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.     

Public–Private Partnerships: Implications for Primary Schooling in Pakistan

Since the early 1990s, the government of Pakistan has promoted a policy of public–private partnerships to increase access and improve the quality of education in Pakistan. This article describes the evolution of the policy and discusses a variety of partnership arrangements aimed to establish and govern primary schools. It suggests that, while partnerships have positive outcomes and may be a viable option for resourceful communities, they are located in a hierarchical structure and lack equal distribution of power and trust between partners. Partnerships are often temporary and established for the purpose of a transition to privatization. These problems make them an unlikely strategy for a sustained increase in the chances of access to good‐quality schooling for the poor and disadvantaged.     

Euthanasia and assisted suicide: a survey of registered social workers in British Columbia

This anonymous postal survey explores the attitudes and experiences concerning voluntary euthanasia (VE) and assisted suicide (AS) held by professionally registered members of the British Columbia Association of Social Workers. Social workers determine only a minor moral distinction between VE and AS and a large majority believe both acts should be legal, in certain circumstances (VE 75.9 per cent; AS 78.2 per cent). Approximately 80.0 per cent feel that social workers should be involved in social policy development concerning VE and AS, and, if such acts were to be legal, 70.0 per cent believe social workers should be involved in the decision making process with clients. Over 21.0 per cent of all social workers and nearly 40.0 per cent of social workers with medical employers have been consulted by a patient about VE or AS. Six respondents (1.1 per cent) reported assisting the death of a patient by VE. None had involvement in AS. Further research and education is required to better inform social work practice in this ethical area. Given the unique position of social workers in health care, they should, for the benefit of patients, families, and physicians, actively participate in the discussion concerning end of life decisions.     

South Korea’s successful education system: lessons and policy implications for Peru

South Korea’s quality education system rests on four pillars: (1) putting education at the center of a long-term development strategy, (2) getting the right people to become teachers, (3) developing these people into effective instructors, and (4) prioritizing information and communications technology in education. In contrast, education policies in Peru change from government to government, official evaluations of teacher education institutes do not exist, teachers do not receive regular training, and the use of technology in education is limited. Taking into account South Korea’s successful experience, Peru could seek to improve its education system with initiatives to support a long-term education policy, which has to include a clear plan to improve the accreditation process of teacher education institutes, the current salaries of teachers, the training of teachers, and the use of technology in schools.     

‘Problematising’ Australian policy representations in responses to the physical health of people with mental health disorders

Australia, like other jurisdictions, is recognising the poorer physical health of people with mental health disorders. This paper explores policy responses to this issue through discourse analysis of 22 Australian Federal and State government policy documents published in 2006–2011. The paper utilises Bacchi's ‘what's the problem represented to be?‘ approach to explore policy solutions in relation to the representation of the issue, enabling identification of issues which are not problematised and policy solutions that have not been considered. The poor physical health of people with mental health disorders is attributed in policy to poor lifestyle habits and limited access to monitoring of physical health care. Three policy solutions are offered: collaborative care delivery involving greater use of fee‐for‐service primary care to manage physical health; the monitoring of physical health status by mental health teams; and the promotion of lifestyle change. These solutions fail to address ongoing issues with collaboration between specialist mental health and primary care services. Reliance upon fee‐for‐service primary mental health care may, in fact, reduce rather than increase access to services. The strategies are discussed in light of neoliberal ideals of governance and personhood which are underpinned by informed consumer choice and personal responsibility for health.     

The cross-border portability of social security benefits: Status and progress?

The importance of the cross-border portability of social benefits is increasing in parallel with the rise in the absolute number of international migrants and their share of the world population, and perhaps more importantly with the much higher and rising share of the world population that for some part of their life is working and/or retiring abroad. This article estimates how the rising stock of migrants is distributed over four key portability regimes ranging from portability through bilateral social security arrangements to undocumented workers with no access to any scheme. The comparison of estimates for 2000 and 2013 indicate a modest but noticeable increase in the share of migrants under regime I (full portability) by 1.4 per cent, but the biggest change occurred under regime III (no access to social security but also no contributions required), which almost doubled to 9.4 per cent. Regime II (potential exportability without totalization) reduced by 3.0 percentage points but remains the dominant scheme (at 53.2 per cent). The estimates suggest that the scope of regime IV (informality) reduced by 2.9 percentage points, accounting for 14.0 per cent of all migrants in 2013. This trend is positive, but more will need to be done to progress on benefit portability and various potential solutions lie outside bilateral agreements that are difficult to establish.     

Quantifying Quality: Can Quantitative Data (“Metrics”) Explain the 2001 RAE Ratings for Social Policy and Administration?

This paper finds that around 80 per cent of the differences in the ratings awarded in the 2001 RAE for social policy may be “explained” using half a dozen pieces of quantitative data. Social policy excellence—as judged by peer review—is associated with the award of doctorates, the amount of money raised, publications in a particular (if broad) range of journals and books by major publishers, and being large. Even taking account of differences on all these factors, the analysis found that new universities fared worse than their quantitative data would suggest. It is argued that quantitative data should play a larger role in decisions about research quality, aiding equity and transparency.     

How Studies of the Educational Progression of Minority Children Are Affecting Education Policy in Denmark

Over the past decade, the number of ethnic minorities in Denmark has increased rapidly, now accounting for over 8 per cent of the total population. This paper presents results from a number of recent studies regarding the educational choices of minority children from less developed countries. An important social concern is that the educational attainment of these children is much lower than among native Danes. The studies show that that a main reason for the education gap is very high dropout rates from vocational schools among minority children and that inadequate Danish language proficiency of immigrants, parents and their children, is an important reason for the high dropout rates, as are inadequate educational preparedness from grade school and insufficient apprenticeship positions available for minority youth. Socio‐economic background, however, has relatively little effect. Recent policy changes to reduce dropout rates from vocational schools are reviewed and additional policy interventions are proposed.     

The effectiveness of poverty reduction and the target efficiency of social security transfers in South Korea, 1999–2003

The purpose of this study was to investigate the impact of social security transfers between 1999 and 2003 in South Korea, the period during which the Asian economic crisis of 1997 occurred. The study used a secondary data set, which is part of the Korea Labour Panel Data. Of 5,000 original household samples, the results for the 2,728 households (54.6 per cent) that completed the surveys for all five years studied were analysed. One finding was that the average percentage of social security transfers appeared to be nominal, as was the 1.9 per cent in 1999, which grew to 2.4 per cent in 2003. Another finding was that the average poverty-reduction effectiveness for the five-year period was as low as 7.9 per cent, indicating a slightly increasing pattern. This percentage is only one-seventh to one-tenth that of Western countries. Target efficiency appeared to be 31.8 per cent. We give the following reasons to explain why the level of the poverty-reduction effectiveness of Korean social security transfers is comparatively low: the immaturity of the Korean Old Age Pension; the lack of diversity in social transfer programmes; and a cultural factor of stronger dependency on private transfers within the family structure.     

“Wearing a Mask Won't Protect Us from Our History”: The Impact of COVID-19 on Black Children and Families

The data on COVID-19 show an irrefutable and disturbing pattern: Black Americans are contracting and dying from COVID-19 at rates that far exceed other racial and ethnic groups. Due to historical and current iterations of racism, Black Americans have been forced into conditions that elevate their risk for COVID-19 and consequently place Black children at the epicenter of loss across multiple domains of life. The current paper highlights the impact of the pandemic on Black children at the individual, family, and school levels. Based on an understanding of the influence of structural racism on COVID-19 disparities, policy recommendations are provided that focus on equitable access to quality education, home ownership, and employment to fully address the needs of Black children and families during and after the pandemic. Research, practice, and policy recommendations are made to journal editors, funding agencies, grant review panels, and researchers regarding how research on COVID-19 should be framed to inform intervention efforts aimed at improving the situation of Black children and families.     

Why Ugandan rural households are opting to pay community health insurance rather than use the free healthcare services

Twikirize JM, O'Brien C. Why Ugandan rural households are opting to pay community health insurance rather than use the free healthcare services Uganda reintroduced free healthcare in 2001, but today, nine years later, less than 30 per cent of the population are using these services. This study investigated why rural households were under‐utilising the government's free health services and turning to community health insurance instead. A survey carried out on 260 randomly selected households was triangulated with qualitative data gained from 3 focus groups and 12 in‐depth interviews. The findings showed that 21 per cent of the households always accessed the government's free health services, while 79 per cent used private health services. The reasons given were poor quality services, including frequent drug stock‐outs, unmotivated and insufficiently trained health personnel, and overcrowding. Factors influencing enrolment in community health insurance included easier access to healthcare, financial protection against the cost of care, better quality care and benefits related to mutual assistance. This has both practical and policy implications, which are discussed in this article.     

Privatising health: the demise of MEDICARE?

Health policy was an integral component of the post‐war welfare state, which represented a nationally based class compromise providing concessions in the form of income support and service provision outside the ambit of the market. In Australia, development of a universal health system was delayed until the introduction of Medibank, and subsequently Medicare. Since its inception, Medicare has been subjected to retrenchment pressures that have dominated welfare state developments since the mid 1970s. This paper traces developments in the Australian health system, revealing that the major trends, privatisation and the transfer of responsibility from the collective to the private sphere, represent a movement towards a more residual system that threatens the Medicare goal of equitable access to quality medical treatment.     

西部大开发与高等教育发展

高等教育优先发展是实施西部大开发的根本大计,具有十分重要的战略意义。优先发展西部地区高等教育,关键是树立教育是事关全局的基础性和先导性产业的观念,将党和国家发展贫困地区教育的政策落到实处,千方百计增加对教育的投入,全面提高教师队伍的整体素质;发展西部高等教育除了中东部要主动参与西部的教育资源开发外,西部高等教育要加快布局结构调整;办学模式的多样化;合理利用教育资源,促进产、学、研结合,实现西部高等教育与西部经济和社会发展的协调一致。     

(Mis)framing Higher Education in South Africa

The question of how to make higher education more inclusive has been a central concern in South Africa and elsewhere over the past two decades. However, in South Africa there remains a disjuncture between policy aimed at promoting inclusivity and the experiences of students and staff in the higher education sector. In this article, the relationship between equity of access and equity of outcomes and the expectations that follow from these policy imperatives are examined from the perspective of Nancy Fraser's normative framework of social justice. In particular, her notion of misframing is used to analyze the current situation in the higher education sector in South Africa. The article concludes that a focus on individual higher education institutions is not sufficient to gain a perspective on the social arrangements required for participatory parity in higher education; and, in fact, such a focus is an instance of misframing and thus a form of injustice.     

市场转型、教育分流与中国城乡高等教育机会不平等(1977-2008)——兼论重点中学制度是否应该为城乡高等教育机会不平等买单

20世纪90年代以来,城乡间高等教育机会不平等愈演愈烈。本文使用CGSS 2008数据,基于梅尔模型,首先从总体上分析了城乡教育不平等的演进过程,结果发现,城乡间高等教育机会不平等主要肇始于小学升初中和初中升高中两个阶段,而由后者产生的不平等尤为严重。继而,本文对中学阶段升学过程展开专门分析,发现在“课外补习班市场”发育过程中,受益最大的是就读于非重点初中的城镇子弟,正是这类高中候选人与同样就读于非重点初中的农村子弟在市场转型后升学机会差距的迅速扩大,导致在后续高中升大学阶段,虽然高等教育规模一再扩张,城乡居民教育机会的不平等却愈演愈烈。本文还发现,就读于重点中学的城乡子弟间升学机会的不平等并未在市场化后显著增大,因而,本文认为,重点中学制度不应为近年来日益加剧的城乡高等教育机会不平等负责。     

扩张的中国高等教育：教育质量与社会分层

本文利用2011年首都高校生发展状况调查的数据，分析北京高校学生的分层现状，并讨论了1999年高等教育扩张对大学生入学和就业分层的影响，发现这一轮扩张强化了社会阶层的复制而非再生产。一方面，在其他条件不变的情况下，来自社会优势阶层家庭的学生有更大概率进入具有更好教育质量的精英院校，这说明中国高等教育在这一时期具有排他性的特征；家庭的社会阶层背景对子女教育分层的影响在中学阶段更加明显；家庭背景对专业选择没有显著影响。另一方面，在控制家庭社会经济背景的影响后，教育质量与学生选择市场化部门就业的概率和工作起薪显著正相关。如果高等教育扩张降低了教育质量，就可能削弱高等教育对社会阶层流动的促进作用。     

Closing pathways: refugee-background students and tertiary education

Abstract

Recent changes to policies and funding for tertiary education are exacerbating an already difficult situation for refugees aiming to earn university degrees. No one intended to create the barriers that the refugee-background community faces; government agencies continue attempts to improve educational outcomes for those who arrive as refugees. The root causes of this situation are the complexity of the refugee situation and a lack of holistic knowledge about this diverse group of New Zealand residents among policy makers and educators. In addition, the complexity of interactions among policy changes and refugee situations has prevented any single agency from predicting outcomes of its policies for refugee-background students. In this paper, I discuss how new policies interact with a range of existing barriers faced by refugees pursuing degrees and how, without urgent attention, this will constrict or close pathways into and through university study. I further suggest that the strongest foundation for an effective program to provide equitable access to university education is including refugee-background students among those groups who receive equity consideration.     

The impact of globalization and financial development on India’s income inequality

This paper empirically examines the combined effects of globalization and financial development on income inequality in a unified framework for an emerging economy. Using annual data for the Indian economy over the period 1980–2014, we show that the perceived benefits of globalization and financial development have not trickled down; rather, has aggravated income inequality. Our results also indicate that while inflation aggravates income inequality, education seems to alleviate the differential effect. Proactive measures in providing access to financial services, creating equitable employment opportunities, and improving the quality of education are required to offset the negative impacts of globalization and financial development on income disparity.     

Problematising Australia's Nanny Pilot Program as evidence‐based policy: A reconstruction of the problem of childcare

In a notable departure from long‐standing childcare policy in Australia, in January 2016 fee relief was extended to nannies providing in‐home care in a 2‐year pilot program. This policy is significant as fee relief is not tied to the meeting of regulatory requirements designed to ensure quality early learning and care for young children. Drawing on Carol Bacchi's approach to policy analysis, this paper extends previous problematising of evidence‐based policy by highlighting the value of first considering how a policy ‘problem’ has been constructed. We propose that the nanny pilot is an ideologically driven policy that has emanated from a construction of childcare that is adult (parent)‐centred and marginalises the needs and interests of young children. Accordingly, certain evidence is privileged while other evidence is ignored, with the ensuing policy focused on economic imperatives rather than quality early learning and care experiences for young children. We draw on an analysis of parent, peak body and researcher submissions to the Productivity Commission's 2013–2014 childcare inquiry, nanny‐focused research, and data from three national surveys to explore the limitations of such a policy approach. The utility of problem reconstruction as a means of disrupting policy‐informed evidence and the legitimisation of purported evidence‐based policy is considered.     

Drinking patterns and attitudes about alcohol among New Zealand adolescents

ABSTRACT

Questionnaires about alcohol use were administered to consenting Year 10 students at 10 secondary schools located in regions of Southland, Otago and Hawkes Bay (n?=?579) to examine drinking patterns and attitudes about alcohol of 14–15-year-olds. The average age of first drink was 12.6 years, two years younger than previously reported, with no difference in age of first drink for different socioeconomic statuses or ethnicities. Fifty-four per cent self-reported having consumed alcohol, and 23% had done so at least once within the last four weeks, with 13% reported regularly drinking more than five drinks in one session. While almost half of the 14–15-year-olds in this study reported never drinking alcohol, 75 individuals reported regular binge drinking. This was more common for students in lower socioeconomic schools; almost a third of students in the lowest socioeconomic group reported drinking five or more drinks every time they drink. There may be benefits of alcohol education resources for children as young as 12 years.