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The politics of funding universal healthcare: Diverting local tobacco taxes to subsidise the national health scheme in Indonesia 资助全民医疗保健的政治:转移地方烟草税以补贴印度尼西亚的国家医疗计划
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-09-24 DOI: 10.1002/app5.334
Abdillah Ahsan, Elisabeth Kramer, Nadhila Adani, Askar Muhammad, Nadira Amalia

In Indonesia, the national universal health coverage scheme (Jaminan Kesehatan Nasional [JKN]) has consistently overspent against its budget since it was introduced in 2014. In 2017, a new regulation diverted 37.5% of tobacco tax revenue collected at the district and city level to the central government in order to increase government contributions to the JKN. Through a review of policy documents and interviews and focus group discussions with relevant stakeholders, this article explores the history of the JKN and its relationship to local tobacco taxes. Offering an ex-post assessment of the policy and its implementation, we find it negative on three fronts: funding for local anti-smoking initiatives and services was cut, the procedures for implementing the policy were complex and time-consuming, and it did not contribute as much as anticipated to the JKN. These findings underscore potential pitfalls of politically motivated policy that fails to consider implementation and impact. We recommend that the policy be revoked, and local tobacco tax revenue reallocated to its initial purpose, which includes promoting local smoking prevention programs and health service delivery.

在印度尼西亚,全国全民健康覆盖计划(Jaminan Kesehatan Nasional [JKN])自2014年推出以来一直超支。2017年,一项新规定将区、市一级征收的烟草税收的37.5%划归中央政府,以增加政府对烟草协会的贡献。通过对政策文件的回顾、与相关利益相关者的访谈和焦点小组讨论,本文探讨了JKN的历史及其与地方烟草税的关系。在对该政策及其实施进行事后评估后,我们发现该政策在三个方面是消极的:地方禁烟措施和服务的资金被削减,实施该政策的程序复杂而耗时,以及它对JKN的贡献没有预期的那么大。这些发现强调了出于政治动机而不考虑实施和影响的政策可能存在的缺陷。我们建议取消这一政策,并将地方烟草税收重新分配到最初的目的,包括促进地方预防吸烟计划和卫生服务的提供。
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引用次数: 3
Malaria elimination in the Asia-Pacific: Going the last mile 亚太地区消除疟疾:走最后一公里
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-09-22 DOI: 10.1002/app5.335
Vivian Lin, Tikki Pangestu
<p>There has been good progress in the bid to eliminate malaria from the Asia-Pacific region by 2030. Malaria elimination has been certified by the World Health Organization in Sri Lanka and China, is expected to be certified in Malaysia, and is within reach in Bhutan and Timor-Leste. The countries in the Greater Mekong Subregion have also made good progress and reached many milestones of success. However, the COVID-19 pandemic has threatened derailment of these impressive gains as countries in the region divert their attention and resources to combating the pandemic.</p><p>Much of the success in malaria control can be attributed to the vertical nature of the malaria program both at the global level and national level. That is, a program with clear objectives, quantifiable targets, focused on a single condition, and implemented with centralised management and dedicated means (staff, funds, etc). The last mile to elimination, however, is posing new challenges and new approaches are needed.</p><p>First, we need to tackle the challenge of reaching the hardest to reach communities. For example, those living in remote, rural areas, ethnic minorities and other marginalised sections of the population tend to have access difficulties and therefore the most limited contact with health services, lower levels of education and health literacy, and suffer poorer health for many conditions.</p><p>Second, we need to go beyond rolling out standard technical, vertical approaches and carry out a review of all demand- and supply-side factors. We need to understand better the social and cultural factors shaping health behaviours in communities, the role of community organisations and networks in providing trusted advice, and community perceptions of the health system. We need to reflect on shortfalls in current program implementation, including reviewing important policy barriers.</p><p>Third, we need to mainstream public health services and integrate better with the rest of the health system in order to tackle the elimination task. This approach should emphasise integrated, people-centred services, delivered where people live. Primary health care is the pivotal point for individual and community services, where case identification and treatment can occur for individuals, health education can be done for patients and for the community, and population outreach and environmental interventions can be carried out.</p><p>Fourth, we need to keep our minds open to new innovations which can help us achieve the elimination goal, including the potentially important results of recent vaccine trials and new therapeutic agents.</p><p>Finally, and importantly, we need to sustain political will and commitment in the face of competing priorities and reduced resources as countries continue to grapple with the COVID-19 pandemic. In the initial period of the pandemic, many countries focused their scarce resources on COVID-19 services, even to the neglect of other health issues. With t
到2030年在亚太地区消除疟疾的努力取得了良好进展。斯里兰卡和中国的消除疟疾工作已获得世界卫生组织的认证,预计马来西亚也将获得认证,不丹和东帝汶的消除疟疾工作已触手可及。大湄公河次区域国家也取得了良好进展,取得了许多里程碑式的成就。然而,2019冠状病毒病大流行有可能使这些令人印象深刻的成果脱轨,因为该地区各国将注意力和资源转移到防治大流行上。疟疾控制方面的大部分成功可归因于全球和国家层面疟疾规划的纵向性质。即目标明确、指标可量化、专注于单一条件、以集中管理和专用手段(人员、资金等)实施的方案。然而,消灭疟疾的最后一英里正在提出新的挑战,需要采取新的办法。首先,我们需要应对向最难到达的社区提供服务的挑战。例如,生活在偏远农村地区、少数民族和其他边缘化群体的人往往难以获得保健服务,因此与保健服务的接触最为有限,教育水平和卫生知识水平较低,在许多情况下健康状况较差。第二,我们要超越标准的技术、纵向方法,全面审视需求侧和供给侧因素。我们需要更好地了解影响社区卫生行为的社会和文化因素,社区组织和网络在提供可信建议方面的作用,以及社区对卫生系统的看法。我们需要反思当前项目实施中的不足之处,包括审查重要的政策障碍。第三,我们需要将公共卫生服务纳入主流,更好地与卫生系统其他部门整合,以完成消除任务。这种方法应强调在人们居住的地方提供以人为本的综合服务。初级卫生保健是个人和社区服务的关键,在初级卫生保健中,可以对个人进行病例鉴定和治疗,可以对病人和社区进行卫生教育,可以开展人口外展和环境干预。第四,我们需要对有助于我们实现消除目标的新创新保持开放的心态,包括最近疫苗试验和新治疗剂可能取得的重要结果。最后,重要的是,在各国继续应对COVID-19大流行之际,面对相互竞争的优先事项和资源减少,我们需要保持政治意愿和承诺。在大流行初期,许多国家将稀缺资源集中用于COVID-19服务,甚至忽视了其他卫生问题。随着大流行病的持续,政府和卫生部门领导人需要重新认识到,卫生和发展是相互不可或缺的,并重新配置资源,以实现最高效率、效果和公平。健康受环境、行为和寻求保健等因素的影响。为了解决最后一英里的问题,需要考虑如何解决需求侧和供给侧的影响。卫生服务提供者与患者和社区之间的相互作用受到一系列力量的影响,因此,在认识到卫生系统资源和能力的同时,需要为社区和人群量身定制达到最后一英里的战略。我们不应低估需求侧影响的重要性,如文化、传统、性别、地方知识、语言、卫生知识和社区组织的作用。与此同时,卫生系统也可能需要得到加强。供应的可用性可能是一个与无序物流相关的因素;服务的可及性可能与社会和文化因素以及财政和地理有关;服务质量可以反映卫生工作人员的技术和社会/文化能力;服务成本将作为价格信号发挥重要作用。薄弱的卫生系统最终会阻碍社区对政府政策和卫生系统的信任。全民健康覆盖可能是解决最后一英里问题的最关键的政策干预措施。首先,需要制定适当的、循证的和可行的政策,例如确保加强监测、实验室能力、信息系统和外联/教育战略等核心公共卫生职能。还必须在全民健康覆盖(UHC)和“整个卫生部门”方法的背景下看待这些政策。
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引用次数: 1
Notifiable diseases: Testing and treating every case to get ahead of the curve 法定疾病:检测和治疗每一个病例,以取得领先地位
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-09-21 DOI: 10.1002/app5.331
Marie Lamy, Amita Chebbi, Rittika Datta, Phone Si Hein, Chris Erwin G. Mercado, Steve Mellor, Gao Qi, Geoff Clark

This article explains how making a disease notifiable by law is a core component of a robust and well-functioning health system. Mechanisms to rapidly detect and report existing or emerging infectious diseases in a timely manner are key to disease control and elimination. Using malaria in Asia-Pacific as a case in point, we explore different policy considerations involved in making malaria a notifiable disease. These include the timing of legislative changes at different stages of elimination, investing in adequate infrastructure for a robust surveillance system that can support targeted interventions, and the importance of involving all sectors in the delivery of malaria services to detect, report and respond to every case. The article explains how frameworks to report on notifiable diseases, in this case malaria, contribute to improved regional health security.

这篇文章解释了如何使一种疾病依法通报是一个健全和运转良好的卫生系统的核心组成部分。及时迅速发现和报告现有或新出现的传染病的机制是控制和消除疾病的关键。以亚太地区的疟疾为例,我们探讨了使疟疾成为一种法定疾病所涉及的不同政策考虑。这些问题包括在消除疟疾的不同阶段修改立法的时机,投资建设足够的基础设施,建立能够支持有针对性干预措施的健全监测系统,以及让所有部门参与提供疟疾服务以发现、报告和应对每一个病例的重要性。这篇文章解释了报告法定疾病(这里是疟疾)的框架如何有助于改善区域卫生安全。
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引用次数: 1
Local child protection in the Philippines: A case study of actors, processes and key risks for children 菲律宾当地儿童保护:行为者、程序和儿童主要风险的案例研究
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-09-07 DOI: 10.1002/app5.332
Steven Roche, Catherine Flynn

This article explores the child protection actors, processes and child maltreatment issues in a regional Local Government Unit in the Philippines. Utilising a qualitative case study design, it engages with 14 young people with histories of child maltreatment and 13 key child protection actors, exploring their views and experiences of child protection actions, processes and outcomes. The findings highlight informal community-based actors, including neighbours, family, friends and non-government organisations in initial responses to child maltreatment, compared to formal child protection actors, who respond to severe maltreatment utilising a legal framework. Actors are constrained by limited government capacity and community reach, revealing misalignment between formal child protection activities and breadth of risks for children. Non-government organisations assist child protection efforts through the provision of residential care. Policy recommendations include strengthening relationships between formal actors and communities, expanding early intervention activities, and developing the capacity of community-based child protection actors.

本文探讨儿童保护行为者,程序和儿童虐待问题在菲律宾的一个区域地方政府单位。利用定性案例研究设计,它与14名有虐待儿童历史的年轻人和13名主要的儿童保护行为者接触,探讨他们对儿童保护行动、过程和结果的看法和经验。研究结果强调,与利用法律框架应对严重虐待的正式儿童保护行为者相比,以社区为基础的非正式行为者,包括邻居、家人、朋友和非政府组织,在对虐待儿童的初步反应中发挥了重要作用。行为者受到政府能力和社区影响力有限的制约,这表明正式的儿童保护活动与儿童面临的广泛风险之间存在不协调。非政府机构透过提供住宿照顾,协助儿童保护工作。政策建议包括加强正式行为者与社区之间的关系,扩大早期干预活动,以及发展社区儿童保护行为者的能力。
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引用次数: 3
The impact of land fragmentation on food security in the North Central Coast, Vietnam 越南中北部海岸土地破碎化对粮食安全的影响
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-08-04 DOI: 10.1002/app5.330
Tuyen Quang Tran, Huong Van Vu

While the effect of land fragmentation on farm efficiency and production diversification in Vietnam has been well established, no evidence exists for its effect on household food security. Using a unique dataset from household surveys in combination with micro-econometric models, the current study examines the impact of land fragmentation on food security in the poorest districts of Vietnam’s North Central Coast. Even after controlling for other factors in the models, we provide the first evidence that in Vietnam, ethnic minority households whose land holdings are fragmented are more likely to suffer from food insecurity. A higher likelihood of achieving food security is found for households whose members have better education and non-farm self-employment. The findings suggest that land policies that encourage land consolidation and improve the access of ethnic minorities to better education and non-farm self-employment would help them improve their food security. Such policies should be promoted in the study area.

虽然土地碎片化对越南农业效率和生产多样化的影响已得到充分证实,但没有证据表明其对家庭粮食安全的影响。本研究利用来自家庭调查的独特数据集,结合微观计量经济学模型,研究了越南中北部沿海最贫困地区的土地破碎化对粮食安全的影响。即使在控制了模型中的其他因素之后,我们也提供了第一个证据,证明在越南,土地所有权分散的少数民族家庭更有可能遭受粮食不安全。研究发现,成员受教育程度较高且从事非农业自营职业的家庭实现粮食安全的可能性较高。研究结果表明,鼓励土地整理和改善少数民族接受更好的教育和非农业自营职业的土地政策将有助于他们改善粮食安全。这些政策应该在研究地区得到推广。
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引用次数: 7
Increasing smallholder farmers’ market participation through technology adoption in rural Timor-Leste 通过在东帝汶农村采用技术提高小农的市场参与度
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-07-31 DOI: 10.1002/app5.329
Sonia Akter, Namrata Chindarkar, William Erskine, Luc Spyckerelle, Julie Imron, Lucia Viana Branco

This study examines the role of high-yielding maize varieties as one of the key drivers of smallholder farmers’ market participation in a highly subsistence rural economy. The analysis is based on the End-of-Program Survey data collected by the Seeds of Life program in 2016 covering 700 households in rural Timor-Leste. The results reveal significant positive impacts of technology adoption on farmers’ market participation. Households where women are relatively more active in agriculture than men are more likely to engage in agricultural commerce. The results also show a positive impact of technology adoption on maize productivity. These findings present the first empirical evidence of the causal link between technology adoption and market participation choices.

本研究考察了高产玉米品种在高度自给自足的农村经济中作为小农参与市场的关键驱动因素之一的作用。该分析基于2016年“生命种子”项目收集的项目结束调查数据,涵盖东帝汶农村700户家庭。结果表明,技术采用对农民市场参与有显著的正向影响。妇女在农业中相对比男子更活跃的家庭更有可能从事农业商业。结果还表明,技术采用对玉米生产力有积极影响。这些发现首次提供了技术采用与市场参与选择之间因果关系的实证证据。
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引用次数: 4
Labour law reform and labour market outcomes in Vietnam 越南劳动法改革和劳动力市场结果
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-07-22 DOI: 10.1002/app5.328
Kieu-Dung Nguyen, Duc-Thanh Nguyen, Duy-Dat Nguyen, Van-Anh Thi Tran

Although there has been substantial literature on the economic impact of labour legislation in the world, the number of studies related to Vietnam is, surprisingly, very small. Our article provides the first evidence on the link between labour law and various labour market outcomes using the Vietnamese context. We examine how labour supply, earnings and social protection outcomes adjusted to labour contract reform under the 2012 Labour Code. The study uses three waves of the Vietnam Labour Force Survey to examine both medium-term and short-term impacts of the reform. Difference-in-differences and fixed-effect techniques are utilised. Overall, we find that the law change significantly affected hours worked, work absenteeism, monthly allowance and incidence of bonuses among contracted workers. However, the effects on workers’ monthly wages, overtime remuneration and other allowances, and the social protection-related outcomes were not clear in the short run.

虽然世界上有大量关于劳工立法的经济影响的文献,但令人惊讶的是,与越南有关的研究数量非常少。我们的文章在越南的背景下提供了劳动法和各种劳动力市场结果之间联系的第一个证据。我们考察了劳动力供给、收入和社会保障结果如何适应2012年《劳动法》下的劳动合同改革。该研究利用越南劳动力调查的三波数据来检验改革的中期和短期影响。使用了差中差和固定效应技术。总体而言,我们发现法律的变化显著影响了合同工的工作时间、缺勤率、月津贴和奖金的发生率。然而,短期内对工人月工资、加班费和其他津贴的影响,以及与社会保护相关的结果尚不清楚。
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引用次数: 13
Local politics for democratic quality and depth: Lessons from South Korea 追求民主质量和深度的地方政治:来自韩国的教训
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-06-02 DOI: 10.1002/app5.324
O. Fiona Yap
<p>A vast literature debates the causes, workings and consequences of democracy: a Google Scholar search returns some 3.6 million studies on the subject; by way of contrast, studies on authoritarianism or populism barely reach 350,000. Importantly, the expansive interest in democracy is not merely academic. Instead, studies on democracy are irrefutably empirically driven. Earlier work on the causes and effects of democracy—such as when, why and how do democratic transitions occur, and who are the proponents of transitions—was spurred in no small part by the expansion of liberal democracies in the Second Wave of democratisation following World War II that, set against the backdrop of economic crises and the rise of fascism that preceded the war, saw economic booms and an expanding middle class in the United States and across Europe (Huntington, <span>1991</span>; Lipset, <span>1959</span>; Moore, <span>1966</span>).1 These themes persisted through scholarship on the Third Wave of democratic transition between 1974 and 1990, with voluminous works on the relationship between democracy and economic development explaining or predicting the spread of democratisation in Southern Europe, Latin America, and East and Southeast Asia, which appeared to coincide with economic growth in the 1970s and 1980s in these regions (Huntington, <span>1991</span>; O'Donnell et al., <span>1986</span>; Przeworski, <span>1991</span>; Remmer, <span>1991</span>). Notably, events on the ground in the Third Wave also brought new research pursuits, such as the regional and international diffusion of democracy, the effects of democracy on economic growth, and popular support for democracy (Bratton & Mattes, <span>2001</span>; Brinks & Coppedge, <span>2006</span>; Helliwell, <span>1994</span>; Pevehouse, <span>2002</span>).</p><p>Unsurprisingly, then, recent trends of democratic stalling, reversals, backsliding and deconsolidation are driving the latest research about the quality and depth of democracy, which may be defined as the extent to which democracy in practice approximates its philosophical foundations of ‘government by the people’ (Fishman, <span>2016</span>).2</p><p>Recent studies of democracy have called attention to the need for more robust and systematic evaluation of democratic variability, democratic consolidation, or the demise of democracy, with an emphasis on political factors that have received little attention beyond earlier generations of work (Haggard & Kaufman, <span>2016</span>, p. 126; see also Diamond & Morlino, <span>2004</span>; Foa & Mounk, <span>2017</span>; Fuchs & Roller, <span>2018</span>; Kadivar et al., <span>2020</span>; Yap, <span>2006</span>).</p><p>The articles in this special issue respond to these calls for new treatments. In particular, we point out the need to take account of local or subnational3 politics and their consequences in studies of democratic quality and depth.</p><p>There are at least four reasons to s
大量文献对民主的起因、运作和后果进行了辩论:b谷歌学者搜索得到了大约360万份关于这一主题的研究;相比之下,关于威权主义或民粹主义的研究只有35万篇。重要的是,对民主的广泛兴趣不仅仅是学术上的。相反,对民主的研究无可辩驳地是由经验驱动的。早期工作的原因和影响民主时,为什么和如何民主转型发生,谁的支持者transitions-was刺激扩张在很大程度上的自由民主国家在二战后的第二波民主化,在经济危机的背景下和法西斯主义的兴起前的战争,看到了经济繁荣和不断扩大的中产阶级在美国和整个欧洲(亨廷顿,1991;利,1959;摩尔,1966)。这些主题在1974年至1990年间第三波民主转型的学术研究中得以延续,大量关于民主与经济发展之间关系的著作解释或预测了民主化在南欧、拉丁美洲、东亚和东南亚的传播,这似乎与这些地区20世纪70年代和80年代的经济增长相吻合(亨廷顿,1991;O'Donnell et al., 1986;Przeworski, 1991;快速眼动,1991)。值得注意的是,第三次浪潮中的实地事件也带来了新的研究追求,例如民主的区域和国际扩散,民主对经济增长的影响,以及民众对民主的支持(Bratton & Mattes, 2001;brinks&coppedge, 2006;Helliwell, 1994;Pevehouse, 2002)。因此,不出所料,最近民主停滞、逆转、倒退和解体的趋势正在推动有关民主质量和深度的最新研究,这可以定义为民主在实践中接近其“人民政府”哲学基础的程度(Fishman, 2016)。
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引用次数: 0
Research at public policy schools in the Asia-Pacific region ranked 亚太地区公共政策学院的研究排名
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-05-10 DOI: 10.1002/app5.323
Björn Dressel, David I. Stern

This article presents the first-ever ranking of public policy schools in the Asia-Pacific region based on their research publication output. We used Scopus as our bibliographic database to assess the publication output of 45 schools between 2014 and 2018, based on affiliations listed on the publications rather than current faculty. The results show substantial variation in terms of research output; elite research schools are located in China, Australia, and Singapore. Ranking by total citations, three schools stand out—the Crawford School of Public Policy at the Australian National University, the Lee Kuan Yew School at the National University of Singapore, and the School of Public Policy & Management at Tsinghua University in China. Ranking by impact factor shows that the School of Government at Peking University and the Melbourne School of Government at Melbourne University are the two top-ranked schools, but because of their relatively small research output in this period, their true rank is very uncertain.

本文首次对亚太地区的公共政策学院进行了排名,排名基于它们的研究出版物产出。我们使用Scopus作为我们的书目数据库,根据出版物上列出的隶属关系而不是当前的教师,评估了2014年至2018年间45所学校的出版物产出。结果显示,在研究产出方面存在实质性差异;精英研究型学校位于中国、澳大利亚和新加坡。按总引用次数排名,有三所学校脱颖而出:澳大利亚国立大学克劳福德公共政策学院、新加坡国立大学李光耀学院和公共政策学院。中国清华大学管理学硕士。影响因子排名显示,北京大学政府学院和墨尔本大学墨尔本政府学院是排名最高的两所学校,但由于它们在这一时期的研究产出相对较小,它们的真实排名非常不确定。
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引用次数: 1
Local government performance and democratic consolidation: Explaining ordinance proposal in Busan Metropolitan Council 地方政府绩效与民主巩固——釜山市议会条例提案解读
IF 1.9 3区 社会学 Q1 AREA STUDIES Pub Date : 2021-05-07 DOI: 10.1002/app5.319
Byung-Jae Lee, Tae Wan Kim, Jaekwon Suh, O. Fiona Yap

This article assesses the role of local councils as a conduit for democratic consolidation through the examination of the legislative performance of the members of a South Korean metropolitan city council. We collected data on ordinance proposals in Busan Metropolitan Council from 2006 to 2018 (the 5th to 7th Councils) and analysed, first, the effects of individual attributes of local council members on legislative performance through negative binomial model analysis and, second, the effects of legislative networks on council members' performance. Three findings contribute to the literature: first, the number of proposed ordinances by council members increased over time, while those by the mayor decreased in the same period, suggesting an erosion of executive dominance of policymaking in local councils. Second, female and newly elected council members are most active in legislative proposals, which underlines that these members are more connected to the electorate than long-serving incumbents. Third, network analyses show increasingly diverse and multi-centred communities behind ordinance proposals; this suggests a move from personalistic politics to institutionalised politics.

本文通过对韩国大都市议会成员的立法表现的审查,评估了地方议会作为民主巩固渠道的作用。我们收集了2006年至2018年釜山市议会(第五届至第七届议会)的法令提案数据,并通过负二项模型分析,分析了地方议会成员的个人属性对立法绩效的影响,以及立法网络对议会成员绩效的影响。三项研究结果对文献有贡献:首先,随着时间的推移,议会成员提出的法令数量增加,而市长提出的法令在同一时期减少,这表明地方议会决策的行政主导地位受到了侵蚀。其次,女性和新当选的理事会成员在立法提案中最为积极,这突出表明这些成员比长期任职的现任成员更能与选民建立联系。第三,网络分析显示,条例提案背后的社区越来越多样化和多中心;这意味着从个人化政治转向制度化政治。
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引用次数: 3
期刊
Asia & the Pacific Policy Studies
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