Leveraging human capital to reduce maternal mortality in India: enhanced public health system or public-private partnership?

Developing countries are currently struggling to achieve the Millennium Development Goal Five of reducing maternal mortality by three quarters between 1990 and 2015. Many health systems are facing acute shortages of health workers needed to provide improved prenatal care, skilled birth attendance and emergency obstetric services – interventions crucial to reducing maternal death. The World Health Organization estimates a current deficit of almost 2.4 million doctors, nurses and midwives. Complicating matters further, health workforces are typically concentrated in large cities, while maternal mortality is generally higher in rural areas. Additionally, health care systems are faced with shortages of specialists such as anaesthesiologists, surgeons and obstetricians; a maldistribution of health care infrastructure; and imbalances between the public and private health care sectors. Increasingly, policy-makers have been turning to human resource strategies to cope with staff shortages. These include enhancement of existing work roles; substitution of one type of worker for another; delegation of functions up or down the traditional role ladder; innovation in designing new jobs;transfer or relocation of particular roles or services from one health care sector to another. Innovations have been funded through state investment, public-private partnerships and collaborations with nongovernmental organizations and quasi-governmental organizations such as the World Bank. This paper focuses on how two large health systems in India – Gujarat and Tamil Nadu – have successfully applied human resources strategies in uniquely different contexts to the challenges of achieving Millennium Development Goal Five

The Political Ecology of Palk Bay Fisheries: Geographies of Capital, Fisher Conflict, Ethnicity and Nation-State

Indian trawl fishers in the Palk Bay regularly engage in cross-border fishing to the detriment of Sri Lankan artisanal fishers whose nets are irreparably damaged. Increasing tension between Indian trawl fishers from the state of Tamil Nadu and Sri Lankan artisanal fishers from the Northern Province has resulted in the Sri Lankan government patrolling the international maritime boundary line (IMBL) more stringently and increased arrests of Indian trawl fishers. This paper argues that the present "fisheries crisis" in the Palk Bay must be understood from a political ecology perspective that takes cognizance of the circuitous nature of capital accumulation and how fisher conflict, ethnicity and the politics of the nation-state have shaped the spatial practices of accumulation. In a changing global context where semi-industrial vessels are increasingly crossing boundaries, it argues for more context specific studies of processes of capital accumulation