This chapter bridges cultural and political approaches to determine why elite support for movement claims may be inconsistent across the policy process. I analyze this question empirically through 16 ...in-depth interviews with government officials in two regions of Peru: Arequipa and Cusco. Regional officials appraised feminist advocacy in two opposing ways. First, they valued feminist advocates’ contributions to policy processes, which enabled them to advance reproductive rights and gender equity initiatives. They also perceived women as a group deserving of these initiatives and framed gender policies in terms of rights and equality. Second, they were critical of feminist advocates’ weaknesses in mobilizing support, which hindered the officials’ own ability to advance reproductive rights and gender equity initiatives. Furthermore, regional officials understood reproductive rights and gender equality to be thwarted by the State’s economic instrumentalism and by Catholic Church’s ultra-conservatism. This research shows how a cultural approach to policy elites’ support for movement claims goes beyond their individual attitudes and calculations to capture their perceptions, frames, and understandings tied to the broader cultural context. This wider conceptualization in turn helps clarify inconsistencies in policy elites’ support for movement claims across the policy process.
Inclusion of emergency contraception in national family planning programmes is consistent with international agreements that countries should strive to ensure access to a wide range of contraceptive ...methods and promote voluntary, informed choice. Yet in 2005, USAID/Peru requested that its NGO grantees in Peru take a “neutral” position on emergency contraception in activities or materials that involve its funds. For many decades, donor countries have viewed conservative religious forces in low-income countries as an obstacle to expanding family planning programmes. Today, however, far-right organisations in the United States are having an unprecedented influence on US public policy, including in countries such as Peru. This article analyses shifts in USAID/Peru's policy on emergency contraception in Peru since 1992. In Peru today, there is widespread official and public support for making emergency contraception available. Given USAID's long support for family planning internationally and in Peru, the current policy appears to be the result of attacks by US far-right organisations carried out in synergy with sympathetic US public officials and anti-choice Peruvian allies.
To compare the diagnostic interval for patients with colorectal cancer before and after the introduction of cancer patient pathways in northern Sweden.
A retrospective study comparing two cohorts ...(2012 and 2018) of patients diagnosed with colorectal cancer before and after the introduction of cancer patient pathways in 2016.
Three counties in northern Sweden with large sparsely populated areas and some cities (637143 residents ∼5.1 residents/km
2
).
Patients were included from the Swedish Cancer Register. Electronic health records reviews were performed and linked to socioeconomic data from Statistics Sweden.
Differences in the diagnostic intervals, the patient intervals and the characteristics associated with the longest diagnostic intervals and investigations starting at the emergency department.
The two cohorts included 411 patients in 2012 and 445 patients in 2018. The median diagnostic interval was reduced from 47 days (IQI 18-99) to 29 days (IQI 9-74) (p < 0.001) after the introduction of cancer patient pathways in general. Though for the cases of cancer in the right-side (ascended) colon, the reduction of the diagnostic interval was not observed and it remained associated with investigations starting at the emergency department.
Our results indicate that cancer patient pathways contributed to an improvement in the diagnostic interval for patients with colorectal cancer in general, yet not for patients with cancer in the right-side colon.
In general, cancer patient pathways seem to reduce the diagnostic interval for colorectal cancer but it is not a sufficient solution for all colorectal cancer localisations.
Key points
Diagnostic interval for colorectal cancer reduced in general, particularly for patients seeking primary healthcare, after the introduction of cancer patient pathways.
Patients with cancer in right-side colon still have long diagnostic intervals and mainly start their investigation through the emergency department.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
44.
Easier said than done Anticona, Cynthia; Coe, Anna-Britt; Bergdahl, Ingvar ...
BMC public health,
2013, Letnik:
13
Journal Article
Recenzirano
Odprti dostop
Background The renewed interest in community participation in health research is linked to its potential for bridging gaps between research and practice. Its main attributes are the generation of ...knowledge that can lead to socially robust, long-lasting solutions and the creation of a colearner relationship between researchers and research users. Following this philosophy, Ecohealth has evolved into a specialized framework for participatory research on the impact of pollution on ecosystems and human health. However, its principles pose considerable challenges. Its outcomes are strongly influenced by contextual factors that are impossible to control for ahead of time.
This paper describes how the Ecohealth principles were applied to an epidemiological study of heavy metals exposure among indigenous communities of the Peruvian Amazon. It illustrates how knowledge generated from participatory research does not necessarily imply solving a public health problem. This study aimed to contribute to the understanding of the benefits and barriers of following the basic principles of the Ecohealth approach, and assist researchers working in similar contexts.
Research process Based upon their personal experience as participant observers, the authors describe the research process; then, they discuss the most important challenges faced, their implications, and the attempted strategies for resolution.
Challenges Challenges were grouped into four themes: (1) building trust; (2) one partnership, many stakeholders, multiple agendas; (3) being a researcher; and (4) communicating complex and unexpected findings.
Conclusions Integrating the principles of transdisciplinarity and participation posed a series of challenges to the research process that were difficult, and sometimes impossible to overcome. However, positive outcomes from this experience were the lessons learned by the different actors. Despite the lack of immediate action, it is expected that useful interventions to prevent and control lead exposure in the Corrientes population will be implemented in the medium term.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In the 1990s, some segments of Latin American feminist movements shifted to advocacy strategies to influence government policies. Long-standing social movement theories predict that this tactical ...change to institutional means has two possible consequences for a movement: either it gains greater influence over policy arenas and becomes more effective in achieving outcomes, or it loses capacity to carry out protest tactics and becomes less effective in achieving outcomes. However, empirical studies on Latin American feminist organizations intervening in policies, and recent social movement theorizing, indicate that the relationship between social movements and policy influence is more complex. Moreover, these theories have been formulated based on empirical studies in contexts with established democratic frameworks and institutions. The study presented here employed Grounded Theory to examine inductively the research questions of how reproductive rights organizations carry out advocacy to influence government policies in Peru. Data was collected through participant observation and focus group discussions among two reproductive rights coalitions in the regions of Arequipa and Cusco. The findings indicate that the reproductive rights coalitions develop a multiplicity of interactions with government officials, as a means to influence policies through various channels and handle constraints on their ability to act as independent pressure groups. In addition, the findings show that the coalitions deal with a wide range of factors to influence policies: organizational capacity, advocacy strategies, issue frames, relationships with other policy actors as well as political and social aspects that facilitate or hinder advocacy. The study concludes that the relationship between social movements and policy influence is more complex than portrayed by long-standing theories. Instead, the findings are consistent with, and enhance the scholarship on Latin American feminist organizations involved in policies, as well as recent social movement theorizing that takes into account how various factors affect social movement influence on policies.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background: Despite evidence showing that adolescent-friendly health services (AFSs) increase young people's access to these services, health systems across the world are failing to integrate this ...approach.
In Latin America, policies aimed at strengthening AFS abound. However, such services are offered only in a limited number of sites, and providers' attitudes and respect for confidentiality have not been addressed to a sufficient extent.
Methods: The aim of this study was to explore the mechanisms that triggered the transformation of an 'ordinary' health care facility into an AFS in Ecuador. For this purpose, a realist evaluation approach was used in order to analyse three well-functioning AFSs. Information was gathered at the national level and from each of the settings including: (i) statistical information and unpublished reports; (ii) in-depth interviews and focus group discussions with policy makers, health care providers, users and adolescents participating in youth organisations and (iii) observations at the health care facilities. Thematic analysis was carried out, driven by the realist evaluation approach, namely exploring the connections between mechanisms, contexts and outcomes.
Results: The results highlighted that the development of the AFSs was mediated by four mechanisms: grounded self-confidence in trying new things, legitimacy, a transformative process and an integral approach to adolescents. Along this process, contextual factors at the national and institutional levels were further explored.
Conclusion: The Ministry of Health of Ecuador, based on the New Guidelines for Comprehensive Care of Adolescent Health, has started the scaling up of AFSs. Our research points towards the need to recognise and incorporate these mechanisms as part of the implementation strategy from the very beginning of the process.
Although contextually limited to Ecuador, many mechanisms and good practices in these AFS may be relevant to the Latin American setting and elsewhere.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Provider: - Institution: - Data provided by Europeana Collections-
With its origins in the early 1990s, feminist advocacy directed at influencing public policies is a relatively new phenomenon in ...Latin America that is commonly studied at the national level. The aim of this thesis was to study feminist advocacy on reproductive rights at the sub-national level in Peru. Specifically, it explored two research questions: how do feminist movements carry out advocacy to intervene with government agencies and what effects does their advocacy have on policies. This aim ties in with the body of literature that seeks to explain how and what outcomes are produced by social movements. Grounded Theory was used to collect and analyze empirical materials on two reproductive rights coalitions and their members in Arequipa and Cusco, Peru. Empirical materials consisted of focus group discussions, individual interviews and participant observation. Data analysis resulted in two core categories: Coalition-Government Interactions and Policy Outcomes. Linked to the core categories are thirteen categories, which constitute factors that the reproductive rights coalitions “deal with” or “strategize about” in order to interact with government officials and attain policy outcomes. The coalitions maneuver those factors they have immediate control over - tactics, organization, framing and emotions - as a means to deal with those factors they do not have immediate control over - relationships with other policy actors as well as political, cultural and social contexts. The findings help refine existing theories on how and what outcomes are attained by social movements. The coalitions and their members influence policies through various channels by developing an array of interactions with government officials. This allows the coalitions to handle potential constraints on their ability to be a critical voice. Political, cultural and social contexts are not the only external factors affecting the coalitions’ influence on policies. Another key external factor is their relationships with other policy actors comprised of a range of organized political and social groups. Concerning internal factors, the coalitions and their members rely on framing activities and emotion work in addition to organization and tactics. Indeed, the coalitions and their members engage in framing activities and emotion work by means of their relationships with other policy actors to influence policies. Finally, the coalitions perceive effects of their advocacy including, but not limited to, the modification of laws and policies. Instead, outcomes were identified along different stages of the policy process, including the impact of coalition frames on policy positions.
- Härtill 4 uppsatser- Diss. (sammanfattning) Umeå : Umeå universitet, 2010- Filosofie doktorsexamen- Doctor philosophiae- Doctor of Philosophy (PhD)- doctorat ès lettres- Norra Beteendevetarhuset HS1031, Umeå universitet, Umeå- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Studies of social movements have developed various frameworks to conceptualize social movement outcomes. These tools are largely based on empirical studies of advanced industrialized contexts and ...tend to differentiate between cultural & political outcomes. Latin American & feminist scholarship points not only to social movement outcomes absent from these tools but also to the interconnectedness of political & cultural outcomes. Rather than testing any one framework, this study used Grounded Theory to examine policy outcomes of reproductive rights advocacy in two regions of Peru, Arequipa & Cusco. Empirical materials were gathered through participant observation, focus group discussions and individual interviews among two reproductive rights coalitions during April & May 2007. The findings indicate that the coalitions experience both political & cultural outcomes in influencing policy processes. For example, access to decision-making arenas leads to changes in the political arena through the creation of new institutions & the inclusion of women from diverse positions as citizens. Further, coalition frames alter policy approaches to reproductive rights by expanding notions of rights to include the body & redefining women's role in society. By bridging the findings with existing scholarship, the study suggests ways to enhance the conceptualization of social movement outcomes.
The goal of ensuring women's access to contraceptive methods, emergency contraception and safe abortion may seem simple. Yet, in Peru, legislation on abortion remains highly restrictive: abortion is ...only permitted when the pregnancy threatens the women's life or health. In addition, women face tremendous socio-economic and geographical barriers to accessing these services due to discrimination based on gender, class and ethnicity. And the Catholic Church leadership strongly opposes reproductive rights and therefore actively seeks to block access to these services. The thesis describes how organizations and individual activists in the regions of Arequipa and Cuzco have contributed to the broader women's movement's struggle for reproductive rights since the 1980s. Initially, organizations and activists carried out training or popular education to low-income women's groups and government health care workers on contraceptives, fertility and the body. By the mid-1990s, they began to shift strategies to advocacy directed at influencing government policies because they found that women lacked legal protection for their rights and government workers lacked directives to back new practices. In 2001, Peru initiated decentralization processes which led to the election of regional governments, with both legislative and executive branches. Organizations and activists in both regions saw the need to coordinate and develop joint advocacy strategies in the form of coalitions, given that neither political parties nor civil society organizations were taking on reproductive rights in the new context for regional politics. The study further portrays how the reproductive rights coalitions carry out advocacy to influence policies and what effects their advocacy has on government policies. Among other things, the coalitions and their members engage in relationships with other policy actors including not only government decision-makers but also grassroots women's organizations, professional associations, the media and the general population as well as opponents, namely the Catholic Church leadership. Another aspect has been to develop frames that convey feminist ideals while reaching these other policy actors. For example, the coalitions are more likely to emphasize women's human rights, women's health and gender equality rather than women's right to control their body and sexual freedom. The coalitions' actions and strategies are embedded with emotions such as women's anger, pride and solidarity, and yet again, the coalitions adjust emotions according to their relationships with different policy actors. Adapted from the source document.
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