Bangladesh introduced menstrual regulation (early abortion) into its national family planning program in 1979, and for more than 20 years women with unwanted pregnancies have been able to avail themselves of a relatively safe and accessible service. Over the years, however, concern has been expressed about deficiencies in the implementation of the policy, and by the mid-1990s, the menstrual regulation (MR) policy was approaching a critical juncture. The introduction of health sector reforms and the waning of international and domestic support raised questions regarding the sustainability of the policy. This study was conducted to determine the factors that influenced the development of and support for the MR policy in Bangladesh, in order to explore how far those factors might influence future sustainability. The study used an analytic framework based on literature from the policy field to test what factors were important in the policy process in Bangladesh. Qualitative data was gathered from interviews and documents in an inductive approach to determine the development of the MR policy, which was then subjected to a retrospective analysis of the entire life cycle of the MR policy-how it came to be placed on the policy agenda, how and why it was formulated the way it was, and why it was not implemented as well as it could have been. Data gathered from interviews and document reviews were then used in a political mapping exercise undertaken in a prospective analysis for the policy, providing insights in relation to the future sustainability of the MR policy. The research suggested that the analytic framework used was helpful in providing a systematic analysis of contextual conditions, agenda-setting circumstances, and policy characteristics that could explain much of the variability in the policy process. The role of international donors and attitudes toward religion were found to be particularly relevant to explaining the policy process. The study concluded that the MR policy would likely not be sustained in the future unless purposeful action were taken to mobilise additional bureaucratic and political resources in support of the policy.

Household ability to pay (ATP) for health care services has become a critical policy issue in developing countries because of changes to health system financing and delivery that are likely to impose higher illness cost burdens on poor households. The research presented in this thesis was driven by widespread concern about ATP among different policy actors, and by the fact that conceptual and empirical understanding of the issue remains poorly developed. The thesis uses a conceptual framework for assessing ATP that is, at its core, concerned with the implications that illness costs and related coping strategies have for household livelihoods. The main research objectives were to measure the household costs of illness, examine the types of asset (e. g. financial, social) that are mobilised to cover illness costs, and to evaluate the impact of these illness cost burdens and coping strategies on household livelihoods in the medium term. In so doing, the thesis aimed to identify factors which make households robust or vulnerable to illness costs which development agencies might support. Research was conducted in two low-income communities in Colombo, Sri Lanka. A survey of 423 households was carried out to obtain a profile of illness, treatment actions and illness costs in the two communities, and to identify case study households. The main part, of the research was to follow 16 case study households for eight months, which enabled in-depth investigation of treatment seeking behaviour, expenditure patterns, asset strategies and their impact on household livelihoods. The main findings of the research were ' that free public provision of health services protected poor households from high treatment -costs. In particular, public tertiary hospitals protected households against potentially catastrophic treatment costs associated with inpatient care. This enabled households to access treatment without adopting risky coping strategies. However, aspects of the health system failed to protect households from illness costs, and in a context of low and insecure incomes, illness costs did not have to be high to exceed daily budgets and undermine ability to meet basic food needs. Consequently, households often required additional resources to meet illness costs, and people's financial and social resources were shown to be important factors influencing ability to manage illness costs. However, the research also found that income-poor households had weak social resource endowments which forced them into riskier borrowing or asset strategies. Policy actions to support household assets are examined.

by David H. Douglass, Jr. and M.W.P. Strandberg. / "September 1, 1961." "Reprinted from Physica, vol. 27, pp. 1-17, 1961." / Bibliography: p. 17. / Army Signal Corps Contract No. W-36-039-sc-78108. Dept. of the Army Task 3-99-20-001 and Project 3-99-00-000. Army Signal Corps Contract DA36-039-sc-87376.

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Relying on new empirical data, derived from a survey, and supplemented by an extensive study of available secondary material, this thesis represents the first attempt systematically to explore key issues regarding occupational welfare in Russia, with special reference to health care. The thesis is divided into three parts: a discussion of the problematic; an investigation of the evolution of policy; and an examination of primary and secondary empirical data. The fundamental theoretical problems of occupational welfare are approached in the light of research in the West, in the Soviet Union and in post-Soviet Russia with emphasis both on divergences and commonalities. It is argued that any endeavour to separate Soviet and Western experiences is artificial and ultimately unproductive. Rather, the analytical penetration of ideological barriers renders possible an examination of their fruitful interaction. On the basis of existing knowledge two perspectives of occupational welfare -- social policy and organisation -- are introduced. An attempt to formulate a general definition of the notion of occupational welfare is also made. The evolution of occupational welfare and in particular its health care component are examined in their context, from the Tsarist era, during the Soviet Union and through to post-Soviet times, with a concrete aim of elucidating any continuities in policy pathways. Contemporary issues are associated with the initial outcomes of health reforms in the 1990s that are indispensable for projecting the future prospects of occupational welfare. The empirical component of the thesis reports the results of fieldwork carried out in Moscow between 1995 and 1997. The brief was to explore the contemporary status of occupational welfare in Russia in the context of changing social policy aims and methods evolving in the course of the transformation. The attitudes of senior managers of industrial enterprises providing in-kind health services for their employees were investigated, as were employers' actual health responsibilities in the light of the introduction of compulsory health insurance legislation. It is argued that occupational welfare has a distinct sphere of operation and offers potential, not only for the survival of the service area but also for its further development in the evolving socio-political environment. The thesis is a first step towards a deeper analysis of occupational welfare in Russia: an audit of outstanding issues, although not exhaustive, completes the account as an aid to further discussion and research.

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This thesis is concerned with staff carers of individuals with a learning disability and a diagnosis of schizophrenia. To date this group of carers have received no attention from researchers. This is in contrast to a vast body of literature, which has established the psychological impact of care giving on the relatives of patients with a diagnosis of schizophrenia, without a learning disability. The term ‘schizophrenia’ has been used throughout this thesis. This reflects the use of psychiatric diagnoses in the body research and clinical literature, which has guided the development of the current study. The first paper critically reviews the application of attribution theory to the study of relatives’ coping responses to schizophrenia and the associated symptomatology. The literature review has been prepared for submission to Schizophrenia Bulletin (see Appendix B for Instructions to Authors). The brief research paper reports on the development of the Attributions for Schizophrenia Questionnaire (ASchizQ) and a preliminary investigation with staff carers of individuals with a mild learning disability and a diagnosis of schizophrenia. This paper has been prepared for submission to the Journal of Applied Research in Intellectual Disabilities (see Appendix C for Instructions to Authors). The main research paper focuses on the application of attribution theory to staff caring for individuals with a mild learning disability and diagnosis of schizophrenia. It examines the relationship between staff carers’ causal attributions about schizophrenia and the associated symptomatology and their current coping styles. This paper has been prepared for submission to the British Journal of Clinical Psychology (see Appendix D for Instructions to Authors). Finally, the research review describes some of my experiences and observations of conducting research with carers of individuals with a mild learning disability and a diagnosis schizophrenia.