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Open Access
Article
Publication date: 24 June 2022

Jean Grugel, Sarah C. Masefield and Alan Msosa

Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs…

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Abstract

Purpose

Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi’s EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of “health for all”.

Design/methodology/approach

This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic.

Findings

The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups.

Research limitations/implications

There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings.

Practical implications

Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Social implications

Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Originality/value

This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors’ knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs.

Details

International Journal of Human Rights in Healthcare, vol. 17 no. 1
Type: Research Article
ISSN: 2056-4902

Keywords

Content available
Book part
Publication date: 24 October 2018

Abstract

Details

Leadership and Power in International Development
Type: Book
ISBN: 978-1-78754-116-0

Content available

Abstract

Details

African Journal of Economic and Management Studies, vol. 7 no. 3
Type: Research Article
ISSN: 2040-0705

Keywords

Content available
Article
Publication date: 8 May 2017

Theo Gavrielides

393

Abstract

Details

International Journal of Human Rights in Healthcare, vol. 10 no. 2
Type: Research Article
ISSN: 2056-4902

Content available

Abstract

Details

Disaster Prevention and Management, vol. 22 no. 1
Type: Research Article
ISSN: 0965-3562

Open Access
Article
Publication date: 27 July 2018

Amy V. Benstead, Linda C. Hendry and Mark Stevenson

The purpose of this paper is to investigate how horizontal collaboration aids organisations in responding to modern slavery legislation and in gaining a socially sustainable…

9554

Abstract

Purpose

The purpose of this paper is to investigate how horizontal collaboration aids organisations in responding to modern slavery legislation and in gaining a socially sustainable competitive advantage.

Design/methodology/approach

Action research has been conducted in the textiles and fashion industry and a relational perspective adopted to interpret five collaborative initiatives taken to tackle modern slavery (e.g. joint training and supplier audits). The primary engagement has been with a multi-billion pound turnover company and its collaborations with 35 brands/retailers. A non-government organisation and a trade body have also participated.

Findings

Successful horizontal collaboration is dependent on both relational capital and effective (formal and informal) governance mechanisms. In collaborating, firms have generated relational rents and reduced costs creating a socially sustainable competitive advantage, as suggested by the relational perspective. Yet, limits to horizontal collaboration also exist.

Research limitations/implications

The focus is on one industry only, hence there is scope to extend the study to other industries or forms of collaboration taking place across industries.

Practical implications

Successful horizontal collaborative relationships rely on actors having a similar mindset and being able to decouple the commercial and sustainability agendas, especially when direct competitors are involved. Further, working with non-business actors can facilitate collaboration and provide knowledge and resources important for overcoming the uncertainty that is manifest when responding to new legislation.

Social implications

Social sustainability improvements aim to enhance ethical trade and benefit vulnerable workers.

Originality/value

Prior literature has focussed on vertical collaboration with few prior studies of horizontal collaboration, particularly in a socially sustainable supply chain context. Moreover, there has been limited research into modern slavery from a supply chain perspective. Both successful and unsuccessful initiatives are studied, providing insights into (in)effective collaboration.

Details

International Journal of Operations & Production Management, vol. 38 no. 12
Type: Research Article
ISSN: 0144-3577

Keywords

Content available
Book part
Publication date: 24 October 2018

Abstract

Details

Leadership and Power in International Development
Type: Book
ISBN: 978-1-78754-116-0

Content available
Book part
Publication date: 23 April 2018

Abstract

Details

Leadership and Public Sector Reform in Asia
Type: Book
ISBN: 978-1-78743-309-0

Open Access
Article
Publication date: 16 April 2024

Khandakar Al Farid Uddin, Abdur Rahman, Md. Robiul Islam and Mohashina Parvin

Decentralised administrative arrangements and the active function of local government organisations are essential to tackle crisis effectively. Using Bangladesh as a case study…

Abstract

Purpose

Decentralised administrative arrangements and the active function of local government organisations are essential to tackle crisis effectively. Using Bangladesh as a case study, this paper examines the central and local government administrative arrangements during COVID-19 pandemic.

Design/methodology/approach

This study applies qualitative content analysis and interviews to explore the local government’s role in Bangladesh’s COVID-19 management by interviews of 18 participants including government officials, experts, non-government organisations (NGOs) representatives, and the general public. This paper also analysed academic papers, policy documents and other publicly available documents, including newspaper reports.

Findings

The Constitution of Bangladesh intensified the active participation of local government in each administrative unit through decentralised administrative management. This paper however reveals that the administrative arrangement during the COVID-19 pandemic in Bangladesh was primarily a centrally led system. The local government was not sufficiently involved, nor had it integrated into the planning and coordination process. This indicated the absence of active decentralised administration.

Originality/value

This study fills the research gap of the administrative pattern and local relations in COVID-19 management by exploring the local government’s role during the catastrophic situation and highlights the importance of decentralised administrative actions in managing the crisis.

Details

Public Administration and Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1727-2645

Keywords

Open Access
Article
Publication date: 15 June 2021

Arju Afrin Kathy and Mohammed Norul Alam

Groundwater resources are the primary source of meeting the water demand in Bangladesh. In rural areas, hand-pumped tube wells have been the primary source of drinking water…

Abstract

Groundwater resources are the primary source of meeting the water demand in Bangladesh. In rural areas, hand-pumped tube wells have been the primary source of drinking water. Though studies claim that Bangladesh has the potential to achieve universal safe drinking water supply coverage, the presence of excessive arsenic in the shallow groundwater sources, and the encroachment of salinity in the coastal aquifers in coastal regions (Satkhira, Khulna, Bagerhat, Patuakhali, Jhalakathi, Pirojpur, Barisal, Barguna etc.) hind the path. The concerned authorities of government and other non-government organizations assist the coastal people with alternative technologies like Desalination Plant, Arsenic-Iron Removal Plant, Pond Sand Filtration (PSF), Managed Aquifer Recharge, Rainwater Harvesting System, Installation of Shallow, and Deep Tube Wells. But based on case studies and surveys, this article shows how these existing technologies fail to ensure water safety within the coastal areas. The Singaporean water management policy is an example, this article advocates for necessary government intervention to ensure safe drinking water in coastal areas.

Details

Southeast Asia: A Multidisciplinary Journal, vol. 21 no. 1
Type: Research Article
ISSN: 1819-5091

Keywords

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