This paper proposes frameworks to analyze the gender dimensions of climate change-induced migration. The experiences, needs and priorities of climate migrants will vary by gender and these differences need to be accounted for if policies are to be inclusive. Among the vulnerable groups, women are likely to be disproportionately affected due to climate change because on average women tend to be poorer, less educated, have a lower health status and have limited direct access to or ownership of natural resources. Both the process (actual movement) and the outcomes (rural-rural or rural-urban migration, out-migration mainly of men) of climate change-induced migration are also likely to be highly gendered.
This article addresses the rise of design thinking and its problematics in the social policy sphere. In particular, it argues that studies of social policy design, like all design work in policymaking, must differentiate more carefully between technical and political considerations in public policymaking and examine the implications each process has for the content of social policy design, its implementation, and its prospects of success or failure. The article develops a model of social policy formulation spaces based on the extent to which policies are intended to address technical or political problems and a government's capacity to engage in policy analysis and alternative assessment. This model is applied in the articles in this special issue to help understand the patterns of policy content and outcome success and failure found in this sector across multiple jurisdictions and issue areas.
Background
Reliable basic infrastructure, particularly electricity, is a critical enabling factor in improving health systems and consequently achieving the health sustainable development goals (SDGs). Yet, there is no systematic and rigorous study examining the effect of reliable electricity on health systems in a developing country context. In this study, we examine the effect of Jyotigram Yojana (JGY), a rural electrification program providing 24-h electricity to rural non-agricultural users in Gujarat, India, on core components of health systems including health facilities, health information, and health services utilization.
Methods
We match data from the District Level Household and Facility Survey (DLHS-II and DLHS-III) and administrative data from electricity distribution companies on JGY implementation. Matching survey data with administrative data allows us to precisely identify the relevant sample from Gujarat for our data analysis. We then apply a difference-in-differences framework to address potential bias in JGY implementation by comparing the sample from Gujarat (treatment group) with that from Maharashtra (control group). Our key independent variable is a dummy indicating JGY implementation, which operationalizes access to reliable electricity. It takes value 1 if the PHC/eligible woman/child is located or residing in the state of Gujarat and 0 if located or residing in the state of Maharashtra. Our outcome variables cover three core components of health systems—health facilities, health information, and child and maternal health services utilization. Each outcome is a binary variable. We therefore estimate probit models with appropriate control variables.
Results
We find that JGY implementation significantly improved the operational capacity of health facilities, in particular primary health centers (PHCs), by increasing the availability and functionality of a wide range of essential devices and equipment. JGY also significantly increased access to health information through television. Further, JGY increased utilization of health services; in particular, it increased the probability of children receiving critical vaccinations and pregnant women receiving antenatal care. Our results are robust to alternate specifications and analysis using alternate data.
Conclusion
Reliable electricity can be an effective tool in improving core components of health systems. In addition to targeting direct factors within the health systems such as health workforce and health financing, investments in supporting infrastructure are warranted to achieve the health SDGs.
Electronic supplementary material
The online version of this article (10.1186/s41043-019-0164-6) contains supplementary material, which is available to authorized users.
Summary
Although policy entrepreneurship is essential for fostering policy innovations to achieve sustainable development, the literature has conflated different types of entrepreneurship and disaggregated it using inconsistent terminology. We conceptualize entrepreneurship using a six‐stream variant of the multiple streams framework (MSF)—which addresses key limitations of the original MSF—to examine entrepreneurial activities in the case of the Jyotigram Yojana, a widely recognized policy innovation for managing the energy–water nexus in Gujarat, India. We find that whereas policy and political entrepreneurship no doubt played a significant role in coupling the streams and fostering this policy innovation, the process broker, program champion, and technology innovator were also important in policy formulation, implementation, and “success.” We conclude that the six‐stream variant of MSF is useful for identifying and distinguishing various types of entrepreneurship involved in policy innovation for sustainability.
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