Theoretical insights into the development of health insurance in low-income countries

This Discussion Paper is concerned with the development of risk-sharing systems for health, in low- and middle-income countries. It questions whether insurance theory developed in wealthier economies, in particular the central ideas of adverse selection and moral hazard, has relevance in the context of poorer countries with high levels of unmet health needs, and low utilisation of health services. Empirical evidence on these two issues is reviewed, as is the debate around social capital and collective action, and its relevance to extending risk sharing in poorer countries. Drawing on thinking and evidence from development economics, it is argued that informal risksharing may crowd-out formal risk-sharing schemes, the reverse of arguments found in much of the literature. Rooted in a holistic framework of household risk-reducing strategies, the paper considers the dynamic of demand for insurance in poorer countries, influenced by factors such as social cohesion, perceived corruption, and duty to the state. A central argument in the paper is that much of the literature on health insurance in low-income countries fails to consider well-developed and highly relevant bodies of literature in development economics and sociology.health insurance

Cost-effective safe motherhood interventions in low-income countries: a review

This paper reviews studies providing evidence of the cost-effectiveness of safe motherhood interventions in low-income countries. The economic case for investing in safe motherhood interventions is also examined. It is estimated that 1,600 women die globally each day as a result of problems during pregnancy or childbirth. A large proportion of these deaths is preventable. According to the World Bank, antenatal and maternal services comprise two of the six most cost-effective sets of health nterventions in low-income countries. Due to the problem of linking programme interventions with outcomes however, few cost-effectiveness studies currently exist. Despite this certain interventions are more cost-effective than others, such as substituting manual vacuum aspiration for dilatation and curettage when dealing with incomplete abortion. It is estimated that 26% of maternal deaths are avoidable through antenatal/community-based interventions, costing around 30% of the World Health Organisation’s Mother Baby Package. Ensuring access to high quality essential obstetric care can prevent a further 58% of maternal deaths, consuming 24% of total Mother Baby Package costs. Current evidence suggests that targeting investments on essential obstetric services would reap the greatest efficiency gains.safe motherhood; maternal mortality; cost-effectiveness

Perceptions of the coach-athlete relationship predict the attainment of mastery achievement goals six months later : a two-wave longitudinal study among F.A. Premier League academy soccer players

All football teams that compete within the F. A. Premier League possess an academy, whose objective is to produce more and better home-grown players that are capable of playing professionally. These young players spend a large amount of time with their coach, but little is known about player’s perception of the coach-athlete relationship within F.A. Premier League Academies. The objectives of this study were to examine whether perceptions of the coach-athlete relationship changed over six months and if the coach-athlete relationship predicted self-reported goal achievement among F. A. Premier League academy players. This study included cross-sectional (n = 104) and longitudinal (n = 52) assessments, in which academy soccer players completed a measure of the coach-athlete relationship and goal achievement across either one or two time periods. The cross-sectional data were subjected to bivariate correlations, whereas the longitudinal data were analyzed using multiple regressions. Perceptions of the coach-athlete relationship remained stable over time. The coach-athlete relationship predicted the achievement of mastery goals six months later. Enhancing the quality of the coach-athlete relationship among elite adolescent athletes appears to be a suitable way of maximizing mastery achievement goals, particularly among developmental athletes who participate in team sports

Coaches

In sport, coaches and athletes work closely together and often form long-term, mutually dependent relationships. The manner in which coaches and athletes interact can have a profound impact upon the effectiveness of their training sessions. Their relationship may directly of indirectly influence such factors as personal satisfaction, enjoyment, motivation, and performance. the aim of this chapter is to provide a critical overview of this area with explicit focus on the 3+1 Cs conceptual model. This chapter will define the coach-athlete relationship and provide an overview of how this relationship has been conceptualised. Moreover, aspects that may potentially contribute to developing the quality and effectiveness of coach-athlete relationships will be discussed. Finally, practical methods for developing and maintaining a harmonious relationship will be examined

Feedback of information in the empathic accuracy of sport coaches

Objective The purpose of this study was to investigate changes in the empathic accuracy of sport coaches in relation to feedback of information. Coaches' experience and qualification level were also considered. Method Sixty badminton coaches were randomly assigned to either an experimental or a control group. All coaches watched a video of an athlete's technical training session with her coach. At designated segments of the video all coaches were asked to make inferences about what the athlete's thoughts and feelings had been. Only the coaches in the experimental group were given corrective feedback on the athlete's thoughts and feelings following their inference. Empathic accuracy was estimated by comparing these inferences with the athlete's own self-reported thoughts and feelings. Results It was shown that both groups' empathic accuracy improved over the course of watching the video; however, the experimental group improved significantly more. It was found that coaches' experience was significantly associated with empathic accuracy for the control group only. Conclusions The results suggest that continued exposure to an athlete increases a coach's empathic accuracy and that this can be significantly improved with accurate feedback about that athlete

Attachment Styles Within the Coach-Athlete Dyad: Preliminary Investigation and Assessment Development

The present preliminary study aimed to develop and examine the psychometric properties of a new sport-specific self-report instrument designed to assess athletes’ and coaches’ attachment styles. The development and initial validation comprised three main phases. In Phase 1, a pool of items was generated based on pre-existing self-report attachment instruments, modified to reflect a coach and an athlete’s style of attachment. In Phase 2, the content validity of the items was assessed by a panel of experts. A final scale was developed and administered to 405 coaches and 298 athletes (N = 703 participants). In Phase 3, confirmatory factor analysis of the obtained data was conducted to determine the final items of the Coach-Athlete Attachment Scale (CAAS). Confirmatory factor analysis revealed acceptable goodness of fit indexes for a 3-first order factor model as well as a 2-first order factor model for both the athlete and the coach data, respectively. A secure attachment style positively predicted relationship satisfaction, while an insecure attachment style was a negative predictor of relationship satisfaction. The CAAS revealed initial psychometric properties of content, factorial, and predictive validity, as well as reliability

The influence of role and gender in the empathic accuracy of coaches and athletes

Objective: The purpose of this study was to investigate differences in the empathic accuracy of coaches and athletes in relation to the gender of the dyad member occupying each role in the coach-athlete relationship. Method: The empathic accuracy of fifty-six coach-athlete dyads was assessed using actual recordings of their own training sessions (see Lorimer & Jowett, 2009a; 2009b). Participants viewed selected video footage of discrete interactions that had occurred during these training sessions. Participants reported what they remembered thinking and feeling while making inferences about what their partner’s had thought and felt at those points. Comparison of partners self-reports and inferences allowed their empathic accuracy to be calculated. Results: It was found that female coaches were more accurate than male coaches. Additionally, for athletes, the highest accuracy scores were displayed by female athletes working with male coaches, and the least by female athletes working with female coaches. Conclusions: The results are discussed in terms of Social Role Theory and suggest that the interaction between the expectations of coach and athlete roles and gender play a key part in how accurately coaches and athletes perceive each other

Empathic accuracy, meta-perspective, and satisfaction in the coach-athlete relationship

This study investigated the empathic accuracy of sixty coach-athlete dyads, its antecedents (meta-perceptions of relationship) and consequences (perceptions of satisfaction). An adaptation of Ickes's (2001) unstructured dyadic interaction paradigm was used to assess empathic accuracy whereby coach-athlete dyads were filmed during training. A selection of video clips containing the dyads' interactions during a typical training session were shown to them. The dyad members were asked to report their recollected thoughts and/or feelings while making inferences about what their partners' thought and felt at specific points of interaction. Empathic accuracy was estimated by comparing the dyads' self-reports and inferences. The results of a structural equation model analysis indicated an association between members' meta-perceptions or judgments that their partner is positive about the athletic relationship and increased empathic accuracy. Increased empathic accuracy was in turn associated with higher levels of satisfaction. These results are discussed based on issues they raise for theory and measurement

Relationship maintenance strategies in the coach-athlete relationship: The development of the COMPASS model

The investigation of relationship maintenance strategies has received considerable attention in various types of dyads including romantic, marital, and familial relationships. No research, however, has yet investigated the use of maintenance strategies in the coach-athlete partnership. Thus, this study aimed to investigate coaches’ and athletes’ perceptions of the strategies they use to maintain relationship quality. Twelve one-to-one interviews with coaches (4 males and 2 females) and athletes (2 males and 4 females) were conducted. The interviews were structured based on the factors within Jowett’s (2007) 3+1C conceptualization of the coach-athlete relationship (i.e., closeness, commitment, complementarity, and co-orientation). Deductive and inductive content analysis revealed seven main categories: Conflict management, openness, motivation, Positivity, advice, support, and social networks. The COMPASS model was developed based on this analysis and was offered as a theoretical framework for understanding how coaches and athletes might maintain the quality of their relationships