Becoming poverty focused: implications for health actors

The article explores the relationship between health sector interventions and poverty analysis. It is suggested that a dynamic asset approach to poverty and health provides a framework for intervention that recognizes the complex strategies adopted by poor individuals, households and communities. The linked nature of the asset approach leads to an inter-sectoral focus and provides extra stimulation to engage with diverse partners who may be slow to own poverty reduction and health policies.

The role of the Hellenic food safety authority in Greece: implementation strategies

During the last 15 years, a series of food scares and crises (BSE, dioxin. foot and mouth disease) have seriously under-mined public confidence in food producers and operators and their capacity to produce safe food. As a result, food safety has become a top priority of the European legislative authorities and systems of national food control have been tightened up and have included the establishment of the European Food Safety Authority. In Greece a law creating the Hellenic Food Safety Authority has been approved. The main objectives of this Authority are to promote the food security to consumers and inform them of any changes or any development in the food and health sector. The paper reviews the general structure of the current food control system in Greece. It describes the structure and the mission of the Hellenic Food Safety Authority and explains the strategy to carry out inspections and the analysis of the preliminary results of such inspections. Details are also given of the personnel training and certification and accreditation standards to be met by the Authority by the end of 2004. (c) 2005 Elsevier Ltd. All rights reserved.

Transforming the English NHS using information technology: the story so far

The use of information and communication technologies (ICT) for transforming the way publicservices are delivered, has been an area of investment and focus in many countries in recentyears. The UK government envisioned moving from e-Government to transformationalgovernment by 2008, and initiatives such as the National Programme for IT (NPfIT) wereunderway towards this end. NPfIT was the largest civil IT programme worldwide at an initialestimated cost of £12.4bn over a ten-year period. It was launched in 2002 by the UKgovernment as part of its policy to transform the English NHS and to implement standardised ITsolutions at a national level. However, this top down, government led approach came underincreasing scrutiny, and is now being reconfigured towards a more decentralised mode of operations. This paper looks into the implementation of NPfIT and analyses the reasons behindits failure, and what effect the new NHS reforms are likely to have on the health sector. Wedraw from past studies (Weill and Ross, 2005) to highlight the key areas of concern in ITgovernance, using the NPfIT as an illustration

Building synergies in development research: The application of the mosaic model to animal health research

Development research has responded to a number of charges over the past few decades. For example, when traditional research was accused of being 'top-down', the response was participatory research, linking the 'receptors' to the generators of research. As participatory processes were recognised as producing limited outcomes, the demand-led agenda was born. In response to the alleged failure of research to deliver its products, the 'joined-up' model, which links research with the private sector, has become popular. However, using examples from animal-health research, this article demonstrates that all the aforementioned approaches are seriously limited in their attempts to generate outputs to address the multi-faceted problems facing the poor. The article outlines a new approach to research: the Mosaic Model. By combining different knowledge forms, and focusing on existing gaps, the model aims to bridge basic and applied findings to enhance the efficiency and value of research, past, present, and future.

Challenges with minimising mercury pollution in the small-scale gold mining sector: Experiences from the Guianas

This paper examines the barriers to mitigating mercury pollution at small-scale gold mines in the Guianas (Guyana, French Guiana and Suriname), and prescribes recommendations for overcoming these obstacles. Whilst considerable attention has been paid to analysing the environmental impacts of operations in the region, minimal research has been undertaken to identify appropriate policy and educational initiatives for addressing the mounting mercury problem. Findings from recent fieldwork and selected interviews with operators from Guyanese and Surinamese gold mining regions reveal that legislative incapacity, the region's varied industry policy stances, various technological problems, and low environmental awareness on the part of communities are impeding efforts to facilitate improved mercury management at small-scale gold mines in the Guianas. Marked improvements can be achieved, however, if legislation, particularly that pertaining to mercury, is harmonised in the region; educational seminars continue to be held in important mining districts; and additional outlets for disseminating environmental equipment and mercury-free technologies are provided.

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.

Ethics of care in supporting disabled forced migrants: interactions with professionals and ethical dilemmas in health and social care in the South-East of England

This article explores the interactions between disabled forced migrants with care needs and professionals and the restrictive legal, policy and practice context that health and social care professionals have to confront, based on the findings of a qualitative study with 45 participants in the South-East of England. In-depth interviews were conducted with 15 forced migrants who had diverse impairments and chronic illnesses (8 women and 7 men), 13 family caregivers and 17 support workers and strategic professionals working in social care and the third sector in Slough, Reading and London. The legal status of forced migrants significantly affects their entitlements to health and social care provision, resulting in prolonged periods of destitution for many families. National asylum support policies, difficult working relationships with UK Border Agency, higher eligibility thresholds and reduced social care budgets of local authorities were identified as significant barriers in responding to the support needs of disabled forced migrants and family caregivers. In this context, social workers experienced considerable ethical dilemmas. The research raises profound questions about the potential and limitations of health and social care policies, provision, and practice as means of protection and support in fulfilling the human rights of forced migrants with care needs.

Investigating the impact of defects on key stakeholders in the UK new housing sector

The UK house building sector is facing dual pressures to expand supply, along with delivering against tougher Building Regulations’ requirements, predominantly in the areas of sustainability. A review of current literature has highlighted that the pressures the UK house building industry is currently under may be having a negative impact on build quality, causing an increase in defects. A review and synthesis of the current defect literature with respect to new-build housing and the wider construction sector has found that the prevailing emphasis is limited to the classification, causes, pathology and statistical analysis of defects. There is thus a need to better understand the overall impact of individual defects on key stakeholders within the new-build housing defect detection and remediation process. As part of ongoing research to develop and verify a defect impact assessment rating system, this paper seeks to contribute to our understanding of the impact of individual defects from a key stakeholder perspective by undertaking the literature review and synthesis phase. The literature review identifies the three distinct, but interrelated, dominant impact factors: cost, disruption, and health and safety. By pulling the strands of defect literature together the theoretical lens and key stakeholder sampling strategy is formed as the basis for the subsequent impact weighting development phase.