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Public Health; Leadership; Organisational Development; Organisational Behaviour; Public Administration Management.

Postgraduate level for honours or masters programmes in courses on public health; executive leadership and management programmes; MBA level.

The case unpacks decentralisation as a means to promote and improve local decision-making and accountability through community participation and engagements. Ayanda Nkele was a programme manager in a health district in South Africa. He was faced with many challenges when trying to implement his programme, most of which were related to local authority, responsibilities and decision-making abilities at his level. This case describes briefly the South African health system. and how it functions. It describes the proposed changes to the health system and its transformation towards Universal Health Coverage. The decision space analysis as discussed in the case illustrates the types of decentralisation in the country and how this also applies to Nkele’s level.

Understanding the concepts and principles of decentralisation within the context of strengthening district health services, the re-engineering of primary health care (PHC) and rolling out a National Health Insurance in South Africa. Applying the “decision space” approach to analyse the extent of decentralisation. Grasping the requirement of leaders to be “contextually intelligent” and identify the important contextual variables to take into account when analysing public health care.

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CSS 7: Management Science.

This paper aims to examine links between women's access to micro‐finance and how they use maternal healthcare services in sub‐Saharan Africa (SSA).

The authors use theoretical and empirical literature to propose a framework to sustain and improve women's access to maternal healthcare services through micro‐financing.

It is found that improved access to micro‐finance by women, combined with education may enhance maternal health service uptake.

The paper does not consider empirical data in the analysis. The authors advocate empirically testing the framework proposed in other SSA countries.

It is important to empower women by facilitating their access to education and micro‐finance. This has implications for improving maternal healthcare utilization in SSA.

The paper moves beyond poor access to maternal health services in SSA and proposes a framework for providing sustainable solutions.

Contrasts the ideology of “productionism” with the rising importance of people‐oriented work (“reproduction”) and the struggle for equal gender status. Examines economic factors that discriminate against reproduction and women’s activities, and explores ways to overcome these barriers to equality.

Although the information needs of women receiving antenatal and postnatal care are well understood, few studies have examined the use of information by minority ethnic women. This paper describes a pilot study that aimed to identify the main maternity information sources used by Somali women living in a northern city in the UK. The study described here utilised unstructured exploratory focus group and semi‐structured interviews with Somali women. All discussions and interviews were audiotaped, translated and transcribed in their entirety and then analysed using a variation of the theme analysis method. Sources of information emerged as a sub‐theme from the data. Women sought and used information from several interpersonal sources. Many were dependent on general practitioners and health visitors for maternity information, although participants favoured community health forums addressed by health professionals. Women also sought maternity information from friends and neighbours. Interpersonal sources as a whole were viewed as having a number of advantages. Informal sources in particular were perceived as being approachable and providing a means through which further information could be sought, while each information source was also evaluated according to specific criteria. The implications of these findings for minority ethnic women are discussed and recommendations for further research are outlined.

Explains the problems disabled women have with the obstacles they must overcome to “cliff jump”. Focuses on the research literature, pointing out that much of this has been oppressive. Argues that the research reinforces on those with disabilities that the differences they face are the results of their individual limitations or inadequacies rather than the limitations of society. Covers areas such as attitude, education, health care, abuse, information and empowerment.

The purpose of this paper is to describe and discuss policy analysis in Nepal and review the wide range of choices feasible in decentralisation decision making.

In this paper an iterative qualitative method was developed and used in the research, which consisted of focus group interviews, key informant interviews, document analysis, including descriptive statistics, and analysis of the policy context. Participants in the research reflected the urban/rural mix of districts and the geography of Nepal. Analysis combined transcribed interviews with findings from document searches and analysis of the policy context. Coding was pre‐determined during the training workshop and further codes were generated during and after the fieldwork.

The paper finds that Nepal is in the process of decentralising public services from the central level to the local level, particularly to local bodies: District Development Committees (DDCs), Village Development Committees (VDCs) and Municipalities. Key contextual factors referred to are the overall structure of decentralisation, the social context of poverty and the political instability leading to a fluid political situation characterised by political tension, armed conflict, controversies and agreements while carrying out the research. The key issues identified and discussed in the paper are the policy process leading to decentralisation, the organisational structure and tension in the proposed system, the systems of resource generation, allocation, planning and management and lastly the forms of accountability, participation, public‐private relations and collaborative strategies.

The paper discusses the challenges faced in conducting such a policy analysis, the broad ranging and unremitting nature of the decentralisation process, and the contextual setting of the process of change.

This chapter provides a comprehensive exploration of the pivotal role of family planning in advancing sustainable development goals (SDGs). It elucidates the intrinsic connection between family planning and sustainable development, scrutinizes the harmonization of family planning initiatives with SDG targets and indicators, gleans insights from global approaches, and identifies formidable challenges, with a particular focus on marginalized communities. This chapter culminates with a set of substantial recommendations aimed at surmounting these challenges and propelling SDG attainment through the prism of family planning.

This study aims to estimate the degree and nature of socioeconomic-related inequalities in sexual and reproductive health in Ghana and further assesses causes of these inequalities using decomposition technique. The authors assess the contribution of personal characteristics of the woman including access to health information and health seeking behaviours, household and locational characteristics to inequalities in sexual and reproductive health in Ghana. The study uses data from the three rounds of the Ghana Demographic and Health Survey conducted in 2003, 2008 and 2014.

Two indicators – use of modern contraceptives and intention to use modern contraceptives – are used to measure sexual and reproductive health of sexually active women. A wealth index, based on household ownership of assets, consumer goods and living conditions, is used as a measure of socioeconomic status. The paper estimates a concentration index to the relationship between cumulative health and socioeconomic rank. Paper procedures to apply decomposition techniques to determine the causes of socioeconomic inequalities in health based on a linear health regression model.

The study finds evidence of varying degrees of socioeconomic-related inequalities in sexual and reproductive health indicators. Specifically, the study finds that whilst use of modern contraceptives was concentrated among women in households with high socioeconomic status in 2003 and 2008, modern contraceptive use was prevalent among women in low socioeconomic status households in 2014. Equally, the study finds significant pro-poor inequalities in the intentions to use modern contraceptives in 2003 and 2014. The degree of socioeconomic inequalities in the intentions to use modern contraceptives increased between 2003 and 2014.

There is the lack of evidence on the degree, nature and causes of socioeconomic-related inequalities, which in tend impedes the design and implementation of sexual and reproductive health policies targeted at vulnerable and under-served populations. In addition, there is the need to study inequalities in health over time to monitor progress of health delivery systems towards equitable and universal coverage and understand the evolution of the determinants.

The central objective of this chapter is to develop a theoretical reading of the international and contemporary discourse of reproductive rights. My hope is that the perspective and analytical proposal set forth represent a contribution to the expansion and consolidation of the field of study, and renders useful for the analysis and evaluation of the situation of reproductive rights within national contexts.

This chapter discusses various aspects of family planning initiatives on a global scale, with a specific focus on their influence in Asian contexts, including Bangladesh. This chapter examines the diverse range of family planning programs and policies implemented worldwide, in Asia and Bangladesh considering cultural factors that significantly shape family planning decisions. By highlighting the unique approaches and challenges faced in different regions, it provides valuable insights into the evolving landscape of family planning efforts and their impact on population dynamics.