Trends in rural fiscal decentralisation in India’s Karnataka state: a focus on public health

For decades, decentralisation reforms have been seen as a powerful instrument by health policy advocates to improve health sector performance in developing countries. In India, the 73rd Constitutional Amendment introduced in 1992 called for strengthening the fiscal autonomy and service delivery capacity of rural local governments. This paper explores how decentralised governance influences public health sector resource allocation, equity and efficiency in rural Karnataka. For this, the authors analysed administrative data published by the Karnataka state government to create tailored standardised performance measures that capture the degree of local governments’ fiscal discretion in implementing public health programmes from 2011–18 at the district level. The findings highlight sector-specific differences in fiscal autonomy, ranging from high local discretion over funds in the nutrition sector to very limited discretion in the medical and public health sector. They also show that decentralised public health funding is not well-targeted to areas of greatest need in Karnataka

Tracing divergence in crisis governance: responses to the COVID-19 pandemic in France, Germany and Sweden compared

This cross-country comparison of administrative responses to the COVID-19 pandemic in France, Germany and Sweden is aimed at exploring how institutional contexts and administrative cultures have shaped strategies of problem-solving and governance modes during the pandemic, and to what extent the crisis has been used for opportunity management. The article shows that in France, the central government reacted determinedly and hierarchically, with tough containment measures. By contrast, the response in Germany was characterized by an initial bottom-up approach that gave way to remarkable federal unity in the further course of the crisis, followed again by a return to regional variance and local discretion. In Sweden, there was a continuation of ‘normal governance’ and a strategy of relying on voluntary compliance largely based on recommendations and less – as in Germany and France – on a strategy of imposing legally binding regulations. The comparative analysis also reveals that relevant stakeholders in all three countries have used the crisis as an opportunity for changes in the institutional settings and administrative procedures. Points for practitioners COVID-19 has shown that national political and administrative standard operating procedures in preparation for crises are, at best, partially helpful. Notwithstanding the fact that dealing with the unpredictable is a necessary part of crisis management, a need to further improve the institutional preparedness for pandemic crises in all three countries examined here has also become clear. This should be done particularly by way of shifting resources to the health and care sectors, strengthening the decentralized management of health emergencies, stocking and/or self-producing protection material, assessing the effects of crisis measures, and opening the scientific discourse to broader arenas of experts.

Challenges to a Rights-Based Approach in Sexual Health Policy: A Comparative Study of Turkey and England

Politics around sexual health have been polarised in recent years, but the policy implications of this polarisation have not yet been examined in depth. Therefore, this article explores political challenges to a rights-based approach in sexual health policies in Turkey and England. Its focus is on two domains: The prevention and treatment of sexually transmitted infections (STI), and sexual health education. Drawing on an interpretive documentary analysis, this article reveals that although social attitudes to sexuality and the levels of overall alignment with a rights-based framework within the selected countries do differ, both face significant political challenges in putting a rights-based approach to sexual health into practice. While common political challenges include heightened domestic controversy regarding sexual health, the specific challenges take the forms of a broader conservative turn that undermines the autonomy of sexual health policy in Turkey (similar to the cases of Hungary and Poland), and neoliberal policy preferences coupled with local discretion and service fragmentation that create access inequities in England (similar to the case of Germany). This study concludes that implementing a rights-based approach is a complex political task requiring a nuanced approach that incorporates the political dimension.

Changes of Local Functions and Local Powers in Lithuania 1994–2016

The interconnection of functions and powers at local level in Lithuania during the period of 1994-2016 is analysed in the article. Using the quantitative capacity methodological approach, the authors provide a novel research model based on the analysis of legal documents and statistical data. The analysis of legal documents, mainly the Law on Local Self-Government (1994) and its amendments, reveal the constant growth of local functions since the beginning of the period. However, the substantial part of the state’s delegated functions in the total of the local functions is the first indicator of the ruling influence of state on local government. To prove the limited capacities of local governments the indicators disclosing functional responsibilities and local discretion are calculated. Several trends reveal as the results of these calculations: (i) the steady trend of the deficit of the local budgets, meaning that municipalities have or to increase their debts, or to provide less services, or to provide services of less quality; (ii) the immutably small trend of local expenditures as the part of total general government expenditures and as the part of the GDP, meaning the stagnancy in the growth of functional responsibilities and low level of fiscal decentralization; (iii) the constant trend of significant state’s subsidies, meaning the constrained local discretion. These calculations prove that the increase of functional responsibilities at local level has not been accompanied by the increase of discretion, thus, the main conclusion of the research is that powers of local governments in Lithuania remain constrained despite the increase of functions.DOI: http://dx.doi.org/10.5755/j01.ppaa.17.3.21955

Prologue

In this prologue, the author reflects on the process of updating in 2005 the United Nations Set of Principles for the Protection and Promotion of Human Rights Through Action to Combat Impunity (‘The Principles’). The author, who drafted the report that accompanied the Updated Principles, discusses the challenges involved in her work as well as the factors that were taken into consideration in the preparation of the report. The Principles, first conceived in 1997, serve two fundamentally different functions: first, as a classic soft law instrument and second, as ‘standards drawn from experience’ that could serve ‘as a broad strategic framework for action against impunity’. As a source of practical guidance derived from ‘best practices’, the Principles seek to honor local agency, reflecting in particular the perspectives of victims. They also recognize the elemental importance of clarifying where local discretion ends and legal obligation begins.

The governance of poverty: Welfare reform, activation policies, and social assistance benefits and caseloads in Nordic countries

Social assistance benefits are the last resort in national social protection systems, and decentralizing reforms leading to increasing local discretion over implementation of national legislation was an international trend frequently referred to as devolution. More recent reforms have instead often implied recentralization and/or involved mandatory institutional cooperation between welfare agencies located at different hierarchical levels. In contrast to North America, there is little European evidence on the extent to which shifting responsibilities influence benefit levels and benefit receipt. Using individual level register data from Denmark, Finland, Norway and Sweden and applying a difference-in-difference approach, we link changes in legislation to changes in municipal benefits as well as caseloads during the period 1990–2010. We only find indications of reform effects linked to distinct benefit centralization, concluding that other reforms were too insubstantial to have an impact. Combined with earlier evidence, this suggests that in order to have an impact, welfare reform requires marked changes in authority.