Conditional cash transfers (CCTs) provide mothers of school-age children in extreme poverty with a cash subsidy conditional on their children's attendance at school and health clinics. This paper assesses the evidence for the claim that these programmes empower women. It finds that, although CCTs are designed to target the extremely poor and the particularly vulnerable, they operate under a highly selective definition of social need, and these programmes privilege and target some needs over others even at household level, reinforcing social/gender inequalities within the family itself. Highly unequal gender relations were found to be central in the functioning of such programmes. The paper argues that cash transfers should be part of a broader effort to improve and strengthen the social sector while attending to the urgent needs of the most deprived. If they signal a move in the direction of residualist welfare policies designed as compensation for exclusionary economic development, then they represent a more worrying trend. If cash transfers are to enhance the life chances of seriously disadvantaged populations, their design needs to take into account the household as a whole, so that the needs of all members are met.
Governance and participation in health
The articles in this issue on participatory learning and action focus on the recent approaches to adaptation to climate change utilising the priorities, knowledge and capacities of local people. Community-based adaptation (CBA) draws on participatory approaches and methods developed in both disaster risk reduction and community development work and sectoral-specific approaches. The emphasis now leans to policy processes and institutionalisation, issues of difference and power, assessing the quality and understanding the impact of participation, rather than promoting participation. Participatory Learning and Action reflects these developments and recognises the importance of analysing and overcoming power differentials which work to exclude the marginalised. This issue is divided into three sections: reflections on participatory processes and practice in community-based adaptation to climate change; participatory tool-based case studies; and participatory tools, with step-by-step descriptions of how to use them. The report also presents two important tools: communication maps, which help participants to understand communication patterns and relationships, and a tool called Rivers of Life, where participants reflect on personal experiences that have motivated them in their personal lives.
This study and report were commissioned by the Rockefeller Foundation to explore the feasibility of establishing a support mechanism for ministers and ministries of health especially in the poorest countries, as part of the Foundation’s Transforming Health Systems initiative. Based on data from minister and stakeholder interviews and supporting research and consultation activities, this report offers seven action items geared toward building a systematic and sustained program of support for health ministries. Recommendations and proposals provided address: capacity assessment tools; leveraging existing management development resources; mapping country networks of expertise; regional networks to support health systems stewardship and governance; knowledge networks to support ministers of health; executive leadership development; and advocacy for strengthening health ministries. Collective action on these proposals is needed to strengthen health ministries and enhance the leadership capabilities of ministers.
The European Parliament in considering the second review of the Cotonou Agreement between European and African and Caribbean states, deplored the fact that the Parliament, the ACP-EU Joint Parliamentary Assembly (JPA), national parliaments of the ACP (African, Caribbean and Pacific) States and civil society organisations and non-state actors were not involved in the decision-making process that led to the identification of areas and articles of the Cotonou Agreement for revision and to the establishment of the negotiating mandates adopted by the Council of the European Union (EU) and the ACP Council of Ministers. This omission was argued to affect the transparency and credibility of the revision process and to alienate EU and ACP populations from their governments and institutions. The Parliament stressed the need to consolidate the political dimension of the Cotonou Agreement, particularly in respect of the commitment of the parties to implement the obligations stemming from the Rome Statute of the International Criminal Court. The European Parliament called on the Commission, the EU and the ACP Council to take into account the principles and results of the International Aid Transparency Initiative, and to launch a debate, involving also non state actors, on the future of ACP-EU relations post-2020.
Distinguishing between ‘(good) governance’ as a process and an outcome, this paper examines both the processes and outcomes of governance in the context of the European Union’s (EU) relationship with African, Caribbean and Pacific (ACP) States within the period of the Cotonou Agreement (CA). It discusses and assesses a variety of governance mechanisms, including the European Commission’s use of the governance concept, economic partnership agreements (EPAs), manifestations of partner preferences, the revision of the CA, and Fisheries Partnership Agreements. Specific examples of the wielding of each mechanism are assessed based upon two criteria: the extent to which the wielding of the mechanism by the EU is a manifestation of ‘good governance’, and the extent to which the EU’s wielding of the mechanism has resulted, or is likely to result, in the sustainable development of and reduction of poverty in ACP countries. The examples are chosen to illustrate contradictions between rhetoric and practice and the consequential negative (actual and potential) impact upon development in ACP States. The final section offers suggestions for improving the EU’s governance processes and their outcomes for development.
In this book the author cautions against promises of the market as a means to meeting the challenges of social change. The author proposes that real change will come when business acts more like civil society, not the other way around, as business by its very nature is not equipped to attack the root causes of poverty, inequality, violence, and discrimination. Achieving fundamental social transformation requires a different set of operating values – cooperation rather than competition, collective action more than individual effort, and patient, long-term support for systemic solutions over immediate results. He argues that people give their money and time to social change organisations to serve a cause, not a balanced quarterly spreadsheet. With a vested interest in the status quo, all business can promise are valuable but limited advances: small change, in comparison to the more sweeping transformation that can be brought about by social action.
This study proposes to sketch out an overview of the challenge of accountability within donor countries, and includes a few innovative initiatives set up by these countries to reinforce the demand for accountability, as well as to advance the production of ‘accountable’ information and diversify the tools for disseminating agencies’ action and for opening the debate. It aims to find the thread linking services provided by different agencies, to understand how they interface and what their limitations are. The study poses and attempts to answer the following questions: What is the ‘accountability demand’ currently levelled at development agencies? How can the tools for producing and disseminating information be ‘grown’ so as to meet the mounting accountability objective? How can the agencies’ accountability targets and tools be broadened to better answer the needs for information and dialogue of the stakeholders and the public at large?
Preventing malaria by controlling mosquitoes in their larval stages requires regular sensitive monitoring of vector populations and intervention coverage. The study assessed the effectiveness of operational, community-based larval habitat surveillance systems within the Urban Malaria Control Programme (UMCP) in urban Dar es Salaam, Tanzania. Cross-sectional surveys were carried out to assess the ability of community-owned resource persons (CORPs) to detect mosquito breeding sites and larvae in areas with and without larviciding. CORPs reported the presence of 66.2% of all aquatic habitats, but only detected Anopheles larvae in 12.6% of habitats that contained them. Detection sensitivity was particularly low for late-stage Anopheles, the most direct programmatic indicator of malaria vector productivity. Whether a CORP found a wet habitat or not was associated with their unfamiliarity with the area. Accessibility of habitats in urban settings presents a major challenge because the majority of compounds are fenced for security reasons. Furthermore, CORPs under-reported larvae especially where larvicides were applied. This UMCP system for larval surveillance in cities must be urgently revised to improve access to enclosed compounds and the sensitivity with which habitats are searched for larvae.
This book identifies four types of dynamics impact on reforms at the sector-level: sector-specific dynamics, cross-sectoral dynamics, the dynamics of the political process and country-wide dynamics. It divides approaches into two groups: sector-level political economy approaches; and country-level and politics-centred political economy approaches. Based on this analysis, the book found that sector-level political economy approaches can be characterised by a series of strengths, weaknesses and gaps. Strengths tended to be their focus on core development challenges, methodological diversity and dynamic evolution. Weaknesses, on the other hand, tended to be around having a very small number of empirical, comparable and publicly accessible sector studies; too few policy management-oriented action frameworks and an insufficient theoretical guidance on using some approaches, frameworks and matrices. Gaps were identified in the assessment of political viability of sector reforms; in the analysis of domestic decision making and subsequent implementation; and in the consideration of concrete operational implications. One of the sectors covered in this book is the health sector.
This study's aim was to explore whether adding a gender and HIV training programme to microfinance initiatives can lead to health and social benefits beyond those achieved by microfinance alone. Cross-sectional data were derived from three randomly selected matched clusters in rural South Africa. Adjusted risk ratios (aRRs) employing village-level summaries compared associations between groups in relation to indicators of economic well-being, empowerment, intimate partner violence (IPV) and HIV risk behaviour. The magnitude and consistency of aRRs allowed for an estimate of incremental effects. A total of 1,409 participants were enrolled, all female, with a median age of 45. After two years, both the microfinance-only group and the IMAGE group showed economic improvements relative to the control group. However, only the IMAGE group demonstrated consistent associations across all domains with regard to women's empowerment, intimate partner violence and HIV risk behaviour. In conclusion, the addition of a training component to group-based microfinance programmes may be critical for achieving broader health benefits. Donor agencies should encourage intersectoral partnerships that can foster synergy and broaden the health and social effects of economic interventions such as microfinance.