Since the publication of the 2004 World Development Report, a range of different attempts have been made to make the design, prioritisation and delivery of health services more accountable to different stakeholders. However, complex politics and power dynamics can limit or skew people’s abilities to access services or hold them to account, particularly for poor and marginalized people.
In July 2017, the IDS hosted a workshop in collaboration with Future Health Systems, the Impact Initiative, the Open Society Foundations, Unequal Voices, and Health Systems Global, to develop new thinking and practical approaches to improving accountability relationships and processes in favour of greater health equity.
This new issue of the IDS Bulletin focusses on three principal themes that emerged from this workshop as needing particular attention. First, the nature of accountability politics ‘in time’ and the importance of longitudinal approaches to change. Second, the contested politics of ‘naming’ and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology.
For the first time in IDS Bulletin history, themes are explored not only in text but also through multimedia contributions. This expansion into other forms of communication is explicitly aimed at galvanising larger numbers of people in a movement towards Universal Health Coverage (UHC) and the linked agenda of accountability for health equity. The content of this issue reflects the fact that while the desired outcome might be the same – better health for all – accountability strategies are as diverse as the contexts in which they have developed.
This IDS Bulletin Archive Collection reviews four decades of analysis and research on peace, security, and development, drawing on articles published in previous issues of the Bulletin throughout this timeframe. IDS first began to investigate the relationship between disarmament and development in the 1970s. Then, research focused initially on disarmament and its actual and potential contributions to development. Disarmament, along with reductions in military spending, it was argued, would release resources for development. It would also break the cycles of militarisation which propelled violent conflicts in many parts of the developing world.
After the end of the Cold War, development research engaged more and more directly with conflict prevention and peace-building. The focus then turned towards security in a global context, in which donor agencies involved themselves directly with security questions. As shown by the articles in this edition, work at IDS has been distinctive in three respects: first, in interrogating the multiple meanings and forms of security – international, national, military, personal, livelihood, food, environmental, etc. – and how these interconnect, or indeed clash; second, in tracing the complex links between global, national, local, and personal security; and third, in its insistence that security be inclusive, drawing upon the experience and agency of the people and groups who are ‘developed’ and ‘secured’. The pieces reprinted in this Archive Collection help analyse shifts in focus over the four decades, before highlighting that it may be time to revisit disarmament, as a tangible policy goal, in these present times of chronic insecurity and increasing violence.
There is currently much talk of the private sector role in nutrition, and whether the state can ‘shape’ the market to deliver better nutritional outcomes. This issue of the IDS Bulletin presents research findings in this area, developed by the consortium of research partners under the Leveraging Agriculture for Nutrition in South Asia (LANSA) programme.
The IDS Bulletin aims to analyse existing (or potential) agri-food value chain pathways for delivering nutritious foods from agriculture to vulnerable populations in South Asia. It discusses the role of both public and private actors in making these value chains more effective in achieving sustained increased consumption of nutrient-rich foods.
In comparing the different pathways, this set of articles warns against the assumption that increasing the supply of certain products will directly lead to increased consumption. It highlights how, in South Asia, interventions or policies that try to enhance these pathways often struggle because of a mix of supply, distribution, marketing, and consumption challenges.
This IDS Bulletin argues that the key to sustainable food systems might be a ‘food sovereignty’ approach. This calls for awareness at all levels of decision-making – public, private and civil society – in the promotion of nutrition-sensitive value chains, emphasising the need for a stronger government role in shaping agri-food value chain pathways. By looking at the limits of what business can and cannot achieve in a given market environment, the IDS Bulletin provides insights to policymakers about how to create an appropriate institutional environment that shapes how these value chains operate for the benefit of nutritionally vulnerable target groups.
Inadequate power supply in sub-Saharan Africa (SSA) means that only 37 per cent of sub-Saharan Africans have access to electricity. Those with access are prone to experience problems with regular power outages. In many sub- SSA countries, electricity access rates are decreasing because electrification efforts are slower than population growth.
The authors of this IDS Bulletin provide insights from power systems engineering, macroeconomics, microeconomics, and political economy on how to overcome constraints to green electricity in Africa. One of the biggest contributions of this issue is that is allows a dialogue between academics and practitioners that would not normally be published in the same journal. What also emerges as an underlying thread is the essential role of donors to achieve sustainable energy for all in Africa.
The contributions to the IDS Bulletin underline the enormity of the clean electrification challenge in Africa, and demonstrate the benefits of a multidisciplinary approach where technical, economic, and political perspectives are involved in the design of interventions.
Humanitarian crises appear dramatic, overwhelming and sudden, with aid required immediately to save lives. Whereas climate change is about changing hazard patterns and crises are in reality rarely unexpected, with academic researchers and humanitarian and development organisations warning about possible risks for months before they take place. While humanitarian organisations deal directly with vulnerable populations, interventions are part of global politics and development pathways that are simultaneously generating climate change, inequities and vulnerability. So what is the level of convergence between humanitarian interventions and efforts to support adaptation to climate change, and what lessons can be drawn from current experience on the prospects for reducing the risk of climate change causing increased burdens on humanitarian interventions in the future?
This IDS Bulletin is a call for increasing engagement between humanitarian aid and adaptation interventions to support deliberate transformation of development pathways. Based on studies from the ‘Courting Catastrophe’ project, contributors argue that humanitarian interventions offer opportunities for a common agenda to drive transformational adaptation. Changes in political and financial frameworks are needed to facilitate longer-term actions where demands move from delivering expert advice and solutions to vulnerable populations to taking up multiple vulnerability knowledges and making space for contestation of current development thinking. Yet while the humanitarian system could drive transformative adaptation, it should not bear responsibility alone.
In this issue, alternative pathways and practical ways to support local alternatives and critical debates around these are illustrated, to demonstrate where humanitarian actions can most usefully contribute to transformation.
