Non-government organisations and the dialectics of state and civil society

This paper is concerned with envisioning the development of non-government organisations (NGOs) in Australia over the next 200 years. It begins with a discussion of a hypothetical NGO, providing vignettes of its activities in 2104 and 2204, and sketching out contextual factors that might influence NGO development. This discussion is followed by an outline of the methodology upon which the projections indicated in the hypothetical case-study are based. Three methodological approaches are used. The first approach begins from an analysis of current contextual trajectories, and projects the role of NGOs within these trajectories. The second approach postulates that the changes that will occur will be affected by the reflexive nature of social change, involving continual reflection and action. The third methodological approach draws on this notion of reflexivity, but emphasises that social change is not only a reflexive process, it is also a dialectical one. The dialectical approach rests on the premise that change occurs through a process of the accumulation of contradictions, challenge and resolution. Using these methodological approaches the paper proceeds to identify three factors which will influence the Australian NGO sector in the next 200 years. These factors are the shifting relations between the state and civil society, including the rise of the neo-authoritarian state in the 21st century; the ways in which least advantaged people are dealt with and, finally, the idea of risk society. While it is more difficult to identify the contextual and NGO trajectories into the 22nd and 23rd centuries, the paper postulates a more utopian vision for NGOs in Australia in 200 years time, where the category of people who had been previously marginalised disappears, and the major roles of NGOs are to ensure cultural diversity and develop civil labour.

Brokering knowledge : managing knowledge in a network of government and non-government human service delivery agencies

This paper examines aspects of knowledge management that are particularly important in the network of human service delivery agencies in Victoria. This network is characterised by four features: it is a cluster of networked organisations; professionals and others may act as knowledge brokers within and between organisations in the network; rapid change in both knowledge and organisation accentuates the importance of innovative knowledge and emergent organisation over and above routine instrumental knowledge within stable organisation; and consequently there is an underlying concern with dialogical rather than instrumental knowledge and its management, and particularly how it constitutes and is constituted by organisation. The paper describes the analytical tools that we consider particularly important in examining this situation – in particular, the distinction between instrumental and dialogical knowledge, and the role of knowledge brokers (and professionals as knowledge brokers). It concludes by relating this analysis to broader issues in organisation studies, and suggests paths for further examination of these issues.

Non-government communications and conflict management: the experience of Iraqi Arab tribes

This chapter engages with tribal involvement in conflict management practices since 2003 and seeks to explain the role of this social structure in conflict management.

Mental health service delivery : a profile of mental health non-government organisations in south-east Queensland, Australia.

Non-government organisations make a substantial contribution to the provision of mental health services; despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery.

Costs of psychosis in 2010: findings from the second Australian national survey of psychosis

Objectives
To estimate the annual costs of psychosis in Australia from societal and government perspectives and assess whether average costs per person differ by principal service provider at time of census.

Methods
Costs of psychosis encompassing health sector costs, other sector costs, and productivity losses were assessed for 2010 using a prevalence-based, bottom-up approach. Resource use data were obtained from the second Australian National Survey of Psychosis and unit costs were from government and non-government organization (NGO) sources. Costs to society were assessed by principal service provider at census: public specialized mental health services (PSMHS) and NGOs during the census month (current clients), and PSMHS in the 11 months preceding census (recent clients), and any differences were ascertained.

Results
The average annual costs of psychosis to society are estimated at $77,297 per affected individual, comprising $40,941 in lost productivity, $21,714 in health sector costs, and $14,642 in other sector costs. Health sector costs are 3.9-times higher than those for the average Australian. Psychosis costs Australian society $4.91 billion per annum, and the Australian government almost $3.52 billion per annum. There are significant differences between principal service providers for each cost category. Current PSMHS clients had the highest health sector costs overall, and the highest mental health ambulatory, inpatient, and antipsychotic medication costs specifically. NGO clients had the highest other sector costs overall and the highest NGO assistance, supported employment, and supported accommodation costs. Recent PSMHS clients had the lowest productivity losses for reduced participation and the highest costs for absenteeism and presenteeism.

Conclusions
The costs of psychosis are broad ranging and very high. Development and implementation of cost-effective prevention, treatment, and support strategies is critical to maximizing the efficiency of service delivery. A needs-based framework based on principal service provider and recency of contact may facilitate this process.

Community-based rehabilitation : why not in Iraq?

Introduction: Community-based rehabilitation (CBR) has emerged and developed since the 1950s as a possible solution for socio-economic reintegration of people with disabilities. Government and non government organizations are key players and have vital roles in policy making, planning, funding, managing and implementing CBR programmes.
Contents: This article explores the role of government and non-government organizations and international agencies in community-based rehabilitation in Iraq. It examines the possibility of NGOs initiating and running (CBR) programmes for people with a disability regardless of Iraqi government commitment or participation.
Conclusions: The research results show that implementation of CBR in Iraq is vital but not widely spread. Non-government organizations seem more active, committed and capable at the present time being to initiate, run and manage CBR programmes when compared with the government of Iraq.

Government regulation to promote healthy food environments : a view from inside state governments

Food policy interventions are an important component of obesity-prevention strategies and can potentially drive positive changes in obesogenic environments. This study sought to identify regulatory interventions targeting the food environment, and barriers/facilitators to their implementation at the Australian state government level. In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government organizations (n = 45) to examine participants’ (i) suggestions for regulatory interventions for healthier food environments and (ii) support for pre-selected regulatory interventions derived from a literature review. Data were analysed using thematic and constant comparative analyses. Interventions commonly suggested by participants were regulating unhealthy food marketing; limiting the density of fast food outlets; pricing reforms to decrease fruit/vegetable prices and increase unhealthy food prices; and improved food labelling. The most commonly supported preselected interventions were related to food marketing and service. Primary production and retail sector interventions were least supported. The dominant themes were the need for whole-of-government and collaborative approaches; the influence of the food industry; conflicting policies/agenda; regulatory challenges; the need for evidence of effectiveness; and economic disincentives. While interventions such as public sector healthy food service policies were supported by participants, marketing restrictions and fiscal interventions face substantial barriers including a push for deregulation and private sector opposition.

Context-sensitive development : how international NGOs operate in Myanmar

Development is a difficult undertaking in any environment, but much more so in places such as Myanmar with its “perfect storm” of extreme poverty, international sanctions, and political repression and human rights violations with concomitant conflicts within development organizations over norms and policies.

Context-Sensitive Development examines how to effect successful development interventions in Myanmar. Anthony Ware points out that while practitioners have questioned universal economic prescriptions for development, they have not been as consistent in questioning the normative foundations behind their work. Ware does not argue for a facile moral relativism; he sees Myanmar as an egregious violator of human rights, but he does call for “context sensitivity” to help organizations adapt their values to better meet the needs of client populations.

Through his years of practice in the field and extensive series of interviews, the author brings into focus key issues of perception and practice that are intrinsic to the development enterprise. Although the focus is on Myanmar as a quintessential “difficult” case, Ware shows how his conclusions can be used elsewhere. His book represents a major contribution to both development theory and practice, vital for both the classroom and the development organization in situ.

What’s in a name? The personal and political meanings of 'LGBT' for non-heterosexual and transgender youth in Kyrgyzstan

In this article, we focus on the ways in which non-heterosexual and transgender youth involved with the non-governmental organization ‘Labrys’ in Kyrgyzstan have begun to demand the protection of their basic civil and human rights on the basis of self-identification as ‘LGBT’. This acronym, which stands for Lesbian, Gay, Bisexual and Transgender, is relatively new to Kyrgyzstan and other post-Soviet states, and represents a change in the terms used by non-heterosexual and transgender people to describe themselves. We frame our discussion using the concepts of sexual citizenship, private/public divides and stigma and base our discussion on debates amongst the staff and community of Labrys about the purpose and scope of the organization. Centrally, we suggest that the strategic use of ‘LGBT’ as a public and politicized identity represents a new, pro-active form of stigma management. By employing this strategy, young LGBT people become ‘would-be’ sexual citizens and challenge traditional societal norms that seek to keep discussion of sex and sexuality in the private sphere and restrict rights to heterosexual, cisgender citizens.

An analysis of potential barriers and enablers to regulating the television marketing of unhealthy foods to children at the state government level in Australia

Background In Australia there have been many calls for government action to halt the effects of unhealthy food marketing on children's health, yet implementation has not occurred. The attitudes of those involved in the policy-making process towards regulatory intervention governing unhealthy food marketing are not well understood. The objective of this research was to understand the perceptions of senior representatives from Australian state and territory governments, statutory authorities and non-government organisations regarding the feasibility of state-level government regulation of television marketing of unhealthy food to children in Australia.

Method Data from in-depth semi-structured interviews with senior representatives from state and territory government departments, statutory authorities and non-government organisations (n=22) were analysed to determine participants' views about regulation of television marketing of unhealthy food to children at the state government level. Data were analysed using content and thematic analyses.

Results Regulation of television marketing of unhealthy food to children was supported as a strategy for obesity prevention. Barriers to implementing regulation at the state level were: the perception that regulation of television advertising is a Commonwealth, not state/territory, responsibility; the power of the food industry and; the need for clear evidence that demonstrates the effectiveness of regulation. Evidence of community support for regulation was also cited as an important factor in determining feasibility.

Conclusions The regulation of unhealthy food marketing to children is perceived to be a feasible strategy for obesity prevention however barriers to implementation at the state level exist. Those involved in state-level policy making generally indicated a preference for Commonwealth-led regulation. This research suggests that implementation of regulation of the television marketing of unhealthy food to children should ideally occur under the direction of the Commonwealth government. However, given that regulation is technically feasible at the state level, in the absence of Commonwealth action, states/territories could act independently. The relevance of our findings is likely to extend beyond Australia as unhealthy food marketing to children is a global issue.

Regulation to create environments conducive to physical activity : understanding the barriers and facilitators at the Australian State Government level

Introduction Policy and regulatory interventions aimed at creating environments more conducive to physical activity (PA) are an important component of strategies to improve population levels of PA. However, many potentially effective policies are not being broadly implemented. This study sought to identify potential policy/regulatory interventions targeting PA environments, and barriers/facilitators to their implementation at the Australian state/territory government level.

Methods In-depth interviews were conducted with senior representatives from state/territory governments, statutory authorities and non-government organisations (n = 40) to examine participants': 1) suggestions for regulatory interventions to create environments more conducive to PA; 2) support for preselected regulatory interventions derived from a literature review. Thematic and constant comparative analyses were conducted.

Results Policy interventions most commonly suggested by participants fell into two areas: 1) urban planning and provision of infrastructure to promote active travel; 2) discouraging the use of private motorised vehicles. Of the eleven preselected interventions presented to participants, interventions relating to walkability/cycling and PA facilities received greatest support. Interventions involving subsidisation (of public transport, PA-equipment) and the provision of more public transport infrastructure received least support. These were perceived as not economically viable or unlikely to increase PA levels. Dominant barriers were: the powerful ‘road lobby’, weaknesses in the planning system and the cost of potential interventions. Facilitators were: the provision of evidence, collaboration across sectors, and synergies with climate change/environment agendas.

Conclusion This study points to how difficult it will be to achieve policy change when there is a powerful ‘road lobby’ and government investment prioritises road infrastructure over PA-promoting infrastructure. It highlights the pivotal role of the planning and transport sectors in implementing PA-promoting policy, however suggests the need for clearer guidelines and responsibilities for state and local government levels in these areas. Health outcomes need to be given more direct consideration and greater priority within non-health sectors.

Salt reduction in Australia: from advocacy to action

BACKGROUND: As part of its endorsement of the World Health Organization's Global Action Plan to prevent non-communicable diseases, the Federal Government of Australia has committed to a 30% reduction in average population salt intake by 2025. Currently, mean daily salt intake levels are 8-9 g, varying by sex, region and population group. A number of salt reduction initiatives have been established over the last decade, but key elements for a co-ordinated population-level strategy are still missing. The objective of this review is to provide a comprehensive overview of existing population-level salt reduction activities in Australia and identify opportunities for further action.

METHODS: A review of the published literature and stakeholder activities was undertaken to identify and document current activities. The activities were then assessed against a pre-defined framework for salt reduction strategies.

RESULTS: A range of initiatives were identified from the review. The Australian Division of World Action on Salt and Health (AWASH) was established in 2005 and in 2007 launched its Drop the Salt! Campaign. This united non-governmental organisations (NGOs), health and medical and food industry organisations in a co-ordinated advocacy effort to encourage government to develop a national strategy to reduce salt. Subsequently, in 2010 the Federal Government launched its Food and Health Dialogue (FHD) with a remit to improve the health of the food supply in Australia through voluntary partnerships with food industry, government and non-government public health organisations. The focus of the FHD to date has been on voluntary reformulation of foods, primarily through salt reduction targets. More recently, in December 2014, the government's Health Star Rating system was launched. This front of pack labelling scheme uses stars to highlight the nutritional profile of packaged foods. Both government initiatives have clear targets or criteria for industry to meet, however, both are voluntary and the extent of industry uptake is not yet clear. There is also no parallel public awareness campaign to try and influence consumer behaviour relating to salt and no agreed mechanism for monitoring national changes in salt intake. The Victorian Health Promotion Foundation (VicHealth) has recently instigated a State-level partnership to advance action and will launch its strategy in 2015.

CONCLUSIONS: In conclusion, salt reduction activities are currently being implemented through a variety of different programs but additional efforts and more robust national monitoring mechanisms are required to ensure that Australia is on track to achieve the proposed 30% reduction in salt intake within the next decade.