The Future Organization of Community Health Councils

This paper examines the ways in which Community Health Councils (CHCs) might organize themselves in the light of the changes arising out of the purchaser–provider split. These changes have meant that they are only one among several agencies claiming to represent the interests of the user, with most fundamentally the Health Authorities themselves being entrusted with the duty of championing the people. Other means of consulting the public, which bypass the CHCs altogether, are also becoming increasingly popular. Taking as its starting-point EL(95)142, "Guidance on the changes in establishing arrangements", this paper looks at practical ways in which CHCs might best organize themselves to face the future. It does this by considering, in turn, membership issues, staffing, resources and accommodation, and the roles and relationships of CHCs with regard to other agencies. It also, more radically, considers their continued viability and relevance in the context of other means of tapping into or representing the public's views in the NHS of the future.     

Stress at Home, Peace at Work: A Test of the Time Bind Hypothesis

Objective . We test the central thesis of Hochschild's (1997) The Time Bind : people who are unsatisfied with housework, parenting, or their marriage work more hours, or at a minimum prefer to work more hours, especially if satisfaction with work is high. Methods . Using the data from the 1987–1988 National Survey of Families and Households, we analyzed the influence of work and home satisfaction on the actual and desired work hours of 1,533 respondents who were employed, married to an employed spouse, and had one or more resident children under age 18. Results . We found that people who were more satisfied with work than home or who were dissatisfied with home life in general did not work more hours or even desire to do so. Conclusions . Contrary to Hochschild's assertions, there was little evidence that working parents dissatisfied with home life worked more hours or desired to spend more time at work.     

Popular Moralities and Institutional Rationalities in Malawi's Struggle Against AIDS

The AIDS epidemic in sub‐Saharan Africa is fertile ground for examining how moral evaluations evolve over time and across different settings. We compare the discourse on AIDS in Malawi as presented in the media with that of everyday conversations. Drawing on two sets of texts, newspaper articles and conversational journals, produced over a ten‐year period from 1999 through 2008, we analyze their moral injunctions, or what individuals should or should not do in response to the AIDS epidemic. The predominant injunctions in the early years in both sources were premarital abstinence and marital fidelity. Following the introduction of HIV testing and treatment, however, the discourses diverged. Discourse in the media turned toward moral injunctions requiring individuals to interact with authoritative institutions; thus the conceptual center of gravity of the struggle against AIDS in the media shifted from collectivities of individuals to collectivities of institutions. Rural Malawians, however, received these moral injunctions with great skepticism and continued to advise each other to prevent death by controlling one's sexual appetites.     

Developmental Idealism and Cultural Models of the Family in Malawi

This paper examines the extent to which developmental idealism has been disseminated in Malawi. Developmental idealism is a set of beliefs and values about development and the relationships between development and family structures and behavior. Developmental idealism states that attributes of societies and families defined as modern are better than attributes defined as traditional, that modern societies help produce modern families, that modern families facilitate the achievement of modern societies, and that the future will bring family change in the direction of modernity. Previous research has demonstrated that knowledge of developmental idealism is widespread in many places around the world, but provides little systematic data about it in sub-Saharan Africa or how knowledge of it is associated with certain demographic characteristics in that region. In this paper, we address this issue by examining whether ordinary people in two settings in Malawi, a sub-Saharan African country, have received and understood messages that are intended to associate development with certain types of family forms and family behaviors. We then examine associations between demographic characteristics and developmental idealism to investigate possible mechanisms linking global discourse about development to the grassroots. We analyze data collected in face-to-face surveys from two samples of Malawian men in 2009 and 2010, one rural, the other in a low-to-medium income neighborhood of a city. Our analysis of these survey data shows considerable evidence that many developmental idealism beliefs have been spread in that country and that education has positive effects on beliefs in the association between development and family attributes. We also find higher levels of developmental idealism awareness in the urban sample than we do in the rural sample, but once dissimilarities in education and wealth between the two samples are controlled, awareness levels no longer differed between urban and rural respondents. We explore how these beliefs intersect with longstanding local values and beliefs in Malawi.     

Inclusive Financial Markets: Is Transformation Under Way in Kenya?

Policy emphasis on financial‐sector development has shifted away from microfinance and towards the development of ‘inclusive financial markets’. But, for inclusion to take place, policy must address barriers to access. This article analyses the socio‐economic, demographic and geographical factors associated with financial‐service use across formal, semi‐formal and informal financial services in Kenya between 2006 and 2009, including the new and rapidly growing mobile‐phone‐based payments service – M‐PESA. It finds that, despite an expansion of services, evidence of access barriers is now clearer than it was in 2006. However, there is some evidence that M‐PESA is reversing age as a barrier to inclusion, but, as yet, it is more of a complement than a substitute for formal services.     

Avoiding the curves: Direct elicitation of time preferences

We propose and test a new method for eliciting curvature-controlled discount rates that are invariant to the form of the utility function. Our method uses a single elicitation task and obtains individual discount rates without knowledge of risk attitude or parametric assumptions about the form of the utility function. We compare our method to a double elicitation technique in which the utility function and discount rate are jointly estimated. Our experiment shows that these methods yield consistent estimates of the discount rate, which is reassuring given the wide range of estimates in the literature. We find little evidence of probability weighting, but in a second experiment, we observe that discount rates are sensitive to the length of the front-end delay, suggesting present bias. When the front-end delay is at least two weeks, we estimate average discount rates to be 11.3 and 12.2% in the two experiments.