Remitting behaviour of Nepalese rural-to-urban migrants: Implications for theory and policy

This article uses data for Nepal to test contemporary hypotheses about the remitting behaviour and associated motives of rural-to-urban migrants and to consider the likely impact of such remittances on rural development. Possibilities for inheritance, degree of family attachment, likelihood of eventual return to place of origin and family investment in the education of the migrants are found to be significant influences on levels of remittances by Nepalese migrants. However, in Nepal, remittances do not seem to result in long-term capital investment in rural areas and so may not promote long-term development of these areas.

Evaluating Australia's National Medicines Policy using geographical mapping

Background: There has been a proliferation of quality use of medicines activities in Australia since the 1990s. However, knowledge of the nature and extent of these activities was lacking. A mechanism was required to map the activities to enable their coordination. Aims: To develop a geographical mapping facility as an evaluative tool to assist the planning and implementation of Australia's policy on the quality use of medicines. Methods: A web-based database incorporating geographical mapping software was developed. Quality use of medicines projects implemented across the country was identified from project listings funded by the Quality Use of Medicines Evaluation Program, the National Health and Medical Research Council, Mental Health Strategy, Rural Health Support, Education and Training Program, the Healthy Seniors Initiative, the General Practice Evaluation Program and the Drug Utilisation Evaluation Network. In addition, projects were identified through direct mail to persons working in the field. Results: The Quality Use of Medicines Mapping Project (QUMMP) was developed, providing a Web-based database that can be continuously updated. This database showed the distribution of quality use of medicines activities by: (i) geographical region, (ii) project type, (iii) target group, (iv) stakeholder involvement, (v) funding body and (vi) evaluation method. At September 2001, the database included 901 projects. Sixty-two per cent of projects had been conducted in Australian capital cities, where approximately 63% of the population reside. Distribution of projects varied between States. In Western Australia and Queensland, 36 and 73 projects had been conducted, respectively, representing approximately two projects per 100 000 people. By comparison, in South Australia and Tasmania approximately seven projects per 100 000 people were recorded, with six per 100 000 people in Victoria and three per 100 000 people in New South Wales. Rural and remote areas of the country had more limited project activity. Conclusions: The mapping of projects by geographical location enabled easy identification of high and low activity areas. Analysis of the types of projects undertaken in each region enabled identification of target groups that had not been involved or services that had not yet been developed. This served as a powerful tool for policy planning and implementation and will be used to support the continued implementation of Australia's policy on the quality use of medicines.

Impact numbers in health policy decisions

Objective: To outline the major methodological issues appropriate to the use of the population impact number (PIN) and the disease impact number (DIN) in health policy decision making. Design: Review of literature and calculation of PIN and DIN statistics in different settings. Setting: Previously proposed extensions to the number needed to treat (NNT): the DIN and the PIN, which give a population perspective to this measure. Main results: The PIN and DIN allow us to compare the population impact of different interventions either within the same disease or in different diseases or conditions. The primary studies used for relative risk estimates should have outcomes, time periods and comparison groups that are congruent and relevant to the local setting. These need to be combined with local data on disease rates and population size. Depending on the particular problem, the target may be disease incidence or prevalence and the effects of interest may be either the incremental impact or the total impact of each intervention. For practical application, it will be important to use sensitivity analyses to determine plausible intervals for the impact numbers. Conclusions: Attention to various methodological issues will permit the DIN and PIN to be used to assist health policy makers assign a population perspective to measures of risk.

Public policy and the prevention of substance-use disorders

Drug prevention has traditionally focused on influencing individual attitudes and behaviours. In particular, efforts have been directed towards adolescents in the school setting. However, evaluations of school-based drug education have identified limited success. There is increasing recognition that drug abuse is one of a number of risk behaviours, including truancy, delinquency and mental health problems, which share common antecedents that begin in the early years of childhood. Furthermore, these behaviours are shaped by macroenvironmental influences including the economic, social, cultural, and physical environment. Drug prevention needs to adopt a broader perspective: with greater collaboration in related programmes such as crime prevention and suicide prevention; with greater attention to the macroenvironmental influences on problem behaviours; and with greater attention to healthy development in the first years of childhood. (C) 2002 Lippincott Williams Wilkins.

Translating policy: Power and action in Australia's country towns

Controversies In its present condition, rural Australia is characterised by a discourse of decline that sees country towns and regions as places of demoralisation and despair. From a Foucauldian governmentality perspective, those who live in these spaces are not so much 'powerless' to the demands of urban-based governments and global capital, as rendered governable according to the socio-political ambitions of late capitalism. While important insights have been derived from such analyses, it is argued in this paper that excessive attention is often paid to the power of the state with little concern for the various ways in which local people engage with, and transform the strategies and effects of state power. Rather than utilising the concept of resistance to make sense of these interactions, a sociology of translation is adopted from the Actor Network Theory literature. Applied to two case examples, it shows how governmental policies and programmes are frequently the outcome of the interactions and negotiations that take place between all those enrolled in the actor-network.

The Utility of the Human Security Agenda for Policy-makers

The idea of “human security” is gaining attention among policy-makers and security analysts. Little scholarly attention has been given to the questions of why states accept (or reject) a human security agenda or how such an agenda is incorporated into policy practices. The article suggests that a human security approach is most likely to be applied when both humanitarian and national interests combine. Yet when states or organisations adopt a human security approach, they often misjudge the complex and long-term commitment required of such an approach. There is also the potential for such an agenda to be manipulated to justify questionable courses of action. These issues frame an analysis of six recent case studies.

Evidence and information for health policy: a decade of change

Over the past decade or so, there has been increasing demand for greater clarity about the major causes of disease and injury, how these differentially affect populations, and how they are changing. In part, this demand has been motivated by resource constraints and a realisation that better health is possible with more informed allocation of resources. At the same time, there has been a change in the way population health and its determinants are quantified, with a much closer integration of the quantitative population sciences (such as epidemiology, demography and health economics) to strengthen and broaden the evidence base for healthcare policy.

Plano de implementa????o do projeto de desenvolvimento de capacidade de governan??a

Desde a d??cada de 1990, o Governo Federal brasileiro vem implementando uma agenda ambiciosa de reformas do Estado, centradas na redu????o da pobreza e na melhoria da efici??ncia dos servi??os p??blicos. As principais prioridades, conforme previstas no Plano Plurianual (PPA) para o per??odo 2003-2007, s??o as seguintes: inclus??o social e redu????o da desigualdade; crescimento econ??mico com gera????o de emprego; distribui????o de renda e respeito ao meio ambiente; promo????o e amplia????o dos direitos de cidadania; e fortalecimento da democracia. No in??cio de 2006, o Governo criou a Pol??tica Nacional de Desenvolvimento de Pessoal (Decreto 5.707), com o objetivo de melhorar e aumentar a efici??ncia e a efic??cia na presta????o de servi??os p??blicos. No marco dessa pol??tica recente, as escolas de administra????o p??blica desempenham um papel fundamental na identifica????o das compet??ncias que precisam ser desenvolvidas nas institui????es do governo, bem como na implementa????o de pol??ticas de capacita????o para os servidores p??blicos, diretamente e/ou em parceria com escolas de governo nos n??veis federal, estadual ou local. O Canad?? tamb??m est?? criando uma estrutura para levantar as compet??ncias necess??rias para os servidores p??blicos e desenvolv??-las como um componente da Renova????o do Servi??o P??blico em todo o governo. Como institui????es l??deres no desenvolvimento de compet??ncias de servidores p??blicos, a Canada School of Public Service (CSPS) e a Escola Nacional de Administra????o P??blica (ENAP) firmaram uma parceria para implementar o Projeto de Desenvolvimento de Capacidade de Governan??a no Brasil. A finalidade do Projeto ?? melhorar a capacidade de servidores p??blicos federais, estaduais e municipais do Brasil para desenvolver e implementar programas de capacita????o e gerenciar pol??ticas p??blicas descentralizadas. Espera-se que essa parceria e o resultante compartilhamento de experi??ncias em capacita????o para governan??a efetiva contribuam para a redu????o da pobreza e das desigualdades no Brasil, por meio do desenvolvimento de compet??ncias de servidores na presta????o de servi??os p??blicos eficazes e eficientes, voltados para o cidad??o. O Projeto re??ne, al??m das duas principais Escolas de Governo no Canad?? e no Brasil, seis Escolas Brasileiras de Administra????o P??blica regionais e duas renomadas Institui????es Acad??micas Canadenses ??? a Queen???s University e a Western Ontario University. O Minist??rio do Desenvolvimento Social e Combate ?? Fome (MDS) e tr??s Secretarias Especiais do Governo Federal ??? Ra??a (SEPPIR), Direitos Humanos (SEDH) e Pol??ticas para as Mulheres (SPM) ??? tamb??m se envolver??o nas atividades de compartilhamento de conhecimentos com o Human Resources and Skills Development Canada (HRSDC) e a Canada Public Service Agency (CPSA). A CIDA fornecer?? CND$1.700.000 por meio do Programa Brasil-Canad?? de Interc??mbio de Conhecimentos para a Promo????o da Equidade (PIPE). A contribui????o da ENAP ser?? de CND$1.069.707 em esp??cie. A CSPS contribuir?? com cursos, al??m de conhecimentos e suporte t??cnicos, avaliados em CND$1.000.000. Aproveitando a parceria entre a CSPS e a ENAP, que resultou na transfer??ncia e na adapta????o bem sucedidas de cursos e metodologias canadenses, o novo projeto extrapola o n??cleo do servi??o p??blico em Bras??lia, alcan??ando escolas de governo em regi??es brasileiras em situa????o de desvantagem. ?? semelhan??a do papel da CSPS no primeiro projeto, a ENAP fortalecer?? a capacidade das escolas parceiras regionais para capacitar servidores p??blicos envolvidos na presta????o de servi??os aos brasileiros. O interc??mbio estruturado entre Minist??rios dos Governos canadense e brasileiro tamb??m aplicar?? a aprendizagem mais diretamente a quest??es de pol??ticas e programas sociais do Brasil. O desafio assumido neste Projeto ?? a adapta????o de conhecimentos e aprendizagem, com vistas a melhorar a implementa????o de pol??ticas e programas sociais. Para tanto, a CSPS e a ENAP introduzir??o novos cursos nos curr??culos das escolas parceiras e incorporar??o novos m??todos e tecnologias de aprendizagem como, por exemplo, comunidades de pr??tica virtuais e um componente de tutoria (mentoring) envolvendo o Human Resources and Skills Development Canada e o Minist??rio do Desenvolvimento Social e Combate ?? Fome do Brasil. Seis institui????es da Rede Nacional de Escolas de Governo do Brasil e do Programa de Parceria da ENAP foram selecionadas e convidadas a se unir ?? CSPS e ?? ENAP nesse novo Projeto: a Universidade Federal do Par?? (UFPA), de Bel??m (estado do Par?? ??? regi??o Norte); a Funda????o Joaquim Nabuco (FUNDAJ), de Recife (Pernambuco ??? Nordeste); a Universidade Corporativa do Servi??o P??blico / Secretaria de Administra????o do Estado da Bahia (UCS/SAEB), Salvador (Bahia ??? Nordeste); a Escola de Governo do Mato Grosso do Sul (ESCOLAGOV), Campo Grande (estado do Mato Grosso do Sul ??? Centro-Oeste); a Escola Nacional de Ci??ncias Estat??sticas / Instituto Brasileiro de Geografia e Estat??stica (ENCE/IBGE), Rio de Janeiro (estado do Rio de Janeiro ??? Sudeste); e o Instituto Municipal de Administra????o P??blica (IMAP) de Curitiba (Paran?? ??? Sul). Essas escolas de refer??ncia foram escolhidas segundo sua capacidade de trabalhar como p??los de pr??ticas inovadoras em pol??ticas p??blicas e disseminar os benef??cios do Projeto para outras escolas em suas regi??es, por meio da Rede Nacional coordenada pela ENAP. O objetivo dessa parceria ?? fortalecer as escolas de governo locais, para que estas desenvolvam, por meio de eventos de aprendizagem, compet??ncias em servidores p??blicos, a fim de aumentar a capacidade do governo na implementa????o e gest??o de pol??ticas p??blicas. O Plano de Implementa????o do Projeto (PIP) descreve o trabalho a ser realizado por essas institui????es nos pr??ximos 30 meses, ao tempo em que serve de guia para os Parceiros do Projeto no que se refere ??s a????es e aos recursos necess??rios para a obten????o dos resultados acordados. Na medida em que o Projeto estiver em andamento e os parceiros iniciarem um interc??mbio produtivo de conhecimentos, o Plano de Trabalho Anual ser?? atualizado e revisto por meio de reuni??es anuais de avalia????o e encontros do Comit?? Diretor do Projeto, com vistas a assegurar que os resultados descritos no PIP sejam alcan??ados com sucesso