Priority setting for health in the context of devolution in Kenya: implications for health equity and community-based primary care

Devolution changes the locus of power within a country from central to sub-national levels. In 2013, Kenya devolved health and other services from central government to 47 new sub-national governments (known as counties). This transition seeks to strengthen democracy and accountability, increase community participation, improve efficiency and reduce inequities. With changing responsibilities and power following devolution reforms, comes the need for priority-setting at the new county level. Priority-setting arises as a consequence of the needs and demand for healthcare resources exceeding the resources available, resulting in the need for some means of choosing between competing demands. We sought to explore the impact of devolution on priority-setting for health equity and community health services. We conducted key informant and in-depth interviews with health policymakers, health providers and politicians from 10 counties (n = 269 individuals) and 14 focus group discussions with community members based in 2 counties (n = 146 individuals). Qualitative data were analysed using the framework approach. We found Kenya’s devolution reforms were driven by the need to demonstrate responsiveness to county contexts, with positive ramifications for health equity in previously neglected counties. The rapidity of the process, however, combined with limited technical capacity and guidance has meant that decision-making and prioritization have been captured and distorted for political and power interests. Less visible community health services that focus on health promotion, disease prevention and referral have been neglected within the prioritization process in favour of more tangible curative health services. The rapid transition in power carries a degree of risk of not meeting stated objectives. As Kenya moves forward, decision-makers need to address the community health gap and lay down institutional structures, processes and norms which promote health equity for all Kenyans

Careers work in higher education in Pakistan: current practice and options for the future

In this article we examine the development of career guidance in Pakistani higher education. The article is primarily based on a review of the existing literature on career guidance in Pakistan, but also includes the consideration of some new data gathered from a review of higher education institutions websites and five case study interviews. It considers both local and global influences as relevant contexts for understanding how the development of career guidance in Pakistani higher education is taking place. Concerns about alignment between skills supply and demand provide key drivers both for the development of career guidance and for wider higher education reform. However the practice of career guidance in Pakistani higher education is shown to be lagging behind the policy aspirations, both due to limited investment and due to more fundamental cultural challenges that have yet to be fully addressed. If career guidance is going to continue to develop within Pakistan it will need to be strengthened by new policy and resources but also through the development of indigenous theories.N/

The land capability classification of Sabah [cartographic material].

Land classification map series of Sabah showing international, state and residency boundaries, transportation, land use and populated places.; "This map accompanies the Land Resources Study No.25 'The Land Capability Classification of Sabah' published by the Land Resources Division, Ministry of Overseas Development"; At top of map: Malaysia (Sabah) 1:250 000.; English and Malay.; Inlcudes residency boundaries diagram, index to sheets, glossary and compilation notes

Tabora rural integrated development programme, Tanzania Land use component: livestock production in Tabory Region

SIGLELF:6924.8688(86) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Montane Plains and Wadi Rima project A land and water resources survey: Soils and land suitability of the Montane Plaine and Wadi Rima

SIGLELD:6924.852(52) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Yemen Arab Republic Montane Plains and Wadi Rima project A land and water resources survey: results of groundwater drilling

SIGLELD:6924.852(33) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Yemen Arab Republic Montane Plains and Wadi Rima Project A land and water resources survey: hydrogeology of the Montane Plains

SIGLELD:6924.852(38) / BLDSC - British Library Document Supply CentreGBUnited Kingdo