting and assimilating local and traditional forms, norms, and practices. With a generous multiyear grant from the Ford Foundation, Carnegie has launched an innovative body of research on Chinese engagement strategies in seven regions of the world—Africa, Central Asia, Latin America, the Middle East and North Africa, the Pacific, South Asia, and Southeast Asia. Through a mix of research and strategic convening, this project explores these complex dynamics, including the ways Chinese firms are adapting to local labor laws in Latin America, Chinese banks and funds are exploring traditional Islamic financial and credit products in Southeast Asia and the Middle East, and Chinese actors are helping local workers upgrade their skills in Central Asia. These adaptive Chinese strategies that accommodate and work within local realities are mostly ignored by Western policymakers in particular. Ultimately, the project aims to significantly broaden understanding and debate about China’s role in the world and to generate innovative policy ideas. These could enable local players to better channel Chinese energies to support their societies and economies; provide lessons for Western engagement around the world, especially in developing countries; help China’s own policy community learn from the diversity of Chinese experience; and potentially reduce frictions.
Topic:
Diplomacy, Disaster Relief, Health, Pandemic, and COVID-19
Political Geography:
China, Asia, South America, and Chile

4. ASEAN Matters for America/America Matters for ASEAN

Author:
East-West Center
Publication Date:
12-2021
Content Type:
Working Paper
Institution:
East-West Center
Abstract:
This project maps the trade, investment, employment, business, diplomacy, security, education, tourism, and people-to-people connections between the United States and the 10 member states of the Association of Southeast Asian Nations (ASEAN) at the national, state, and local levels. Part of the Asia Matters for America initiative, this publication, the one-page connections summaries for states, and the AsiaMattersforAmerica.org website are resources for understanding the robust and dynamic US-ASEAN relationship.
Topic:
Defense Policy, Agriculture, Diplomacy, Health, and Infrastructure
Political Geography:
Asia, North America, Southeast Asia, and United States of America

5. The Effects of Financial Inclusion on Development Outcomes: New Insights from ASEAN and East Asian Countries

Author:
Rajabrata Banerjee, Ronald Donato, and Admasu Afsaw Maruta
Publication Date:
09-2020
Content Type:
Working Paper
Institution:
Economic Research Institute for ASEAN and East Asia (ERIA)
Abstract:
This study empirically examines the effects of financial inclusion on economic development, – economic growth, education, health, and income inequality – in 20 Asian countries in the period 2004-2015. The financial inclusion index at an aggregate level is constructed using a hybrid methodology (reported in the previous paper) and we empirically examine its relationship with particular development outcomes. We then disaggregate the index into the three dimensions of financial inclusions – access, usage, and quality – and further into the top two indicators from each dimension based on principal component analysis scores (reported in the previous paper), to examine whether specific dimensions or indicators are more strongly associated with particular development outcomes than with others. Our results show that aggregate financial inclusion has a strong positive effect on all development outcomes and this effect improves for countries with lower political risk. At the dimension level, while usage is the only dimension impacting on economic growth, and access is the only dimension impacting on health outcomes, both usage and access influence education and income inequality. Moreover, the top ranked indicators in each dimension exert a far greater positive influence on development outcomes than the second highest ranked indicators. Our findings show that adopting a single blanket policy may not be appropriate to realise the full potential of financial inclusion in a less developed country. Policy prescriptions should therefore target specific dimension and indicators of financial inclusion to maximise the positive effect on development outcomes.
Topic:
Development, Health, Finance, and Fiscal Policy
Political Geography:
Asia

6. Intended and Unintended Consequences of a New Limit on Working Hours in South Korea: Implications for Precarious Employment

Author:
Sungchul Park and Hansoo Ko
Publication Date:
06-2020
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Effective as of July 1, 2018, South Korea set a new cap on employees’ weekly working hours, decreasing the maximum number from 68 to 52. In this study, we comprehensively analyze the effectiveness of the law’s implementation by observing changes in work time, health status, health care utilization, health behavior, monthly expenses, and satisfaction between pre- and post-implementation periods (2014–2017 vs. 2019). We find evidence of both intended and unintended consequences—and, in this last category, some are beneficial and some not. As intended, employees eligible for the 52-hour work week saw their average working hours decrease, while their monthly spending on leisure increased substantially. A beneficial unintended consequence was that work time also decreased in firms with less than 300 employees that had not yet implemented the 52-hour work schedule (they have done so since, in January 2020). Among adverse unintended consequences, the most notable were heterogeneous effects across employment types (full-time vs. precarious employment) and, in particular, negative impacts on precarious employees (that is, those facing relatively high levels of job insecurity). Despite almost no change in their work time, precarious employees saw substantial increases in outpatient visits and monthly expenses for health care, indicating suggestive evidence of adverse health consequences. Another adverse unintended consequence was that overall job satisfaction decreased among several groups of employees. This may reflect a heavy workload among employees still expected to work overtime, especially experienced employees or those working in large firms. While employment rates increased after the new schedule’s implementation, the majority were in precarious jobs. This has negative implications because of the adverse health impacts of being in precarious employment; also, the workload of experienced employees in this field might have intensified amid all the new hiring. Our findings suggest key policy recommendations for how to leverage the benefits of the 52-hour cap on weekly working hours while addressing its negative unintended consequences.
Topic:
Health, Labor Issues, Employment, and Labor Policies
Political Geography:
Asia and South Korea

7. People’s Polyclinics: The Initiative of the Telugu Communist Movement.

Author:
Tricontinental: Institute for Social Research
Publication Date:
02-2020
Content Type:
Working Paper
Institution:
Tricontinental: Institute for Social Research
Abstract:
The Indian Communist movement has experimented with various forms of people’s polyclinics, which provide free or reduced-cost health care to anyone. The epicentre of this initiative has been in the Telugu-speaking region of India, where the Nellore People’s Polyclinic alone treats 1,000 patients per day at rates 40% lower than corporate hospitals and has trained over five hundred doctors who now provide health care across the region. Our Tricontinental: Institute for Social Research Dossier no. 25 focuses on the history of the polyclinics in this region.
Topic:
Communism, Health, Community, and Medicine
Political Geography:
India and Asia

8. Fight the COVID-19 Pandemic and Improve Global Health Governance

Author:
Lin Ren, Aizong Xiong, Guoding Wu, Chen Shen, Xu Tian, and Bo Peng
Publication Date:
07-2020
Content Type:
Working Paper
Abstract:
The fast spreading of the COVID-19 across the globe points to the urgency of strengthening global health governance. As the core global health governance institution, the WHO has taken a series of actions after the eruption of the epidemic and played an important role in providing guidance and coordinating global forces to combat the epidemic. The epidemic, however, has also exposed some defects of the global health governance mechanism, especially the WHO, and posed challenge to it. The international community needs to strengthen its support for the WHO to improve its role in the global health governance.
Topic:
Health, Governance, and COVID-19
Political Geography:
China, Asia, and Global Focus

9. Social Interventions, Health and Wellbeing: The Long-Term and Intergenerational Effects of a School Construction Program

Author:
Bhashkar Mazumder, Maria Rosales-Rueda, and Margaret Triyana
Publication Date:
12-2020
Content Type:
Working Paper
Institution:
Kellogg Institute for International Studies
Abstract:
We analyze the long-run and intergenerational effects of a large-scale school building project (INPRES) that took place in Indonesia between 1974 and 1979. Specifically, we link the geographic rollout of INPRES to longitudinal data from the Indonesian Family Life Survey covering two generations. We find that individuals exposed to the program have better health later in life along multiple measures. We also find that the children of those exposed experience improved health and educational outcomes and that these effects are generally stronger for maternal exposure than paternal exposure. We find some evidence that household resources, neighborhood quality, and assortative mating may explain a portion of our results. Our findings highlight the importance of considering the long-run and multigenerational benefits when evaluating the costs and benefits of social interventions in a middle-income country.
Topic:
Education, Health, Poverty, Inequality, Economic Growth, and Economic Development
Political Geography:
Indonesia and Asia

10. Modicare Post-Election: Recommendations to Enhance the Impact of Public Health Insurance on UHC Goals in India

Author:
Kalipso Chalkidou, Nishant Jain, Françoise Cluzeau, and Amanda Glassman
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.[1] In this note, we describe the program, with an emphasis on its better-known secondary and tertiary care component, and offer policy recommendations to strengthen the scheme post-election to enhance its contribution to India’s vision for universal health coverage (UHC). In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly 1 percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the world’s performance against the Sustainable Development Goals over the coming decade.
Topic:
Health, Health Care Policy, Public Health, and Health Insurance
Political Geography:
India and Asia