The poor quality and effectiveness of much of government expenditure in India makes it important to analyze ways of improving effectiveness through institutional reform. Improvements in outcomes include better targeting of redistributive measures and more efficient spending on productive projects. Four potential areas of institutional reform are: (1) improved functioning of individual ministrie...

Nation-state restructuring has resulted in significant political, economic and social change in rural communities. One manifestation of this transformation has been the changing nature of local governance, characterised by the re-working of central-local relations and public-private responsibilities, such that local informal and voluntary sectors now play an active and direct role in the organi...

Epidemiologists and environmental health researchers have a joint responsibility to acquire scientific knowledge that matters to public health and to apply the knowledge gained in public health practice. We examine the nature and source of these social responsibilities, discuss a debate in the epidemiological literature on roles and responsibilities, and cite approaches to environmental justice...

OBJECTIVE To understand the establishment of bond in the construction of autonomy of the subjects who generate the practices of oral health in the Family Health Program. METHODOLOGICAL PROCEDURES A critical reflexive approach was undertaken in this qualitative study carried out in Alagoinhas (Northeastern Brazil). ANALYSIS OF RESULTS Interviewees taken care of by the oral health team of the...

Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people responsible by introducing measures that decrease their share of available resources. Introducing per...

OBJECTIVE To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health. METHODS We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent...

international health is still highly dominated by equilibrium approaches. the emergence of systems thinking in international health provides a great avenue to develop innovative health interventions adapted to changing contexts. the public health community, nevertheless, has the responsibility to translate concepts related to systems thinking and complexity into concrete research methods and in...

In this commentary on the exercise of Lehoux et al (this volume) I argue that in discussions on the current challenges of health systems, a better diagnosis of the health system is required. The cause of responsible innovation in health (RIH) requires a better understanding of the dynamics of health systems, in particular how innovation, demand, and responsibility are m...