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561. The Health Financing Transition: A Conceptual Framework and Empirical Evidence

Author:
William Savedoff and Victoria Fan
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a "health financing transition" to provide a conceptual framework for understanding health markets and public policy. Using data over 1995-2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending - rising about 1 percent annually - which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends.
Topic:
Development, Economics, Health, and Governance
Political Geography:
United States

562. Peace and Stability in the Post-Conflict Era

Author:
Douglas Farah, Robert D. Lamb, and Carl Meacham
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
The project that culminated in this report was conceived just over a year ago as an initiative to assess the major accomplishments in strengthening the Colombian government's efforts to bring peace and stability to its countryside.
Topic:
Development, Economics, Terrorism, International Security, and Governance
Political Geography:
South America

563. Afghanistan after the Drawdown

Author:
Gerald F. Hyman
Publication Date:
04-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
In his 2013 State of the Union speech, President Barack Obama announced that by the end of 2014 "our war in Afghanistan will be over" and, a month earlier, that "by the end of next year, 2014, the transition will be complete—Afghans will have full responsibility for their security, and this war will come to a responsible end." The military transition, successful or not, is in full swing. Of course the war will not come to an end in 2014, responsible or otherwise. Even if the military drawdown goes as planned, "America's commitment to a unified and sovereign Afghanistan will endure, but the nature of our commitment will change," the president said. On the military side, our enduring commitment will focus on training, equipping, and funding the Afghan National Security Forces (ANSF) and "some counterterrorism efforts that allow us to pursue remnants of al Qaeda and their affiliates," presumably the Taliban. As the United States draws down, so too will the remaining coalition countries of the International Security Assistance Force (ISAF) under North Atlantic Treaty Organization (NATO) command.
Topic:
Security, Development, Economics, and Governance
Political Geography:
Afghanistan, United States, and South Asia

564. Myanmar's Military: Back to the Barracks?

Publication Date:
04-2014
Content Type:
Policy Brief
Institution:
International Crisis Group
Abstract:
Myanmar's military, the Tatmadaw, has been the dominant institution in the country for most of its post-independence history. After decades of military rule, it began the shift to a semi-civilian government. A new generation of leaders in the military and in government pushed the transition far further and much faster than anyone could have imagined. Major questions remain, however, about the Tatmadaw's intentions, its ongoing involvement in politics and the economy, and whether and within what timeframe it will accept to be brought under civilian control. Transforming from an all-powerful military to one that accepts democratic constraints on its power will be an enormous challenge.
Topic:
Governance and Reform
Political Geography:
East Asia, Asia, and Myanmar

565. South Sudan: A Civil War by Any Other Name

Publication Date:
04-2014
Content Type:
Working Paper
Institution:
International Crisis Group
Abstract:
On 15 December 2013 the world's newest state descended into civil war. Continuing fighting has displaced more than 1,000,000 and killed over 10,000 while a humanitarian crisis threatens many more. Both South Sudanese and the international community were ill-prepared to prevent or halt the conflict: the nation's closest allies did little to mediate leadership divisions within the Sudan Peoples' Liberation Movement's (SPLM). The SPLM and its army (SPLA) quickly split along divisions largely unaddressed from the independence war. Were it not for the intervention of Uganda and allied rebel and militia groups, the SPLA would likely not have been able to hold Juba or recapture lost territory. The war risks tearing the country further apart and is pulling in regional states. Resolving the conflict requires not a quick fix but sustained domestic and international commitment. Governance, including SPLM and SPLA reform and communal relations, must be on the table. Religious and community leaders, civil society and women are critical to this process and must not be excluded.
Topic:
Conflict Resolution, Human Rights, International Cooperation, and Governance
Political Geography:
Africa and South Sudan

566. The Indian Ocean Region: A Strategic Net Assessment

Author:
Anthony H. Cordesman and Abdullah Toukan
Publication Date:
04-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
This study examines the key strategic risks that shape the stability and security of the Indian Ocean Region or IOR. This means examining risks that cut across a vast span of territory that directly affects both the global economy and some 32 nations–some within the limits of the Indian Ocean, but others that play a critical role in shaping the security of the nations in the IOR region and the security of its sea lanes and petroleum exports.
Topic:
Development, Economics, and Governance
Political Geography:
India and Asia

567. Bedingungen nachhaltigen Handelns. Eine Fallstudie über die Implementierung eines landwirtschaftlichen Klimaanpassungsprogramms im bolivianischen Tiefland

Author:
Martin David
Publication Date:
01-2014
Content Type:
Working Paper
Institution:
Institute for Development and Peace
Abstract:
The adverse effects of climate change are a genuine risk for global food security. Especially the populations of low income countries are highly depending on the agricultural sector and so particularly vulnerable to the adverse effects of climate change. This paper evaluates a local program of adaptation to climate change in the Bolivian lowlands. The departmental government of Santa Cruz began a pilot-program to secure departmental food security and to acquire knowledge for the design of future politics of adaptation to climate change. In a Farmer Field School, implemented by a cooperating Nongovernmental Organisation, farmers were taught sustainable agricultural practices to make their crops more resistant against natural disasters, related to the effects of climate change. This theory-based cased study examines – using the method of fuzzy-set- Qualitative Comparative Analysis those conditions, which enabled and disabled the implementation of the program. It thus tries to shed light on the question, if transferred knowledge can lead to action. Based on this analysis recommendations are made for future designs of such types of cooperation.
Topic:
Agriculture, Climate Change, Food, and Governance
Political Geography:
South America

568. Die Global Governance des Wassers. Eine Untersuchung der Wasserpolitik und städtischen Versorgungslage in Uganda

Author:
Anne Siebert
Publication Date:
04-2014
Content Type:
Working Paper
Institution:
Institute for Development and Peace
Abstract:
Over the past decade, Uganda has developed strong water and sanitation sector reform policies grounded in a constitutional guarantee to the human right to water. This yielded not yet to comprehensive results in improvement of the supply situation. This Working Paper analyzes and critically evaluates this rights-based water reform process on global and national level to identify the context-specific conditions in Uganda for the successes and failures. It investigates the related policies in Uganda; and also has a look at formal and informal sectors of society. In particular, the paper asks whether and how human rights-based arrangements and strategies can serve as a model for addressing the urgent water sector challenges. Furthermore, the paper discusses how policy transfer, rights awareness, and community participation in context of water supply and sanitation might be influenced in a sustainable way.
Topic:
Human Rights, Water, and Governance
Political Geography:
Uganda and Africa

569. Amazonian policy and politics, 2003-13: deforestation, hydropower and biofuels

Author:
Eduardo Viola and Larissa Basso
Publication Date:
04-2014
Content Type:
Working Paper
Institution:
Norwegian Centre for Conflict Resolution
Abstract:
In the period 2003-13 Brazil experienced important economic and political developments: it became a much more relevant international player; its economy entered the world's top ten; and society became more politically active and expressed its complaints more aggressively. Amazonian policy and the politics of the period developed in this context, and three issues played a central role. Firstly, a cutback in deforestation led to a decrease in Brazil's carbon emissions by around one-third, which is a unique situation in the world. Secondly, despite the region's hydropower potential, projects developed slowly due to new environmental requirements and societal opposition. Thirdly, the production of biofuels was greatly encouraged by the introduction of flexible-fuel vehicles technology, but lost momentum after the discovery of offshore oil reserves; and there was a heated debate about the relationship between the expansion of sugar-cane plantations and deforestation after the decline in deforestation demonstrated that such plantations were not its main cause. Analysis indicates that there were three trends in Amazonian environmental policy and politics during the decade: continuity of former policies (2003-05), an upward trend towards sustainability (2005-10) and a downward trend (2010-13). The results of the 2014 elections are key to predicting future developments.
Topic:
Economics, Environment, Human Rights, Politics, and Governance
Political Geography:
Brazil and South America

570. Governance Transfer by the Economic Community of West African States (ECOWAS)

Author:
Christof Hartmann
Publication Date:
02-2014
Content Type:
Working Paper
Institution:
Collaborative Research Center (SFB) 700
Abstract:
In the early 1990s, ECOWAS already committed its member states to standards of democracy and human rights. The organization developed its framework for governance transfer primarily through its 1999 and 2001 protocols in the wake of democratization processes in its member states. Overall standards are more developed in the fields of (liberal) democracy and human rights than in the rule of law and good governance. ECOWAS's instruments for protecting democracy and human rights are far-reaching, allowing for sanctions and military interventions under the so-called 'Mechanism.' By comparison, there are few instruments to actively promote governance standards beyond election observation missions. In practice, ECOWAS has generally reacted to political crises and security threats in its member states with a mixture of diplomatic interventions, fact-finding missions, and (the threat of) sanctions. These measures were mostly carried out by individual member states and only loosely linked to regional rules and procedures.
Topic:
Political Violence, Economics, Human Rights, Regional Cooperation, and Governance
Political Geography:
Africa