Volume 3, Issue 4, October 2010 Edition
Global Health Governance: Framework Convention on Tobacco
Control (FCTC), the Doha Declaration, and Democratisation
Belinda Townsend, Erik Martin, Hans Löfgren and Evelyne de Leeuw
Abstract
Global public health agreements are heralded as a success for the affirmation of the right to health within a complex and contested political landscape. However, the practical implementation of such agreements at the national level is often overlooked. This article outlines two radically different global health agreements: The Doha Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement and Public Health; and the Framework Convention on Tobacco Control (FCTC). We identify significant challenges in their implementation, particularly for low and middle income countries. Shifts in the policy network constellations around these two agreements have allowed for some positive influence by civil society. Yet industry influence at the national level constrains effective implementation and those affected by these policies have largely been left on the periphery. The broader provisions of these two agreements have been watered down by vested interests and donor conditions. We advocate for both activist and academic actors to play a significant role in highlighting the consequences of these power asymmetries. Deliberative democracy may be the key to addressing these challenges in a way that empowers those presently excluded from effective participation in the policy process.
Key words: global health governance; deliberative democracy; implementation; international public health policy; FCTC; TRIPS; Doha Declaration on TRIPS and Public Health
Of Coordinators and Dictators: A Public Goods Experiment
J¨urgen Fleiß and Stefan Palan
Abstract
We experimentally investigate whether human subjects are willing to give up individual freedom in return for the benefits of improved coordination. We conduct a modified iterated public goods game in which subjects in each period first decide which of two groups to join. One group employs a voluntary contribution mechanism, the other group an allocator contribution mechanism. The setup of the allocator mechanism differs between two treatments. In the coordinator treatment, the randomly selected allocator can set a uniform contribution for all group members, including herself. In the dictator treatment, the allocator can choose different contributions for herself and all other group members. We find that subjects willingly submit to authority in both treatments, even when competing with a voluntary contribution mechanism. The allocator groups achieve high contribution levels in both treatments.
Key words: allocator; public goods game; self-selection, institution choice, power
Psychosocial Effect on Career Concerns among Staff of the Department Of Petroleum Resources, Nigeria
Aramide, Olufemi Kunle, Idowu, Sarah Olubunmi, Aderibigbe, John Kolawole
Abstract
This study explored effect of error-strain, covering-up errors, gender and education on career concerns among staff of Department of Petroleum Resources, Nigeria. Quasi-experimental research design, purposive and convenience sampling techniques were adopted. 217 male and female staff participated. A questionnaire form was administered to participants. Three hypotheses were tested using univariate analysis of variance and t-test of Independent groups. Results showed that, covering-up errors significantly affected career concerns F (3, 213) = 5.432; P<.05. However, error-strain did not affect career concerns F (3, 213)= 1.133; P>.05. Furthermore, covering-up errors and error-strain did not have interaction effect on career concerns, F (3, 213)= 0.083; P>.05. Female participants significantly scored higher on career concerns than male participants (t= .07, df (215) p <.05). Similarly, low educated staff significantly scored higher on career concerns than the high educated staff (t= 3.52, df (189) p <.05). Hence, it was concluded that, covering-up errors, gender and education are significant factors that affect career concerns among employees. Recommendation was given that managers should give more managerial attentions to female employees to help them match equally with their male counterparts on education and job related skills so that they feel comfortable with their chosen career.
Key words: Career Concerns, Covering-up Errors, Education, Error-Strain and Gender
Corporate Leadership Failure and Its Implications for the consolidation of Corporate Governance and Accountability in Nigeria
Usman D. Umaru, Adole Raphael Audu, Mbaya Y. Paul
Abstract
Leadership is at the centre of the successes and failures of corporate organization world-wide. In this paper, leadership is at the centre of corporate failures as exemplified by the failure of some banks and corporations in Nigeria. To avert failure occurrence, this paper recommends that regulatory agencies, Professional Associations/Bodies and Audit firms should be alive to their responsibilities by raising alarm before the harm is done, and where a corporate leader has failed as a result of his/her personal or selfish dealings, an appropriate commensurate punishment should be meted out to him or her, to serve as a deterrent. The analysis of this paper would be through the use of some secondary sources relevant to the theme of this paper.
Key words: Corporate Governance,Accountabilty,Leadership failure, Nigeria
Smoking Behaviour and Mental Health Disorders—Mutual Influences and Implications for Therapy
Amedeo Minichino, Francesco Saverio Bersani, Wanda Katharina Calò, Francesco Spagnoli, Marta Francesconi, Roberto Vicinanza, Roberto Delle Chiaie, Massimo Biondi
Abstract
Tobacco use is strongly associated with a variety of psychiatric disorders. Smokers are more likely than non-smokers to meet current criteria for mental health conditions, such as mood disorders, anxiety disorders and psychosis. Evidence also suggest that smokers with psychiatric disorders may have more difficulty quitting, offering at least a partial explanation for why smoking rates are higher in this population. The mechanisms linking mental health conditions and cigarette smoking are complex and likely differ across each of the various disorders. The most commonly held view is that patients with mental health conditions smoke in an effort to regulate the symptoms associated with their disorder. However some recent evidence suggests that quitting smoking may actually improve mental health symptoms. This is particularly true if the tobacco cessation intervention is integrated into the context of ongoing mental health treatment. In this paper we reviewed and summarized the most relevant knowledge about the relationship between tobacco use and dependence and psychiatric disorders. We also reviewed the most effective smoking cessation strategies available for patients with psychiatric comorbidity and the impact of smoking behavior on psychiatric medication.
Key words: smoke; nicotine dependence; schizophrenia; mood disorders; anxiety; ADHD
Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review
Georgia L. Kayser, Patrick Moriarty, Catarina Fonseca, and Jamie Bartram
Abstract
Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.
Key words: drinking water services; water indicators and frameworks; monitoring & evaluation; policy & planning; public health; human rights; poverty reduction
“We Made the Rule, We Have to Stick to It”: Towards Effective Management of Environmental Tobacco Smoke in Remote Australian Aboriginal Communities
Jan Robertson, Boris Shane Pointing, Leah Stevenson, and Alan R. Clough
Abstract
Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a lack of appropriate regulation resources. This paper celebrates a grassroots approach to control of environmental tobacco smoke (ETS) in these settings. We report on selected findings from a tobacco intervention study in Arnhem Land, Northern Territory in 2007–2012. In community-level tobacco use surveys at baseline (n = 400 ≥ 16 years), participants reported concern about the constant exposure of non-smokers to tobacco smoke. Suggestions for action included restricting smoking in private and public spaces. We selected three case studies illustrating management of ETS from observational data during the study’s intervention phase. Using a critical realist approach, the context and mechanisms that contributed to specific strategies, or outcomes, were examined in order to develop a hypothesis regarding more effective management of ETS in these environments. Our results suggest that in discrete, disadvantaged communities, enhanced local ownership of smoke-free policies and development of implementation strategies at the grassroots level that acknowledge and incorporate cultural contexts can contribute to more effective management of ETS.
Key words: aboriginal; Australian; remote communities; environmental tobacco smoke; smoke-free policies
Circulating Practices: Migration and Translocal Development in Washington D.C. and Cochabamba, Bolivia
Christopher Strunk
Abstract
Migrant remittances are increasingly seen as a potential form of development in the global South, but the impact of international migration on sending regions is far from straightforward. In this article, I analyze migrant communities of origin in rural Bolivia as dynamic places that are constantly reproduced through connections with other places. I document the movement of migrant practices between Washington D.C. and Cochabamba and the influence of monetary and non-monetary flows on Bolivian cultural practices, politics, and development. I demonstrate how hometown associations and returning migrants have transferred organizational practices and political ideas about development from the United States to rural Bolivia. In addition, I explore migration’s role in struggles over belonging in Cochabamba, focusing on the efforts by migrants in Washington D.C. to stake their claim through transnational houses and collective remittance projects and on recent internal migration from other regions in Bolivia. Finally, I assess the sustainability of migrant-led development in Cochabamba. Although collaboration with migrants can strengthen the local state by providing more resources, it conditions the type of development that can take place and has yet to provide adequate opportunities for returning migrants or young people in rural Bolivia.
Key words: development; social remittances; migrant transnationalism; citizenship; Bolivia
Inorganic Arsenic Exposure and Children’s Neurodevelopment: A Review of the Evidence
David C. Bellinger
Abstract
Experimental studies suggest a myriad of mechanisms by which inorganic arsenic can interfere with central nervous system development, and, indeed, epidemiological studies published in the last dozen years suggest that exposure to arsenic impairs children’s cognitive development. Most of the studies have been conducted in developing countries (e.g., Bangladesh, India, Mexico), where exposure to arsenic is thought to be considerably higher than it is in developed countries. This review summarizes the results of these studies, focusing in particular on issues pertinent to risk assessment, including the existence of critical windows of vulnerability, characteristics of the dose-effect relationships (e.g., the lowest adverse effect level, the functional form), the most sensitive neurodevelopmental endpoints, and potential effect modifiers such as host characteristics (e.g., methylation efficiency, sex) and co-exposures to other neurotoxicants (e.g., lead, manganese). At present, the epidemiological data do not permit firm conclusions to be drawn regarding these issues. Several factors that complicate an effort to compare the results of studies are identified, including use of a variety of indices of external and internal exposure, and inconsistency in the measurement of important potential confounders for neurodevelopmental outcomes.
Key words: arsenic; children; neurodevelopment
Belinda Townsend, Erik Martin, Hans Löfgren and Evelyne de Leeuw
Abstract
Global public health agreements are heralded as a success for the affirmation of the right to health within a complex and contested political landscape. However, the practical implementation of such agreements at the national level is often overlooked. This article outlines two radically different global health agreements: The Doha Declaration on the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement and Public Health; and the Framework Convention on Tobacco Control (FCTC). We identify significant challenges in their implementation, particularly for low and middle income countries. Shifts in the policy network constellations around these two agreements have allowed for some positive influence by civil society. Yet industry influence at the national level constrains effective implementation and those affected by these policies have largely been left on the periphery. The broader provisions of these two agreements have been watered down by vested interests and donor conditions. We advocate for both activist and academic actors to play a significant role in highlighting the consequences of these power asymmetries. Deliberative democracy may be the key to addressing these challenges in a way that empowers those presently excluded from effective participation in the policy process.
Key words: global health governance; deliberative democracy; implementation; international public health policy; FCTC; TRIPS; Doha Declaration on TRIPS and Public Health
 [Abstract-PDF]
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[References]
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3.4.10.2010.1
|
Of Coordinators and Dictators: A Public Goods Experiment
J¨urgen Fleiß and Stefan Palan
Abstract
We experimentally investigate whether human subjects are willing to give up individual freedom in return for the benefits of improved coordination. We conduct a modified iterated public goods game in which subjects in each period first decide which of two groups to join. One group employs a voluntary contribution mechanism, the other group an allocator contribution mechanism. The setup of the allocator mechanism differs between two treatments. In the coordinator treatment, the randomly selected allocator can set a uniform contribution for all group members, including herself. In the dictator treatment, the allocator can choose different contributions for herself and all other group members. We find that subjects willingly submit to authority in both treatments, even when competing with a voluntary contribution mechanism. The allocator groups achieve high contribution levels in both treatments.
Key words: allocator; public goods game; self-selection, institution choice, power
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.2
|
Psychosocial Effect on Career Concerns among Staff of the Department Of Petroleum Resources, Nigeria
Aramide, Olufemi Kunle, Idowu, Sarah Olubunmi, Aderibigbe, John Kolawole
Abstract
This study explored effect of error-strain, covering-up errors, gender and education on career concerns among staff of Department of Petroleum Resources, Nigeria. Quasi-experimental research design, purposive and convenience sampling techniques were adopted. 217 male and female staff participated. A questionnaire form was administered to participants. Three hypotheses were tested using univariate analysis of variance and t-test of Independent groups. Results showed that, covering-up errors significantly affected career concerns F (3, 213) = 5.432; P<.05. However, error-strain did not affect career concerns F (3, 213)= 1.133; P>.05. Furthermore, covering-up errors and error-strain did not have interaction effect on career concerns, F (3, 213)= 0.083; P>.05. Female participants significantly scored higher on career concerns than male participants (t= .07, df (215) p <.05). Similarly, low educated staff significantly scored higher on career concerns than the high educated staff (t= 3.52, df (189) p <.05). Hence, it was concluded that, covering-up errors, gender and education are significant factors that affect career concerns among employees. Recommendation was given that managers should give more managerial attentions to female employees to help them match equally with their male counterparts on education and job related skills so that they feel comfortable with their chosen career.
Key words: Career Concerns, Covering-up Errors, Education, Error-Strain and Gender
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.3
|
Corporate Leadership Failure and Its Implications for the consolidation of Corporate Governance and Accountability in Nigeria
Usman D. Umaru, Adole Raphael Audu, Mbaya Y. Paul
Abstract
Leadership is at the centre of the successes and failures of corporate organization world-wide. In this paper, leadership is at the centre of corporate failures as exemplified by the failure of some banks and corporations in Nigeria. To avert failure occurrence, this paper recommends that regulatory agencies, Professional Associations/Bodies and Audit firms should be alive to their responsibilities by raising alarm before the harm is done, and where a corporate leader has failed as a result of his/her personal or selfish dealings, an appropriate commensurate punishment should be meted out to him or her, to serve as a deterrent. The analysis of this paper would be through the use of some secondary sources relevant to the theme of this paper.
Key words: Corporate Governance,Accountabilty,Leadership failure, Nigeria
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.4
|
Smoking Behaviour and Mental Health Disorders—Mutual Influences and Implications for Therapy
Amedeo Minichino, Francesco Saverio Bersani, Wanda Katharina Calò, Francesco Spagnoli, Marta Francesconi, Roberto Vicinanza, Roberto Delle Chiaie, Massimo Biondi
Abstract
Tobacco use is strongly associated with a variety of psychiatric disorders. Smokers are more likely than non-smokers to meet current criteria for mental health conditions, such as mood disorders, anxiety disorders and psychosis. Evidence also suggest that smokers with psychiatric disorders may have more difficulty quitting, offering at least a partial explanation for why smoking rates are higher in this population. The mechanisms linking mental health conditions and cigarette smoking are complex and likely differ across each of the various disorders. The most commonly held view is that patients with mental health conditions smoke in an effort to regulate the symptoms associated with their disorder. However some recent evidence suggests that quitting smoking may actually improve mental health symptoms. This is particularly true if the tobacco cessation intervention is integrated into the context of ongoing mental health treatment. In this paper we reviewed and summarized the most relevant knowledge about the relationship between tobacco use and dependence and psychiatric disorders. We also reviewed the most effective smoking cessation strategies available for patients with psychiatric comorbidity and the impact of smoking behavior on psychiatric medication.
Key words: smoke; nicotine dependence; schizophrenia; mood disorders; anxiety; ADHD
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.5
|
Domestic Water Service Delivery Indicators and Frameworks for Monitoring, Evaluation, Policy and Planning: A Review
Georgia L. Kayser, Patrick Moriarty, Catarina Fonseca, and Jamie Bartram
Abstract
Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator—service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.
Key words: drinking water services; water indicators and frameworks; monitoring & evaluation; policy & planning; public health; human rights; poverty reduction
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.6
|
“We Made the Rule, We Have to Stick to It”: Towards Effective Management of Environmental Tobacco Smoke in Remote Australian Aboriginal Communities
Jan Robertson, Boris Shane Pointing, Leah Stevenson, and Alan R. Clough
Abstract
Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a lack of appropriate regulation resources. This paper celebrates a grassroots approach to control of environmental tobacco smoke (ETS) in these settings. We report on selected findings from a tobacco intervention study in Arnhem Land, Northern Territory in 2007–2012. In community-level tobacco use surveys at baseline (n = 400 ≥ 16 years), participants reported concern about the constant exposure of non-smokers to tobacco smoke. Suggestions for action included restricting smoking in private and public spaces. We selected three case studies illustrating management of ETS from observational data during the study’s intervention phase. Using a critical realist approach, the context and mechanisms that contributed to specific strategies, or outcomes, were examined in order to develop a hypothesis regarding more effective management of ETS in these environments. Our results suggest that in discrete, disadvantaged communities, enhanced local ownership of smoke-free policies and development of implementation strategies at the grassroots level that acknowledge and incorporate cultural contexts can contribute to more effective management of ETS.
Key words: aboriginal; Australian; remote communities; environmental tobacco smoke; smoke-free policies
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.7
|
Circulating Practices: Migration and Translocal Development in Washington D.C. and Cochabamba, Bolivia
Christopher Strunk
Abstract
Migrant remittances are increasingly seen as a potential form of development in the global South, but the impact of international migration on sending regions is far from straightforward. In this article, I analyze migrant communities of origin in rural Bolivia as dynamic places that are constantly reproduced through connections with other places. I document the movement of migrant practices between Washington D.C. and Cochabamba and the influence of monetary and non-monetary flows on Bolivian cultural practices, politics, and development. I demonstrate how hometown associations and returning migrants have transferred organizational practices and political ideas about development from the United States to rural Bolivia. In addition, I explore migration’s role in struggles over belonging in Cochabamba, focusing on the efforts by migrants in Washington D.C. to stake their claim through transnational houses and collective remittance projects and on recent internal migration from other regions in Bolivia. Finally, I assess the sustainability of migrant-led development in Cochabamba. Although collaboration with migrants can strengthen the local state by providing more resources, it conditions the type of development that can take place and has yet to provide adequate opportunities for returning migrants or young people in rural Bolivia.
Key words: development; social remittances; migrant transnationalism; citizenship; Bolivia
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.8
|
Inorganic Arsenic Exposure and Children’s Neurodevelopment: A Review of the Evidence
David C. Bellinger
Abstract
Experimental studies suggest a myriad of mechanisms by which inorganic arsenic can interfere with central nervous system development, and, indeed, epidemiological studies published in the last dozen years suggest that exposure to arsenic impairs children’s cognitive development. Most of the studies have been conducted in developing countries (e.g., Bangladesh, India, Mexico), where exposure to arsenic is thought to be considerably higher than it is in developed countries. This review summarizes the results of these studies, focusing in particular on issues pertinent to risk assessment, including the existence of critical windows of vulnerability, characteristics of the dose-effect relationships (e.g., the lowest adverse effect level, the functional form), the most sensitive neurodevelopmental endpoints, and potential effect modifiers such as host characteristics (e.g., methylation efficiency, sex) and co-exposures to other neurotoxicants (e.g., lead, manganese). At present, the epidemiological data do not permit firm conclusions to be drawn regarding these issues. Several factors that complicate an effort to compare the results of studies are identified, including use of a variety of indices of external and internal exposure, and inconsistency in the measurement of important potential confounders for neurodevelopmental outcomes.
Key words: arsenic; children; neurodevelopment
| [Abstract-PDF]
|
[References]
|
3.4.10.2010.9
|
