Jenny M Lewis, Centre for the Study of Health and Society,
Department of Political Science, University of Melbourne
Making connections and setting the agenda: Health policy
networks and issues in Victoria
Networks of influence and networks around specific issues structure policy agendas
and constrain policy making. This paper examines network structures of influence
and networks around particular issues in health in Victoria. A snowballing method
was used to generate a list of people who were regarded as influential in the
health sector. 62 of the 115 people contacted completed forms nominating who
they regarded as having influence and indicating whether they had ongoing contact
with those nominated. Blockmodelling of these data generated eight blocks: a
core block of influentials; one associated with acute care and other health
services; one of public health academics; one associated with Monash University;
one of people interested in particular communities or diseases; one with a consumer
and legal focus; one of people who were peripheral but connected; and one of
people who listed influentials only in their defined areas. On the basis of
these nominations, 20 people were asked in interviews about the main current
issues they were working on and who they were working with. Issue networks were
then generated, highlighting the different configurations and structures that
surround different policy issues in the health sector. The results were compared
with the health sector information from the Victorian Agendas Study carried
out in 1991-3. Substantial changes in who is seen to be influential and what
the main issues are in health have occurred over the last decade.
Email: jmlewis@unimelb.edu.au
Kasumi Nishigaya, National Centre for Epidemiology
and Population Health, Australian National University
Young women garment factory workers in post-UNTAC Cambodia:
Export-orientation, decent work deficit and sexual health risk
Privatization and export-orientation characterize the structural adjustment
processes of Post-UNTAC Cambodia. They have precipitated Cambodia's transition
from a tranquil agrarian economy to a capitalist economy, rapidly restructuring
the social relations in production and reproduction. Combined with the indigenous
patterns of gender relations, they have serious implications for women's power
base and health status. Propelled by the proliferation of direct and discreet
commercial sex, the emergence and spread of HIV/AIDS epidemic coincides with
the above structural adjustment processes. Yet, the government attention has
mainly focused on public health interventions targeting the recognized 'risk
groups' such as brothel-based sex workers, military and police. In a culture
where women are expected to be 'virtuous virgins' till marriage, very little
is known about the sexual health of young women in Cambodia. This paper examines
the determinants of the sexual health risk experienced by young women workers
in post-UNTAC Cambodia. Multiple research methods were executed in close collaboration
with the Union Aid-Australia and ten former and current women workers. The results
highlight that some women workers took up direct and discreet sex work in order
to supplement their low factory income. Their decisions were mainly influenced
by the market forces, very weak tripartite relations to improve labor conditions,
and family expectations for daughters to earn cash. In order to enhance women
workers' economic power base and hence to alleviate their sexual risk, the paper
calls for a more inclusive policy approach by incorporating distributive elements
into the current macroeconomic policy, protecting and promoting labour rights
>and strengthening peer-based rights education.
Email: Kasumi.Nishigaya@anu.edu.au
Tim Tenbensel, Political Studies, University of Auckland
'Let the people decide': Will policy processes designed to
facilitate 'direct' influence on policy outcomes by citizens and consumers deliver
more legitimate policy?
For some time now, governments have routinely acknowledged that public policy
processes suffer from legitimacy problems. These are the problems that stem
from the power relationships that characterise policymaking institutions, particularly
the constellation of interest groups and government agencies. In their attempts
to address such problems, government agencies often sponsor more 'direct' policy
process mechanisms. The aim of these mechanisms is to enable the wishes and
preferences of citizens and/or consumers to be translated more directly and
transparently into public policy outcomes. These mechanisms and the rationale
supporting them are inspired by the theoretical traditions of public choice
and participatory democracy. While these are apparently conflicting traditions,
the similarities between them are highly significant. Both take as their starting
point a fundamental scepticism towards the legitimacy of policymaking institutions.
What happens, then, when agencies of the state adopt the language and techniques
of these 'anti-institutional' approaches in order to bolster the legitimacy
of institutional policy processes? To what extent can public faith in government
be restored by the use of more direct policy process mechanisms? Using international
examples of health policy decision-making as a starting point, this paper suggests
some answers to these questions.
Email: t.tenbensel@auckland.ac.nz
Warren Talbot, School of Social Science and Policy, University
of New South Wales
Inside, outside and offside: HIV/AIDS policy discourses in
Australia, 1989
Australia's response to the HIV/AIDS epidemic has been praised for its success
both in stemming the spread of the epidemic and providing a model for public
health partnerships. The Australian approach was crystallised with the release
of a Commonwealth Government White (Policy Information) Paper in August 1989.
This paper is not primarily concerned with the veracity of those claims. Rather
it examines the multiple policy discourses engaged in that policy process from
the perspective of the writer, who was a policy insider at the time. The discussion
questions the extent and manner in which the contributions of major players
(community-based organizations, bureaucrats, clinicians and researchers) have
subsequently been valorised in many accounts of the Australian response. The
perspective offered is that of in insider, as a lobbyist for Australia's national
NGO AIDS organization, but also as an appointed member of the drafting team
for the White Paper. It is suggested that the 1989 Paper is best seen as the
legitimisation, institutionalisation and justification for existing policies
being adopted in many States and community groups. The spread of the virus had
been substantially slowed five years prior to the White Paper. HIV's public
health partnership, though, was cemented in the structured commitment of new
resources that were delivered as a part of the four year Strategy. Individual
actors played key roles.
Email: warren.talbot@student.unsw.edu.au
This site maintained by Phil Griffiths. This page updated 30 September 2002