Toward a Consensus on Guiding Principles for Health Systems Strengthening

Based upon a review of the literature, Robert Chad Swanson and colleagues present a set of guiding principles for health systems strengthening

A question of confidence. Is tourism as vulnerable to civil unrest as we think? A comparative analysis of the impact of Arab Spring on total reserves and tourism

This paper uses monthly data to compare how international tourism receipts and the overall economy responded to the Arab Spring Total Reserves were used as an indicator of the economy overall, because they reflect confidence in the economy through such factors as Foreign Direct Investment and the effects of capital flight. To examine the response, interrupted time series was employed, using the outbreak of Arab Spring as the key interruption. To separate the impact of Arab Spring from other events, two treated and two untreated cases were selected. The results show that tourist spending recovered faster than the overall economy

Fantasy Paradigms of Health Inequalities: utopian thinking?

This paper argues that, while it can be politically expedient for governments to engage with health inequalities, they cannot, within the confines of neoliberalism, realistically propose actions that evidence suggests will effectively reduce them - such as tackling power inequalities, social status and connections or class inequality. Indeed, a dominant 'policy paradigm' prioritising economic growth restricts the ability of policy actors to imagine alternative, more equitable scenarios. In this context, some policy actors and researchers have devised a parallel fantasy world in which proximal, downstream, easily-tackled exposures are posited as potential solutions to health inequalities. The consequence of this is a widespread public sector culture in which well-meaning policy-makers, practitioners, researchers and members of the public collude in sustaining a 'cargo cult' of health behaviourism. In examining this situation, we draw on accounts and critiques of utopian thinking to help explain: (i) the remarkable persistence of policy proposals to tackle health inequalities via downstream interventions, in spite of the strength of evidence challenging such approaches; and (ii) the limited extent to which more upstream proposals inform policy debates. We argue Ruth Levitas’ notion of ‘utopia as method’ offers an imaginative and potentially useful avenue for future health inequalities research