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Improving Health Sector Performance

Institutions, Motivations and Incentives - The Cambodia Dialogue

Hossein Jalilian and Vicheth Sen

There is growing international evidence that the effectiveness of health services stems primarily from the extent to which the incentives facing providers and consumers are aligned with "better health" objectives. Efficiency in health service provision requires that providers and consumers have incentives to use healthcare resources in ways that generate the maximum health gains. Equity in at least one sense requires that consumers requiring the same care are treated equally, irrespective of their ability to pay. Efficiency in the use of health services requires that consumers are knowledgeable about the services on offer and which are most appropriate to their needs. Although these principles are enshrined in the design of every health system in the world, they have proven extremely difficult to apply in practice. Healthcare providers have financial obligations to their families as well as professional obligations to their patients. Health service consumers generally lack information about both their health and health services so that they under-consume or over-consume healthcare. The papers in this volume are selected from an international conference organized by the CDRI, Cambodia, that tried to deal with some of these issues. With participation of international and local experts, it aimed at collecting major experiences and innovative solutions from inside and outside the country to improve health sector performance, with particular focus on institutions, motivations and incentives.

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Land and Development in Indonesia

Searching for the People's Sovereignty

Edited by John F. McCarthy and Kathryn Robinson

Indonesia was founded on the ideal of the "Sovereignty of the People", which suggests the pre-eminence of people's rights to access, use and control land to support their livelihoods. Yet, many questions remain unresolved. How can the state ensure access to land for agriculture and housing while also supporting land acquisition for investment in industry and infrastructure? What is to be done about indigenous rights? Do registration and titling provide solutions? Is the land reform agenda — legislated but never implemented — still relevant? How should the land questions affecting Indonesia's disappearing forests be resolved? The contributors to this volume assess progress on these issues through case studies from across the archipelago: from large-scale land acquisitions in Papua, to asset ownership in the villages of Sulawesi and Java, to tenure conflicts associated with the oil palm and mining booms in Kalimantan, Sulawesi and Sumatra. What are the prospects for the "people's sovereignty" in regard to land?

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Latino Heartland

Of Borders and Belonging in the Midwest

Sujey Vega

National immigration debates have thrust both opponents of immigration and immigrant rights supporters into the news. But what happens once the rallies end and the banners come down? What is daily life like for Latinos who have been presented nationally as “terrorists, drug smugglers, alien gangs, and violent criminals”? Latino Heartland offers an ethnography of the Latino and non-Latino residents of a small Indiana town, showing how national debate pitted neighbor against neighbor—and the strategies some used to combat such animosity. It conveys the lived impact of divisive political rhetoric on immigration and how race, gender, class, and ethnicity inform community belonging in the twenty-first century.  
Latino Heartland illuminates how community membership was determined yet simultaneously re-made by those struggling to widen the scope of who was imagined as a legitimate resident citizen of this Midwestern space. The volume draws on interviews with Latinos—both new immigrants and long-standing U.S. citizens—and whites, as well as African Americans, to provide a sense of the racial dynamics in play as immigrants asserted their right to belong to the community. Latino Hoosiers asserted a right to redefine what belonging meant within their homes, at their spaces of worship, and in the public eye. Through daily acts of ethnic belonging, Spanish-speaking residents navigated their own sense of community that did not require that they abandon their difference just to be accepted.  
In Latino Heartland, Sujey Vega addresses the politics of immigration, showing us how increasingly diverse towns can work toward embracing their complexity.

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Les defis du developpement local au Senegal

This book is an uncompromising analysis of Senegal's decentralisation policy in rural areas. It discusses the state's inability to promote local development, despite this being its main raison d'?tre in a context of poverty. To identify reasons for the shortcomings, the author goes beyond policy statements and explores, sociologically, the compatibility of the behaviour and the cultural context of actors with the pursuance of local development objectives. Yet, there are indeed solutions to the actors' lethargy and to the weak coverage of the initiatives undertaken. The solutions can be found in the methodical and civic mobilisation around more ambitious actions that are more adapted to receptive localities, though opened to modernity and perfectly anchored in the culture for positive results. Rosnert Ludovic Alissoutin holds a PhD in Law. Since 1995, he has been working as a consultant on development issues in Senegal and Africa, particularly local development issues. The particularity of his approach lies in the rejection of scientific exclusivism and recourse to a multi disciplinary, open and flexible analysis of the complexity of human development. It is this perspective that informed his doctoral thesis on La Gestion de l'eau en milieu aride, which discusses legal, anthropological, geographical, and sociological issues. For additional information on his profile and work, visit his website:

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Light on the Devils

Coming of Age on the Klamath

When Louise Wagenknecht’s family arrived in the remote logging town of Happy Camp in 1962, a boundless optimism reigned. Whites and Indians worked together in the woods and the lumber mills of northern California’s Klamath country. Logging and lumber mills, it seemed, would hold communities together forever.

But that booming prosperity would come to an end. Looking back on her teenage years spent along the Klamath River, Louise Wagenknecht recounts a vanishing way of life. She explores the dynamics of family relationships and the contradictions of being female in a western logging town in the 1960s. And she paints an evocative portrait of the landscape and her relationship with it.

Light on the Devils is a readable and elegant memoir of place. It will appeal to general readers interested in the Pacific Northwest, personal memoir, history, and natural history.

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Linked Arms

A Rural Community Resists Nuclear Waste

Through character development, snappy dialogue, and vivid scenes, Linked Arms tells the story of a rural people’s successful struggle to keep a major nuclear dump out of Allegany County in western New York. Five times over a twelve-month period hundreds of ordinary people—merchants, teachers, homemakers, professionals, farmers, and blue collar workers—ignored potential jail terms and large fines to defy the nuclear industry and governmental authority by linking arms in the bitter cold to thwart the siting commission through civil disobedience. The hearts and minds of the resisters emerge in the narrative, as we find out why these people found civil disobedience compelling, how they organized themselves, and what moral dilemmas they addressed as they fought for their convictions. While becoming more engaged in the resistance, they confronted critical issues in contemporary America: democratic decision making, environmental policy, legal rights, corporate responsibility, and the technology of nuclear waste. Some of the book’s highlights include: conversations that took place between Governor Cuomo, Assemblyman Hasper, and the protestors, which thoughtfully probe who should bear the financial burden of a failed and dangerous technology; the scientific and technological issues discussed between Ted Taylor, a nuclear physicist who was one of the key people in the Manhattan project, and the leaders of the resistance; and the citizens’ initiation of a lawsuit that eventually reached the Supreme Court and abrogated the central provision in the 1987 congressional law that mandated states build low-level nuclear dumps across the country. These dialogues and vignettes illustrate how the civil disobedience and dogged determination of the people of Allegany County changed the course of history.

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The connection between people and companion animals has received considerable attention from scholars. In her original and provocative ethnography Livestock/Deadstock, sociologist Rhoda Wilkie asks, how do the men and women who work on farms, in livestock auction markets, and slaughterhouses, interact with—or disengage from—the animals they encounter in their jobs?


Wilkie provides a nuanced appreciation of how those men and women who breed, rear, show, fatten, market, medically treat, and slaughter livestock, make sense of their interactions with the animals that constitute the focus of their work lives. Using a sociologically informed perspective, Wilkie explores their attitudes and behaviors to explain how agricultural workers think, feel, and relate to food animals.


Livestock/Deadstock looks at both people and animals in the division of labor and shows how commercial and hobby productive contexts provide male and female handlers with varying opportunities to bond with and/or distance themselves from livestock. Exploring the experiences of stockpeople, hobby farmers, auction workers, vets and slaughterers, she offers timely insight into the multifaceted, gendered, and contradictory nature of human roles in food animal production.  

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Living a Land Ethic

A History of Cooperative Conservation on the Leopold Memorial Reserve

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The Story of a Southern Midwife and an Unlikely Friendship

Lisa Yarger

From 1950 until 2001, Lovie Beard Shelton practiced midwifery in eastern North Carolina homes, delivering some 4,000 babies to black, white, Mennonite, and hippie women; to those too poor to afford a hospital birth; and to a few rich enough to have any kind of delivery they pleased. Her life, which was about giving life, was conspicuously marked by loss, including the untimely death of her husband and the murder of her son.

Lovie is a provocative chronicle of Shelton's life and work, which spanned enormous changes in midwifery and in the ways women give birth. In this artful exploration of documentary fieldwork, Lisa Yarger confronts the choices involved in producing an authentic portrait of a woman who is at once loner and self-styled folk hero. Fully embracing the difficulties of telling a true story, Yarger is able to get at the story of telling the story. As Lovie describes her calling, we meet a woman who sees herself working in partnership with God and who must wrestle with the question of what happens when a woman who has devoted her life to service, to doing God's work, ages out of usefulness. When I'm no longer a midwife, who am I? Facing retirement and a host of health issues, Lovie attempts to fit together the jagged pieces of her life as she prepares for one final home birth.

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Loyal Unto Death

Trust and Terror in Revolutionary Macedonia

Keith Brown

The underground Macedonian Revolutionary Organization recruited and mobilized over 20,000 supporters to take up arms against the Ottoman Empire between 1893 and 1903. Challenging conventional wisdom about the role of ethnic and national identity in Balkan history, Keith Brown focuses on social and cultural mechanisms of loyalty to describe the circuits of trust and terror—webs of secret communications and bonds of solidarity—that linked migrant workers, remote villagers, and their leaders in common cause. Loyalties were covertly created and maintained through acts of oath-taking, record-keeping, arms-trading, and in the use and management of deadly violence.

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