Policy entrepreneurship in the development of public sector strategy: the case of London health reform

The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.

The value of cooperatives in rural electrification

The electricity sectors of many developing countries underwent substantial reforms during the 1980s and 1990s, driven by global agendas of privatization and liberalization. However, rural electrification offered little by way of market incentives for profit-seeking private companies and was often neglected. As a consequence, delivery models for rural electrification need to change. This paper will review the experiences of various rural electrification delivery models that have been established in developing countries, including concessionary models, dealership approaches and the strengthening of small and medium-sized energy businesses. It will use examples from the USA, Bangladesh and Nepal, together with a detailed case study of a Nepali rural electric cooperative, to explore the role that local cooperatives can play in extending electricity access. It is shown that although there is no magic bullet solution to deliver rural electrification, if offered appropriate financial and institutional support, socially orientated cooperative businesses can be a willing, efficient and effective means of extending and managing rural electricity services. It is expected that this paper will be of particular value to policy-makers, donors, project planners and implementers currently working in the field of rural electrification. © 2010 Elsevier Ltd.