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.     

Subjekt oder Subjektivation? Zur Kritik der Subjekttheorie von Andreas Reckwitz

Andreas Reckwitz postulates with his concept of subjectivation that the subject must be understood as a product of cultural practices, therefore losing his privileged status outside of the social context. Reckwitz operates with a sociological objectivism making regular behavior describable and explainable, as he documented in his study on different subject forms of modern times, which is underpinned with a large set of data. However, this is bought by cutting off essential characteristics of subjectivity: contingency and generation of meaning. This article therefore provides a critical analysis of the subjectivation assumption under normative and theoretical-methodological aspects. In doing so, the aim is to deduce a plea for the classical concept of subject from this critical analysis.     

Climate shocks and the timing of migration from Mexico

Although evidence is increasing that climate shocks influence human migration, it is unclear exactly when people migrate after a climate shock. A climate shock might be followed by an immediate migration response. Alternatively, migration, as an adaptive strategy of last resort, might be delayed and employed only after available in situ (in-place) adaptive strategies are exhausted. In this paper, we explore the temporally lagged association between a climate shock and future migration. Using multilevel event-history models, we analyze the risk of Mexico-US migration over a seven-year period after a climate shock. Consistent with a delayed response pattern, we find that the risk of migration is low immediately after a climate shock and increases as households pursue and cycle through in situ adaptive strategies available to them. However, about 3 years after the climate shock, the risk of migration decreases, suggesting that households are eventually successful in adapting in situ.     

Cross Cultural Programming for AIDS Orphans: What We are Learning from Other Contexts

The problem of AIDS orphans in Zambia has reached alarming proportions because of the extent of poverty and poor social and economic policies. Worldwide, 15 million children have been orphaned due to AIDS, with 11.6 million orphans in sub-Saharan Africa alone (UNICEF, The State of the World’s Children 2009: maternal and newborn health, UNICEF, New York, 2008), and 670,000 children under the age of 17 in Zambia (UNAIDS, UNAIDS report on the global AIDS epidemic, UNAIDS, Geneva, 2010). Resulting from this situation are child headed households (CHHs) who face hunger, poor health, sanitation and water problems. Despite the challenges, there seems to be an absence of political will to support CHHs. To assess if Africans living in Richmond Virginia in the United States might offer something programmatically useful for CHHs in Zambia, important elements in the Richmond Independent Living services model were identified. Specific elements were screened using Africans as a cultural screen. Important implications for programming and practice suggest that feasibility, content and quality are key areas for appropriate CHHs programming. In this article, the terms orphans, vulnerable children, and young people are used interchangeably.     

‘A Very Hell of Horrors’? The Haitian Revolution and the Early Transatlantic Haitian Gothic

This article explores the Gothicisation of the Haitian Revolution in the transatlantic discourse during the late eighteenth and early nineteenth centuries. As it argues, the Gothic mode has to be understood as a reaction to the profound challenges that the Haitian Revolution posed to a transatlantic world built on the slave economy. Pro-slavery and pro-colonialist authors demonised this successful slave revolution and one of the first anti-colonial revolutions in modern history by resorting frequently to the ‘hegemonic Haitian Gothic'. By contrast, early Haitian leaders and some Black Atlantic radicals appropriated this mode, turning it into the ideologically contrary ‘radical Haitian Gothic'.     

Involving People with Profound and Multiple Learning Disabilities in Social Work Education: Building Inclusive Practice

Abstract

Service user and carer engagement is a foundational requirement of social work education. Despite this, questions remain about how diverse experiences are represented and who might be excluded from involvement. This paper focusses on one group of people who it is suggested are excluded from involvement, people with profound and multiple learning disabilities. Evidence is presented which demonstrates the extent to which this group have been marginalised and excluded from processes of involvement. The paper then provides a case study of one universities’ experience of developing work in this area, when a man with profound and multiple learning disabilities was commissioned to design and deliver specialist teaching for a group of qualifying social work students. We argue that the main barrier to inclusive involvement for people with profound and multiple learning disabilities is the attitudes and assumption of others about what they are capable of. We demonstrate how involvement in social work education helps to address these barriers by challenging the assumptions of students, the academy and society more broadly.     

Projecting Long-Term Care Expenditure in Four European Union Member States: The Influence of Demographic Scenarios

This study examines the sensitivity of future long-term care demand and expenditure estimates to official demographic projections in four selected European countries: Germany, Spain, Italy and the United Kingdom. It uses standardised methodology in the form of a macro-simulation exercise and finds evidence for significant differences in assumptions about demographic change and its effect on the demand for long-term care, and on relative and absolute long-term care expenditure. It concludes that mortality-rate assumptions can have a considerable influence on welfare policy planning. Relative dispersion between country-specific and Eurostat official estimates was found to be higher for the United Kingdom and Germany than for Italy and Spain, suggesting that demographic projections had a greater influence in those countries.