New avenues to be opened for social protection in the Arab world: the case of Egypt*

This article looks at social protection in the Arab world. Giving the example of Egypt, it asks why poverty is so widespread and why – despite the country's numerous social protection systems – social risks are a major contributing factor to it. It concludes that reforms are due. The existing systems are well funded but inefficient and more to the benefit of the better‐off than the poor. A reform approach is proposed which builds on both conventional and more innovative strategies: campaigns should be launched to raise public awareness of social risks; social assistance spending should be increased; and the operating public pension schemes should be reformed. At the same time, new avenues have to be opened to meet the specific needs of informal sector workers who have extreme difficulty in being covered by social insurance or social assistance. To this purpose, micro‐insurance is a promising approach for the Arab‐world region.     

Extension of social insurance coverage to informal economy workers in China: An administrative and institutional perspective

This article reviews administrative issues in the context of decentralized social protection in China. In particular, what are the main obstacles to expanding social insurance coverage for workers in the informal economy? Over the last two decades, China has achieved remarkable progress toward universal social protection when this target was set as a national policy priority. However, the social insurance enrolment of informal economy workers still lags significantly behind. This article reviews the application of the International Labour Organization’s definition of informality in the Chinese context and overviews existing pension and health insurances in China. This article discusses the impact of China’s inter‐governmental fiscal relations and decentralized social protection in the multilevel government system. The article highlights that under a system of decentralized managed social insurance many informal economy workers choose to opt out of the system because of low benefits and high compliance costs. This result in deficits in social insurance coverage amongst informal economy workers.     

Analysis of the implementation of a social protection initiative to admit the poorest of the poor to mutual health funds in Burkina Faso

To enable mutual health funds to extend coverage to poor people, the Mutual Health Support Network (Réseau d’appui aux mutuelles de santé – RAMS) in 2012 launched an initiative in collaboration with the Ministry of Social Action and Solidarity (ministère de l’Action sociale et de la Solidarité nationale – MASSN) in Burkina Faso. This article reveals difficulties in the initiative's implementation, which resulted in the continued exclusion of poor people from health services. Poor people were required not only to make co‐payments, but also to accept a limitation of coverage to three episodes of illness per year. Additional challenges to service takeup were the geographical distance of the homes of some beneficiaries covered by a mutual fund agreement from a health centre and the failure by some health workers and managers of pharmacies to recognize the mutual membership card. A formal framework was lacking that brought together all the actors involved in planning and implementing the initiative. Those involved did not all have the same information. Each structure performed the tasks within its scope, according to its own interests, but without consulting the other parties, and there was no platform for discussing implementation difficulties.     

Informal workers and Kenya’s National Hospital Insurance Fund: Identifying barriers to voluntary participation

This article investigates the barriers to informal workers’ voluntary participation in Kenya’s national health insurance scheme – the National Hospital Insurance Fund. Based on primary data from both qualitative and quantitative methods, we find that the key determinants of enrolment include social factors, such as marital status, which create demand for insurance, and the role of informal workers’ associations that promote the voluntary uptake of health insurance and prevent default through contribution support. Participation barriers and reasons for inactiveness stem from the nature of informal work characterized by irregular earnings, which combine with apprehension about having to pay penalty charges for the late payment of premiums, inadequate levels of knowledge about health insurance schemes, institutional constraints such as complex registration procedures, as well as premium costs and poor-quality services, all of which discourage enrolment or the reactivation of lapsed membership. There is thus a need for health insurance schemes, such as Kenya’s National Hospital Insurance Fund, to educate informal workers on insurance services and protocols and to improve services to encourage uptake and reduce default behaviour.     

Introducing social insurance for long‐term care in Taiwan: Key issues

Nadash P, Shih Y.‐C. Introducing social insurance for long‐term care in Taiwan: Key issues Taiwan will shortly complete its comprehensive social safety net, which includes national health insurance, retirement security, and unemployment insurance, by introducing long‐term care (LTC) insurance – putting it ahead of the many countries that rely on a patchwork of policies to address the need for LTC. The program, to be implemented in 3 to 5 years, will cover all citizens on a primarily social insurance basis. The range of LTC policy options considered is discussed, particularly how to structure the program, how to finance and regulate it, and how to develop its inadequate LTC infrastructure and workforce. Particularly thorny issues include the choice of social insurance, the feasibility of cash benefits, and how to address Taiwan's heavy reliance on foreign workers. Taiwan's increasingly democratic character, along with high levels of public support for the program, creates significant pressure on politicians to deliver on their promises to implement LTC reform. Key Practitioner Message: ?Emphasizes the importance of policy learning from other environments; ?Highlights the need for a strong regulatory and provider infrastructure for delivering long‐term care services; ?Emphasizes the need for training, support, and appropriate regulation of the long‐term care workforce.     

How are policies implemented in children's services? Developing an initial programme theory to evaluate the implementation of the new Child Sexual Exploitation guidance in Wales

Although children's social care is an area rich in guidance, there is very little research looking at the implementation of new policies in the United Kingdom. In this article, we report on the first stage of a realist evaluation of the implementation of the new Safeguarding Children from Child Sexual Exploitation guidance in Wales. We discuss the development of an initial programme theory, for which we conducted semi-structured interviews with practitioners and managers in three local authorities. We developed programme theories across three areas: policy nature and development, implementation plans and organizational context. Findings suggest that, for policies to produce a significant impact on practice, they need to be sufficiently different to social workers' current perceptions of practice. Second, we found that the coordination between national and local policies is critical for successful implementation as contradictions between them might lead to confusion in what local teams should prioritize. Finally, our findings highlight the importance of effective communication of policy changes, as well as a supportive organizational culture to strengthen implementation in local contexts. These findings illustrate the complexity of policy implementation and the need for policymakers to consider the meaningful involvement of local practitioners in national policy development.     

Social health protection in Cambodia: Challenges of policy design and implementation

The Government of Cambodia is implementing ambitious reform initiatives to improve the country's social health protection system. In January 2018, it was announced that the Health Equity Fund (HEF), which is fully subsidized by a joint government‐donor initiative for the reimbursement of user fees for the poor at public health facilities, is to be expanded to some segments of informal workers belonging to associations, as well as to commune and village chiefs. Since 2017, the National Social Security Fund (NSSF) has provided social health insurance for formal economy workers in enterprises with eight employees or more. In January 2018, it was expanded to civil servants and all employees regardless of the size of the enterprise. However, this article highlights that the new ambitious reforms are not accompanied by careful planning as regards funding, service delivery, human resources and institutional design. This article therefore aims to examine key policy issues and challenges for Cambodia's ambitious reform of its social health protection system in terms of resource generation, population coverage, strategic purchasing and governance.     

Social Insurance and Older Adults in China: Effect of Education and Household Income on Coverage Following the 2009 Health Reform

Abstract

Education and income have been considered two primary determinants to affect individuals’ health outcomes. China initiated a comprehensive health reform in 2009, with the goals to provide equal access yet sufficient healthcare to all residents. However, social disparities continue to persist following this large reform. This research hypothesized that older adults’ years of education and income are determinants of participation in each social insurance scheme following the 2009 health reform. Multilevel logistic regression models were used with a nationally representative sample (n?=?5,274) to investigate the education and income disparities in each social insurance scheme for older adults, with random effects among provinces at the national level. The analyses show that years of education was not associated with enrollment in three social insurances, with the exception of the association between 11?years of formal education or above and the rural coverage. Participants with higher levels of household income had greater odds of having urban social insurances, but had lower odds of having the rural scheme. Further research should continue to investigate the disparities of enrollment of each social insurance. Chinese policy makers should consider these social factors carefully to reach a true universal coverage.     

Public response to welfare policy retrenchment: The importance of trust in implementing agencies. The case of early retirement in Sweden 1999–2010

There is a long-standing argument that citizensapos; trust in the state needs to be recurrently reproduced for policies to endure and that this also includes trust in its separate policy agencies. Such trust is likely to be more important for costlier policies, as, for example, social insurance schemes. The article explores whether short-term changes in welfare programme generosity affect peopleapos;s trust in the agency implementing the programme. Using the example of early retirement in the encompassing welfare state of Sweden, we study a decade of significant reform (1999–2010), during which the inflow to early retirement diminished greatly, as did citizensapos; trust in the implementing Swedish Social Insurance Agency (SSIA). We conclude that citizensapos; trust is higher when implementation is more generous. Indeed, a third of the drop in citizensapos; trust in the SSIA over the period can be explained by declining levels of generosity in early retirement, with people politically to the left responding with lower trust. Theoretically, we suggest, first, that trust in implementing institutions can function as feedback to policy and, second, that there is a basic relationship between more generous policy outcome and higher trust in encompassing welfare states such as Sweden.     

A Model for Implementing an Evidence-Based Practice in Student Fieldwork Placements: Barriers and Facilitators to the Use of “SBIRT”

ABSTRACT

This article reports on focus group data analysis that was used to understand initial, largely positive outcomes from a university-based initiative to disseminate and implement an evidence-based practice (EBP)—Screening, Brief Intervention, and Referral to Treatment for Substance Use (SBIRT)—into student fieldwork placements, which are usual care social work settings. Focus groups were conducted with three groups of stakeholders involved in the ongoing project: social work department faculty (n = 10), bachelor- and master-level social work students (n = 8), and social work fieldwork instructors (n = 6). Dimensional analysis of the focus group data yielded results indicating that dissemination and implementation of SBIRT was influenced by agency- and school-level factors and perceived fit between the EBP and individual professional identity, intrapersonal characteristics, and timing. The resulting model, developed through the focus group analysis, is offered and shows how these factors interacted and affected training, supervision, and use of the EBP. The model provides social work educational programs and agencies a working tool for diagnosing and proactively addressing barriers and breakdowns in the EBP implementation process. Future research that tests the model as a diagnostic tool and generates knowledge about its influence in developing competent evidence-based practitioners is indicated. Future focus groups in relation to this initiative are needed to better understand these barriers and facilitators in the EBP implementation process and their critical roles in the process of translating SBIRT into standard social work practice.     

Responding to child maltreatment: Comparison between the USA and China

A recent study estimated that over one‐fourth of Chinese children have suffered maltreatment (Fang et al., 2015 ). However, the current child welfare policy in China is limited to orphans, abandoned children, and children with disabilities. Also, there is very little comparative research in China on Chinese and other countries’ child welfare systems. The purpose of this study was to analyze applicable US and Chinese child welfare policies, identify gaps in Chinese policy regarding child maltreatment, and make recommendations for a policy agenda for improving child welfare in China based on cultural values and existing policy structures. Results show that China has considerable capacity to make improvements in child protective services, foster care, and adoption policies. Based on the results of this study, several implications are provided to develop China's child maltreatment policy to increase children's outcomes of well‐being, safety, and permanency. Key Practitioner Message: ? To understand the background and system of current Chinese child maltreatment policy; ? To review US child maltreatment policy and its implementation to identify gaps in the Chinese child maltreatment system; ? To provide policy suggestions to develop Chinese child maltreatment policy and provide recommendations for social work education and practice in China.     

India's Mahatma Gandhi National Rural Employment Act: Assessing the quality of access and adequacy of benefits in MGNREGS public works

The extension of social protection to all has become a central policy objective, both nationally and internationally. A considerable number of middle‐ and low‐income countries have undertaken substantial efforts to extend social protection, while the international community reaffirmed its commitment to the extension of social protection through the adoption of the ILO Recommendation concerning National Floors of Social Protection, No. 202 (2012). This article reviews the legal provisions and the implementation of the Indian Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), legislated in 2005, and does so in the light of the more recent provisions of ILO Recommendation No. 202. Since its introduction ten years ago, MGNREGA has provided a source of income to rural workers, increased wage rates, achieved high female participation rates and created durable assets. India's local governance bodies, Panchayati Raj Institutions (PRI), have been empowered and involved in the processes of planning and monitoring. However, despite successes, there have been considerable shortcomings in implementation. This article highlights two central themes: first, the innovative policy framework of the Act, which brings together rights‐based entitlements, demand‐driven employment, and citizen‐centred monitoring. Second, it assesses the accessibility and adequacy of benefits in the implementation of MGNREGA. We conclude that MGNREGA offers potential for South‐South learning, both in terms of policy‐design and implementation.     

Correcting misconceptions about the development of social work in China: a response to Cunfu Jia

In this brief debate article we respond to Cunfu Jia's criticism of our article ‘Defining the Profession?’ (International Journal of Social Work 16: 382–389). We address the issue of ‘evidence’ and the issue of the applicability to China of the global definition of social work. We suggest that although debate articles by their very nature risk generating false dichotomies, they provide an important and welcome opportunity to explore commonality and difference and to develop our knowledge and thinking as a result of an international exchange of views.     

Social assistance in Shanghai: Dynamics between social protection and informal employment

China's social assistance programme (dibao 低保) was introduced in Shanghai in 1993 and gradually extended to cover all urban areas by 1998. Due to massive economic restructuring, starting in the early 1990s, many urban dibao recipients were laid‐off, that is, state‐owned enterprise (SOE) employees. Shanghai was the epicentre of SOE reform, and the dibao system was primarily introduced to provide a safety net for laid‐off workers. In 2010, approximately 3 per cent of urban, permanent residents were on dibao, and 72 per cent of its recipients were working‐age adults. We conducted longitudinal qualitative interviews five times over 2 years with 40 dibao families that contained adults of working age in a Shanghai district. The current study demonstrates how they managed their employment, income and the dibao system. Findings suggested that, for various reasons, there was insufficient motivation for recipients to gain reemployment and leave dibao. Furthermore, local cadres, which were responsible for assessing and recommending dibao applicants to the district government, likely just assumed the incomes of adults with working capabilities.     

Missing Elements in the Protection of Children: Three Cases from China

ABSTRACT.

The article analyzes 3 severe cases of child abuse that were widely discussed in the mass media in China in 2007 based on a framework used by the International Society for Prevention of Child Abuse and Neglect in its official publication World Perspectives on Child Abuse. The framework sets out the basic elements that must be included in systems of child protection: a) a responsible government or government-authorized organization; b) a set of institutional arrangements for reporting cases of child abuse, investigation, and intervening when necessary; and c) state guardianship or mechanisms to remove children from their parents’ care when necessary. By applying the framework to the 3 cases under analysis, the authors found that these basic elements are missing from the Chinese child protection system, and therefore, they recommend that a reform of the system to address these elements should be a priority for Chinese social policy. The article makes a number of recommendations for reform.     

The Longitudinal Interplay between Bullying,Victimization, and Social Status: Age‐related and Gender Differences

The current study examined the longitudinal interplay between bullying, victimization, and social status (acceptance, rejection, and perceived popularity) over the course of 1 year. Cross‐lagged path models were estimated for two cohorts, covering grades 3–6 (N = 3904, M age = 11.2 years) and grades 7–9 (N = 4492, M age = 14.4 years). Comparisons between cohorts and by gender were conducted. The results of this study corroborate the complexity of the longitudinal interplay between bullying, victimization, and social status in showing that direction and strength of associations differ by type of peer status, age, and gender. Conclusions cannot be drawn without taking these differences into account. The findings are discussed according to these differences, and directions for future research are provided.     

An Exploratory Study of Social Work with Older Persons in Cuba

Abstract

Assuring a satisfactory quality of life for Cuba's large and fast growing older population is a national challenge. Social work plays an important part in addressing this challenge through its role in Cuba's National Program for the Care of Older Persons. This article explores the role of social work in Cuba's programs for the elderly and its implications for social work practice in the US. The information was obtained from 25 qualitative interviews with policy makers, social work practitioners, and community members in Havana, Cuba in 2003. The community oriented and interdisciplinary nature of Cuban social work with older persons distinguishes it from social work in the US and has implications for social work in this country. Despite the differences between Cuba and the US, the Cuban social work model provides important insights for social work in this country.     

Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps,and social equity considerations

The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio-economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out-of-pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded.