•We evaluate possibilities for restitutive land justice in Myanmar following the political transition that began in 2011.•Competing groups of actors deploy the concepts of legality and legitimacy to ...advocate for and against land restitution.•Myanmar’s transition has created an opening for members of rural communities to challenge the state’s conception of legality.•Progress toward land restitution has been slow and partial, reflecting the messy complexity of contestation over land.
Land reforms, which include restitution and redistribution of land, often accompany political transitions, as new regimes attempt to break with the past by establishing new modes of governance. The political transition that began in Myanmar in 2011 provides one such example. In Myanmar’s ‘rice bowl’, the Ayeyarwady Delta, widespread land confiscations during the 1990s and 2000s facilitated the establishment of large fish farms, often at the expense of smallholder cultivators who worked agricultural lands without formal use rights. Reforms initiated in 2011 appeared to offer the prospect of restitutive land justice for rural households affected by land confiscation, but this promise has been slow to materialize. Drawing on fieldwork conducted in the Delta, this paper analyzes the narratives and strategies deployed by different groups of state and societal actors advocating for and against land restitution, focusing on the competing uses of two concepts: legality and legitimacy. In doing so, we explore how state-society relations in Myanmar have been reworked through these processes of contestation, and examine possibilities for, and limits to, progressive land reform during political transition.
Learning technologies have the potential to transform Higher Education, although multifaceted demands on staff time, confidence and training in using new technologies, and a lack of support can make ...this transformation difficult. The University of Huddersfield recently transitioned to a new virtual learning environment (VLE), which provided the opportunity to change the way staff view and use the new VLE for teaching and learning. As part of this project, three off-site retreats were run to help staff to reflect on and develop their teaching practice to better support student learning in the digital space and develop advanced online resources that support the democratisation of learning, close differential attainment gaps and give every student the best chance of success. Although much is written about different models of practice, there is a lack of theory and conceptualisation around changing practice. Examining the motivations and experiences of staff who participated provides insight into the challenges of implementing change on an institutional level, whilst examining their setup and design highlights ways to support staff during this process. Using participant feedback and experiences to underpin this research, we explore the immediate and ongoing outcomes of these off-site retreats to help transform the University’s approach to technology-enhanced learning.
This article presents a description and preliminary evaluation of a nationwide initiative by the Veterans Health Administration (VHA) called Civility, Respect, and Engagement in the Workforce (CREW). ...The goal of CREW is to increase workplace civility as assessed by employee ratings of interpersonal climate in workgroups. Once endorsed by the VHA leadership and adopted by the leaders of particular VHA hospitals, CREW was conducted by local facility coordinators who were trained and supported by the VHA National Center for Organization Development. This article explains the conceptual and operational background of CREW and the approach used to implement the initiative, presents results from two CREW administrations with a total of 23 sites, and reports significant preintervention to postintervention changes in civility at intervention sites as compared to no significant changes at comparison sites within each administration. It discusses these findings in the conceptual (theoretical) and operational (intervention evaluation) context of interventions targeting civility.
Growing Up Our Way Kruske, Sue; Belton, Suzanne; Wardaguga, Molly ...
Qualitative health research,
06/2012, Volume:
22, Issue:
6
Journal Article
Peer reviewed
In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child ...rearing, development, behavior, health, and well-being between each infant’s birth and first birthday. We found significant differences in parenting behaviors and child-rearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, neocolonialism, and medical hegemony, child-led parenting styles hamper the effectiveness of health services. Hence, until the planners of Australia’s health systems better understand Aboriginal knowledge systems and incorporate them into their planning, we can continue to expect the failure of government and health services among Aboriginal communities.
Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year ...collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia.
A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of 'out of hospital' or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated.
Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an 'outpatient' model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce 'system-introduced' risk.
Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents.
This study investigated the reasons for continued high rates of home births in rural Shanxi Province, northern China, despite a national programme designed to encourage hospital deliveries. We ...conducted semi-structured interviews with 30 home-birthing women in five rural counties and drew on hospital audit data, observations and interviews with local health workers from a larger study. Multiple barriers were identified, including economic and geographic factors and poor quality of maternity care. Women's main reasons for not having institutional births were financial difficulties (n=26); poor quality of antenatal care (n=13); transport problems (n=11); dissatisfaction with hospital care expressed as fear of being in hospital (n=10); convenience of being at home and continuity of care provided by traditional birth attendants (TBAs) (n=10); and belief that the birth would be normal (n=6). These barriers must all be overcome to improve access to and acceptability of hospital birth. To ensure that the national policy of improving the hospital birth rate is implemented effectively, the government needs to improve the quality of antenatal and delivery care, increase financial subsidies to reduce out-of-pocket payments, remove transport barriers, and where hospital birth is not available in remote areas, consider allowing skilled attendance at home on an outreach basis and integrate TBAs into the health system.
Cette étude a enquêté sur les raisons expliquant pourquoi la province rurale du Shanxi, en Chine septentrionale, continue d'enregistrer un taux élevé d'accouchements à domicile, malgré un programme national d'encouragement des naissances à l'hôpital. Nous avons mené des entretiens semi-structurés avec 30 femmes ayant accouché à domicile dans cinq comtés ruraux et avons utilisé les données des audits hospitaliers, les observations et les entretiens avec des agents de santé locaux réalisés dans le cadre d'une étude plus large. Nous avons identifié de multiples obstacles, notamment des facteurs économiques et géographiques, ainsi que la médiocrité des soins maternels. Les principales raisons décourageant les femmes d'accoucher en institution étaient les difficultés financières (n=26) ; la mauvaise qualité des soins prénatals (n=13) ; les problèmes de transport (n=11) ; l'insatisfaction quant aux soins hospitaliers exprimée comme peur de l'hospitalisation (n=10) ; la commodité d'être à la maison et la continuité des soins assurés par les accoucheuses traditionnelles (n=10) ; et la conviction que la naissance serait normale (n=6). Il faut surmonter tous ces obstacles pour améliorer l'accès à l'accouchement en milieu hospitalier et son acceptabilité. Afin de garantir une application efficace de leur politique nationale, les autorités doivent relever la qualité des soins prénatals et obstétricaux, augmenter les subventions financières pour réduire les frais à la charge des patientes, résoudre les difficultés de transport et, quand l'accouchement hospitalier n'est pas disponible dans les zones reculées, envisager d'autoriser une assistance qualifiée à domicile avec du personnel mobile et intégrer les accoucheuses traditionnelles dans le système de santé.
En este estudio se investigaron las razones por las cuales las tasas de partos domiciliarios continúan siendo altas en las zonas rurales de la Provincia de Shanxi, en China septentrional, a pesar de que existe un programa nacional creado para promover partos hospitalarios. Realizamos entrevistas semiestructuradas con 30 mujeres que tuvieron partos domiciliarios en cinco condados rurales, y obtuvimos datos de auditorías hospitalarias, observaciones y entrevistas con trabajadores de la salud de un estudio más amplio. Se identificaron múltiples barreras, como factores económicos y geográficos y la deficiente calidad de la atención materna. Las principales razones por las cuales las mujeres no tuvieron partos institucionales fueron dificultades financieras (n=26); calidad deficiente de la atención antenatal (n=13); problemas de transporte (n=11); insatisfacción con la atención hospitalaria expresada como miedo de estar en el hospital (n=10); conveniencia de estar en la casa y continuidad de la atención brindada por parteras tradicionales (n=10); y la creencia de que el parto sería normal (n=6). Se deben superar todas estas barreras para poder mejorar la accesibilidad y aceptación de los partos hospitalarios. Para asegurar una implementación eficaz de la política nacional de mejorar la tasa de partos hospitalarios, el gobierno debe mejorar la calidad de la atención antenatal y durante el parto, aumentar los subsidios financieros para reducir los pagos de las pacientes, eliminar las barreras de transporte y, en las zonas remotas donde el parto hospitalario no es posible, considerar permitir asistencia calificada en la casa, como extensión a la comunidad, e integrar a las parteras tradicionales en el sistema de salud.
to investigate the beliefs and practices of Aboriginal women who decline transfer to urban hospitals and remain in their remote community to give birth.
an ethnographic approach was used which ...included: the collection of birth histories and narratives, observation and participation in the community for 24 months, field notes, training and employment of an Aboriginal co-researcher, and consultation with and advice from a local reference group.
a remote Aboriginal community in the Northern Territory, Australia.
narratives were collected from seven Aboriginal women and five family members.
findings showed that women, through their previous experiences of standard care, appeared to make conscious decisions and choices about managing their subsequent pregnancies and births. Women took into account their health, the baby’s health, the care of their other children, and designated men with a helping role.
narratives described a breakdown of traditional birthing practices and high levels of non-compliance with health-system-recommended care.
standard care provided for women relocating for birth must be improved, and the provision of a primary maternity service in this particular community may allow Aboriginal Women’s Business roles and cultural obligations to be recognised and invigorated. International examples of primary birthing services in remote areas demonstrate that they can be safe alternatives to urban transfer for childbirth. A primary maternity service would provide a safer environment for the women who choose to avoid standard care.
This article presents a description and preliminary evaluation of a nationwide initiative by the Veterans Health Administration (VHA) called Civility, Respect, and Engagement in the Workforce (CREW). ...The goal of CREW is to increase workplace civility as assessed by employee ratings of interpersonal climate in workgroups. Once endorsed by the VHA leadership and adopted by the leaders of particular VHA hospitals, CREW was conducted by local facility coordinators who were trained and supported by the VHA National Center for Organization Development. This article explains the conceptual and operational background of CREW and the approach used to implement the initiative, presents results from two CREW administrations with a total of 23 sites, and reports significant preintervention to postintervention changes in civility at intervention sites as compared to no significant changes at comparison sites within each administration. It discusses these findings in the conceptual (theoretical) and operational (intervention evaluation) context of interventions targeting civility. Reprinted by permission of Sage Publications, Inc., copyright NTL Institute.
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