Cet ouvrage suit l'évolution et examine la gestion de la réforme
du système de santé du Nouveau-Brunswick lancée en 2008.
Le cadre théorique de la première partie propose un éclairage
inédit sur les ...dynamiques ayant pu moduler la réforme d'un système
public de santé. La partie suivante brosse un tableau de la
prestation des services et des soins de santé au Nouveau-Brunswick,
depuis l'après-Seconde Guerre mondiale jusqu'à maintenant, et en
tire des leçons utiles à l'élaboration et à la mise en œuvre de
réformes éventuelles dans d'autres provinces canadiennes. La
dernière partie présente un constat, à savoir qu'il importe pour
l'État de définir une finalité qui fasse consensus auprès des
principaux acteurs en interaction.
Les décideurs publics qui pensent entreprendre une réforme d'une
telle envergure, tout autant que les gestionnaires qui assurent la
mise en œuvre de plans de changement, trouveront en ce livre un
outil incontournable certain de susciter une réflexion nourrie.
Publié en français.
How to improve regional and local planning by applying a gender-sensitive analysis: examples from Sweden. Regional Studies. Regional development projects normally have gender-equality objectives, as ...these are recognized as one of the cornerstones of regional development. The success of gender-equality objectives is often analyzed by counting the number of men and women taking part in the projects. However, the extent to which this will enhance regional development is unclear and regional agents at a range of organizational levels express uncertainty about the most effective objectives and implementation measures. This paper proposes a way to assess the gender situation at the local level and, thus, to help enhance gender equality.
De-coding New Regionalism Scott, James W
2009, 20160513, 2009-01-01, 2016-05-13, 2016-05-18, 20090101
eBook
Bringing together comparative case studies from Central Europe and South America, this book focuses on 'new' regions - regions created as political projects of modernization and 're-scaling'. Through ...this approach it de-codes 'New Regionalism' in terms of its contributions to institutional change, while acknowledging its contested nature and contradictions. It questions whether these regions are merely a strategy of neo-liberal adjustment to changing political and economic conditions, or whether they are indicative of true reform, greater citizen participation and empowerment. It assesses whether these regions are really representing something new or whether they are a reconfiguration of traditional power relationships. It provides a timely critical analysis of 'region-building' and the extent to which national processes of decentralization and sub-national processes of regionalism can enhance the effectiveness and responsiveness of governance.
The social agenda of the European Union is shifting towards broad social initiatives that align social and economic objectives with the promotion of employment. This calls for an action framework ...that permits social dialogue and political deliberation to inform and complement legislative action at all levels. The debate, however, has been dominated by advocates of traditional welfare states. This book, to break out of this sterile stalemate, demonstrates how an employment-orientated social policy in Europe can develop from a new, different set of policy principles, specifically 'a capability approach'. Taking inspiration from the work of Amartya Sen, this book focuses on the effective freedom people need to achieve their goals in life and work. The result of ongoing collaboration between researchers and social actors, it will appeal to social scientists, students, policy-makers and all those concerned with the building of Europe.
Key Messages
Current per capita funding models have an urbanistic policy bias.
The concept of rurality is undertheorized for social planning purposes.
Four key characteristics define rural service ...barriers: travel time, travel modalities, jurisdictional divides, and per capita funding models.
One of the promises of the Canada Health Act is portability—the principle of equitable access to health services wherever you live. Services for young children in northern and rural communities are structured with a one‐size‐fits‐all funding model that inadvertently disadvantages lower population density areas. We use a socio‐cultural approach to explore the barriers to access to rural early childhood services. With data from two research projects that each covered diverse rural contexts, we focused on service providers’ and parents’ experiences in accessing early intervention and early development programs and services for children with typical development, and those with developmental delay and/or diagnosed disabilities. The results affirm the value of rural and small town life and provide information for developing a more effective rural service delivery model for families with children with typical and atypical development. We demonstrate the way providers and parents make rural services work through “relational functionality.” Parents and service providers rely on key community agents to help organize and innovate collaborative solutions to address lack of access to information, intermodal travel demands, and administrative divides. In short, we confirm an urbanistic policy bias in the per capita funding model.
Découvrir le parti pris urbain de la politique des services de la petite enfance en milieu rural : mise en place d'un cadre fonctionnel de la ruralité
La transférabilité est un des principes de la Loi canadienne sur la santé en vertu de laquelle l'accès équitable aux services de santé est garanti, peu importe le lieu de résidence. Les services offerts aux jeunes enfants dans les collectivités rurales et du Nord sont conçus selon une approche universelle de financement de type invariable qui désavantage par inadvertance les zones de faible densité. Une exploration des contraintes aux services de la petite enfance en milieu rural est menée dans une perspective socioculturelle. En partant des données obtenues de deux projets de recherche qui portaient sur un ensemble de régions rurales, nous avons sondé des fournisseurs de services et des parents sur leurs expériences de l'accès aux programmes d'intervention précoce et de développement précoce et aux services pour les enfants présentant un développement typique, un retard de développement, ou ayant un diagnostic d'incapacité. Les résultats montrent que la vie rurale et dans les petites communautés est un atout. Ils apportent un éclairage permettant d'élaborer un modèle de prestation de services en milieu rural plus efficace pour les familles ayant des enfants présentant un développement typique ou atypique. Ils démontrent l'importance de la « fonctionnalité relationnelle » entre les fournisseurs de services ruraux et les parents. On note que les parents et les fournisseurs de services comptent sur le soutien des principaux intervenants communautaires dans l'élaboration de solutions collaboratives novatrices visant à pallier le manque d'accès à l'information, répondre aux demandes de transport intermodal et dépasser les clivages administratifs. Bref, cet article démontre que la politique de répartition du financement selon le nombre d'habitants comporte un parti pris urbain.
Objectives
To show the utility of combining routinely collected data with geographic location using a Geographic Information System (GIS) in order to facilitate a data‐driven approach to identifying ...potential gaps in access to emergency obstetric care within a rural Rwandan health district.
Methods
Total expected births in 2009 at sub‐district levels were estimated using community health worker collected population data. Clinical data were extracted from birth registries at eight health centres (HCs) and the district hospital (DH). C‐section rates as a proportion of total expected births were mapped by cell. Peri‐partum foetal mortality rates per facility‐based births, as well as the rate of uterine rupture as an indication for C‐section, were compared between areas of low and high C‐section rates.
Results
The lowest C‐section rates were found in the more remote part of the hospital catchment area. The sector with significantly lower C‐section rates had significantly higher facility‐based peri‐partum foetal mortality and incidence of uterine rupture than the sector with the highest C‐section rates (P < 0.034).
Conclusions
This simple approach for geographic monitoring and evaluation leveraging existing health service and GIS data facilitated evidence‐based decision making and represents a feasible approach to further strengthen local data‐driven decisions for resource allocation and quality improvement.
ObjectifsMontrer l'utilité de combiner les données recueillies en routine et la situation géographique à l'aide d'un Système d'Information Géographique (SIG), afin de faciliter une approche guidée par les données, pour déceler les éventuelles lacunes dans l'accès aux soins obstétricaux d'urgence dans un district rural de santé rwandais.MéthodesLe total des naissances attendues pour 2009 à l’échelle des sous‐districts a été estimé à l'aide des données démographiques recueillies par les agents de santé communautaires. Les données cliniques ont été extraites des registres des naissances de 8 centres de santé et de l'hôpital du district. Les taux de césariennes par rapport au total des naissances attendues ont été cartographiés par secteurs. Les taux de mortalité fœtale péri‐partum par naissances dans un service ainsi que le taux de rupture utérine nécessitant une césarienne, ont été comparés entre les zones à taux élevé et bas de césarienne.RésultatsLes plus bas taux de césariennes ont été trouvés dans la partie la plus éloignée de la zone desservie par l'hôpital. Le secteur ayant des taux significativement plus faibles de césariennes avait une mortalité fœtale péri‐partum et une incidence de rupture utérine significativement plus élevées dans un service que le secteur avec les taux de césarienne plus élevés (P < 0,034).ConclusionsCette approche simple pour le suivi et l’évaluation géographique s'appuyant sur les services de santé existants et des données SIG a facilité la prise de décision fondée sur des preuves et représente une approche possible pour renforcer les décisions locales guidées par les données pour l'allocation des ressources et l'amélioration de la qualité.
ObjetivosDemostrar la utilidad de combinar los datos recogidos de forma rutinaria con la localización geográfica obtenida utilizando un Sistema de Información Geográfico (SIG), para facilitar un sistema basado en datos que identifique potenciales brechas en el acceso a los cuidados obstétricos de emergencia en un distrito sanitario de una zona rural de Ruanda.MétodosSe calculó el número total de nacimientos esperados a nivel subdistrital en el 2009 utilizando datos poblacionales recogidos por trabajadores sanitarios comunitarios. Los datos clínicos se tomaron de los registros de nacimientos de 8 centros sanitarios y el hospital distrital. Se realizó un mapa por célula de las tasas de cesáreas como proporción del total de nacimientos esperados. Se compararon las tasas de mortalidad fetal durante el periparto de los nacimientos ocurridos en centros sanitarios, al igual que la tasa de rupturas uterinas como indicación de cesárea, de las áreas con tasas bajas y con tasas altas de cesáreas.ResultadosLas tasas de cesáreas más bajas se encontraron en las partes más remotas del área de influencia del hospital. El sector con tasas de cesáreas significativamente más bajas tenía una mortalidad fetal ocurrida durante el periparto y en centros sanitarios significativamente más alta, así como una incidencia de rupturas uterinas significativamente más alta que el sector con las tasas de cesáreas más altas (P < 0.034).ConclusionesEsta aproximación simple de monitorización geográfica y evaluación, que maximiza los datos existentes en servicios sanitarios y del SIG, facilita la toma de decisiones basada en evidencias y representa un enfoque factible, que fortalece la toma de decisiones apoyada en datos para la distribución de recursos y una mejora de la calidad.
As we move further into the 21st century, the prominence of regions can no longer be taken for granted. A certain skepticism has developed with regard to the feasibility of marginal regions achieving ...self-sustained growth and states have maintained their role as regulators of economic and social activities. Thus, the notion of the region and its significance is currently much debated and contested. Illustrated with a wide range of European case studies, this volume brings together the main strands of these contestations, as economic, political and social actors attempt to institutionalise their vision of their region as the dominant form of territorial governance. It questions both the external delimitation and the internal constitution of regions and critically analyses the societal processes circumscribing ways in which regions are created, maintained and undermined. The volume provides a wide range of analytical perspectives to enable an understanding of the current mosaic of regionalism in Europe.
Contents: Introduction: regional contestations, Henrik Halkier, Iwona Sagan. Actors, Networks and the Production of Regions: Regional policy contested: political discourse, institutions and the transformation of the Scottish Development Agency, Henrik Halkier; Multi level governance and civil society: the third sector in the design and delivery of EU Regional Policy, Harvey W. Armstrong, Peter Wells; Shared leadership and dynamic capabilities in regional development, Markku Sotarauta; Regional business associations, representation and regional governance: the Engineering Employers' Federation Northern Association in North East England, Liz Dixon. Regional Governance: Territory and Institutions: Regional spaces, spaces of regionalism: territory, insurgent politics, and the English question, Martin Jones, Gordon MacLeod; Towards a new regionalism in Norway?, Oddbjørn Bukve; Europeanization towards new forms of regional governance in Greece, Panayiotis Getimis, Leeda Demetropoulou; Spatialities of regional transformation and the administrative spaces of the EU, Iwona Sagan, Roger Lee; Regional governance in industrial regions in Central and Eastern Europe: a Polish-Czech comparison, Martin Ferry, Irene McMaster. Contesting City Regions: Global competition and city regional governance in Europe, Tassilo Herrschel, Peter Newman; Uneven development, sustainability, and city-regionalism contested: English city-regions in the European context, Andrew E.G. Jonas, David C. Gibbs, Aidan While; Metropolitan governance and regionalism: the case of Lisbon, Carlos Nunes Silva, Stephen Syrett; Regional contestations: conclusions, Iwona Sagan, Henrik Halkier; Index.
Dr Iwona Sagan is based at the University of Gdansk in Poland. Dr Henrik Halkier is based at the University of Aalborg in Denmark.
Part of the popular Networked Cities series, Urban and Regional Technology Planning focuses on the practice of relational planning and the stimulation of local city-regional scale development ...planning in the context of the global knowledge economy and network society.
Designed to offer scholars, practitioners, and decision makers studies on the ways of cities, technologies, and multiple forms of urban movement intersect and create the contemporary urban environment, Kenneth Corey and Mark Wilson explore the dynamics of technology-induced change that is taking place within the context of the global knowledge economy and network society.
Examining first the knowledge economy itself, Wilson and Corey go on to discuss its implications before proposing ways to strategize for future intelligent development, with particular emphasis on the ALERT model for regional and local planning.
An important read for those practicing or studying planning in this network society.
Kenneth Corey is Professor in the Department of Geography and the Urban and Regional Planning Program of Michigan State University.
Mark Wilson is Associate Professor in the Urban and Regional Planning Program of the School of Planning, Design and Construction and the Department of Geography at Michigan State University and also serves as a research economist with the Institute for Public Policy and Social Research at MSU.
Introduction Part 1: Change Part 2: Concepts Part 3: Context Part 4: ALERT: A Model for Regional and Local Planning Part 4: Support Bibliography Index
'Corey and Wilson offer some useful provocative thinking on current urban and, especially, regional development planning, and they provide planning practitioners with an open and versatile framework for action ... a refreshing and inspiring read.' – Planning Practice and Research
'It has the drive and the conciseness of a manifesto ... and as such it is fairly convincing. It effectively shows the increasing variety of scales and issues planners have to deal with today, and it provides a framework for analysing these and structuring consequent action.' – Planning Practice and Research
Bański J. Dilemmas for regional development in the concepts seeking to develop Poland's spatial structure, Regional Studies. Post-War Poland has seen work done on three spatial development concepts. ...The first - from the late 1940s - had as its task the decentralization of industry and the strengthening of regions whose development had been lagging behind. The second - drawn up in the 1970s - promoted the system of moderate polycentric concentration and a shifting of part of the country's industrial potential to more weakly developed areas. In turn, the third concept - from the 1990s - again concentrated on balancing regional development, albeit through the idea of priority being assigned to efficiency over equality. The aim of this paper was to analyse the aforesaid three concepts as regards the approach taken to the evening out of regional development. The primary thesis here is that the concepts studied strived in their various different ways to reduce regional disparities, but never actually had the ideas they came up with put into effect properly.
L’information sanitaire est indispensable pour le suivi des progrès accomplis dans l’amélioration et le maintien de la santé des populations et le fonctionnement du système de santé. Dans le contexte ...des réformes de santé, visant à rapprocher les systèmes de santé au plus près des populations et dans le but de planifier de façon cohérente les services à l’échelle des communautés, la question de l’accès à des données sociosanitaires fiables constitue un enjeu majeur. Le besoin de développement d’outils de traitement spécifique et l’appropriation des résultats par la diversité des acteurs concernés (décideurs, planificateurs, chercheurs et consommateurs) forment la trame des interventions et des échanges du symposium.
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