Hitting the target without missing the point: New Zealand’s immunisation health target for two year olds

ABSTRACT

The use of health targets as a form of performance measurement has become more prominent internationally as governments have sought to control public expenditure, produce greater efficiency and improve accountability. However, health targets have faced criticism for their potential to produce negative outcomes within a health system. This paper examines how a health target was used as a policy instrument within the New Zealand health system to improve immunisation coverage at two years of age. It explores how the immunisation health target was implemented within four case study sites and discusses the effectiveness of the health target as a policy instrument for improving immunisation coverage and addressing persistent immunisation inequities. Measuring and monitoring performance towards the immunisation health target improved accountability for immunisation coverage within the New Zealand health system and focused attention on improving immunisation coverage in a way that previous policy attempts had failed to do. Health targets may be an effective policy instrument for creating change within specific areas of a health system if their potential for dysfunctional consequences are taken into consideration at the outset.     

ARTICLES: Studying Cognition in Flux: A Historical Treatment of Fu in the Shifting Structure of Oksapmin Mathematics

This article extends a framework for the study of culture-cognition relations to problems of historical research and diachronic analysis. As an illustrative case, we focus on mathematics in Oksapmin communities located in a remote highland area in central New Guinea. The Oksapmin, like their neighboring Mountain-Ok groups to the West, traditionally use a 27-body-part counting system for number, and there is no evidence that Oksapmin used arithmetic in prehistory. We present a coordinated analysis of shifts in functions of a word form based on field studies completed in 1978, 1980, and 2001. These shifts are related to changing collective practices of economic exchange in which arithmetical activities are increasingly important. The word form fu has changed from its use as an intensive quantifier that means "a complete group of plenty" to one that means double a numerical value. We show how the analytic framework affords a multilevel inquiry into genetic processes of change in the Oksapmin case and argue that the approach is useful for understanding the interplay between cultural and developmental processes in cognition more generally.     

A note on Rescher's ‘Semantic Foundations for the Logic of Preference’

In ‘Semantic Foundations for the Logic of Preference’ (Rescher, ed.,The Logic of Decision and Action, University Press, Pittsburgh, 1967), Nicholas Rescher claims that, on the semantics developed in that paper, a certain principle - call it ‘Q’ turns out to be ‘unacceptable’. I argue, however, that, given certain assumptions that Rescher invokes in that same paper,Q can in fact be shown to be a ‘preference-tautology’, and henceQ should be classified as ‘acceptable’ on Rescher's theory.     

Unrecognised Cosmopolitans: Mobility and Openness Among Globally Engaged Family Farmers

In contemporary cosmopolitanism research, cities are iconic places where cosmopolitan exchanges and actors find their ‘natural’ milieu. Farmers not only are remarkably absent from this literature but have been depicted as operating with a highly localist and agrarian world view and being strongly connected to the land and the farm through history, biography and family tradition. In this paper, we present findings from a three-year study of entrepreneurial family farmers who are globally engaged and undertake extensive mobility as part of their farm business practices. The paper shows how they readily display some of the key hallmarks of contemporary cosmopolitanism: they are highly mobile and frequently engage in the routineness of international travel; they understand the strategic significance of cultural sensitivities and competencies; and they gain pleasure from engaging with difference. Yet, we suggest that these expressions of cosmopolitanism are also contradictory and, at times, may be understood as either ‘instrumental’, ‘banal’ or ‘engaged’. The paper illustrates how ordinary and everyday cosmopolitan repertoires and sentiments can arise outside the usual settings and among actors not readily acknowledged in the cosmopolitanism literature.