Inter-rater agreement of scores to assess quality of care in public sector primary health care facilities – A pattern of performance

PurposeTo determine if the scores obtained from the Ideal Clinic Assessment Tool (ICAT) used to assess the quality of care in public Primary Health Care facilities in South Africa showed inter-rater agreement between self-assessments, district peer reviews and cross-district peer reviews. The ICAT scores obtained in the three types of reviews were paired as follows: self-assessments/district peer reviews, self-assessment/cross-district peer reviews and district/cross-district peer reviews. The global scores and averages of the Vital elements for the three paired reviews for 587 facilities across the country were compared using Bland-Altman plots.ResultsThe Bland-Altman plots showed no inter-rater agreement between the global scores and averages of the Vital elements for the facilities in any of the paired reviews (n = 1 761 reviews). Similarly, there was no inter-rater agreement between the global scores of the three paired reviews in any of the nine provinces in the country.ConclusionThere is still a need to continue to conduct both district and cross-district reviews despite the substantial cost of doing so. Further studies are required to determine what factors contributed to the disagreement in scores between the different types of reviews despite the preparatory training of reviewers.     

The ethics of care and academic motherhood amid COVID‐19

The COVID‐19 pandemic has upended the lives of working parents as they strive to meet the conflicting demands of childcare and professional obligations. While growing evidence suggests the extraordinary challenges to time and work brought by the pandemic, this article explores the pandemic as an opportunity for stillness and reflection, a personal and professional recalibration. Through a personal narrative describing my experiences as an academic and mother before and during the pandemic, framed within the ethics of care, this article brings light to the untenable reality of working mothers pre‐pandemic, explores the ways in which the pandemic has positively facilitated caring relationships at home as well as the reallocation of time and household responsibilities, and argues for policy and legislative action at the institutional and societal levels that support and value the care work of women and men alike.     

Freedom or money? The dilemma of migrant live‐in elderly carers in times of COVID‐19

As a consequence of the lockdown measures imposed by the Belgian government to fight against COVID‐19, migrant live‐in elderly carers had to choose between safeguarding their job — at the detriment of their personal freedom, their health and their working conditions — and safeguarding their freedom but losing their job — at the detriment of their economic survival and that of their families. This article explores this dilemma from an intersectionality perspective. In order to understand their experience in times of COVID‐19 and their response to this dilemma, I analyse their position as women, as migrants, as elderly care workers, as family breadwinners and as ‘quasi‐family members’ in the families of their employer — which correspond to five interlocking systems of oppression.     

跨国公司捐赠的法律规制探研 ——以汶川地震跨国捐赠为视角

汶川震灾发生后,不同的企业做出了不同的社会责任的危机响应,跨国公司的企业社会责任实践也受到普遍关注。跨国公司捐赠的法律规制可以分为两个方面的问题：跨国公司不捐赠关系着我国公司法规定的公司社会责任约束力问题;以及跨国公司捐赠后涉及公司法规定的董事和高管的忠实义务、注意义务问题。     

终极关怀、研究能力培养与知识结构的完善——关于古代文学教学的几点思考

师范生的古代文学教学需要关注学科知识的完善,文学史的通史性教学必须与专书、专题研究相结合,使常识能够具体化。阐释经典作品中对个体和社会的终极思考,使古今沟通成为可能,古代文学就直接成为建构我们心灵的资源。文学史教学还要关注研究方法的传授,以养成学生的元认知能力,能对一些问题作出基本判断。     

女性主义关怀伦理对自由主义三种困境的批判性反思

关怀伦理在对自由主义的剖析中,揭示了后者面临的三大困境：即对人性假设的困境、自由的困境和平等的困境。主张用血肉丰满的现实的人来代替自由主义设置的空洞成熟的理性人;认为自由的概念（特别是对消极自由的推崇）并不能为人类带来幸福和良善的生活;驳斥自由主义的平等在具体的社会生活中脱离现实的土壤,主张在活生生的具体情境中考虑平等概念,真正实现差别的平等。     

教育新视野下学生的自我实现探究

自我实现是"存在人"的精神家园,是一个人想要成为他自己而非预设人的自由选择。教育以培养和发展"人"为目的,却习惯性地回避自我实现问题。自我实现是人类需要心理的最高表现形式,弱化自我实现在教育中的本体性价值,会导致教育目的异化。教育要全面提升生命的品质,就应超越社会的功利性,回归生命本身,使学生在"娱乐精神"中享受学习,在人性关怀中自由呼吸,在人生反思下开放性成长。     

Making the Most of Small Effects

The idea that classroom social ecologies are shaped by the aggregate effects of peers' prior care experiences is provocative, even though the evidence is weak that this explains the small and diminishing effect of childcare experience in the National Institute of Child Health and Human Development study. Small effects may indeed be small effects, but students of early development should attend to the potential importance of group-level influences on social and cognitive growth.     

Extending health care coverage: Potential linkages between statutory social security and community-based social protection

Abstract   The extension of social health protection in developing countries is widely recognized as a priority. Various financing and institutional methods can be used in pursuing this objective, but none of them can achieve universal coverage in the short term. Based on an analysis of the respective strengths and weaknesses of social health insurance and community-based health care schemes, this article demonstrates the high potential of coverage extension strategies that use a pluralistic institutional approach to establish linkages and exploit complementarities optimally. A typology of potential linkages among different methods is presented and their value added illustrated using country examples.     

Cross-national policy learning in health system reform: The case of Diagnosis Related Groups

Observations of policy convergence and the cross-national diffusion of ideas, knowledge and policies have raised the question about the ways countries might learn from their peers. This article examines the role of cross-national learning with regard to Diagnosis Related Groups (DRGs). We review the spread of this policy instrument and analyse the implementation of DRGs in three late-adopting countries: Germany, Switzerland and the Netherlands. The three cases show that the implementation of this policy instrument required intense studies, cooperation with stakeholders and adjustment to country-specific needs. The countries learned from foreign experience, but it was only with the introduction of a regulatory framework for competition between sickness funds that DRGs came fully onto the political agenda. While Germany and Switzerland drew upon foreign DRG models, the Netherlands developed an alternative system to classify patients according to case-mix.