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Universal coverage is a core health system goal which can be met through a variety of health financing mechanisms. The focus of this PhD is on one of these mechanisms, community-based health insurance (CBHI). CBHI aims to provide financial protection from the cost of seeking health care through voluntary prepayment by community members; typically it is not-for-profit and aims to be community owned and controlled. Despite its popularity with international policymakers and donors, CBHI has performed poorly in most low and middle income countries. The overarching objective of this PhD is therefore to understand the determinants of low enrolment and high drop-out in CBHI. The PhD builds on the existing literature, which employs mainly economic and health system frameworks, by critically applying social capital theory to the analysis of CBHI. A mixed-methods multiple case study research design is used to investigate the relationship between CBHI, bonding and bridging social capital at micro and macro levels and active community participation. The study focuses on Senegal, where CBHI is a component of national health financing policy. The results suggest that CBHI enrolment is determined by having broader social networks which provide solidarity, risk pooling, financial protection and financial credit. Active participation in CBHI may prevent drop-out and increase levels of social capital. Overall, it seems CBHI is likely to favour individuals who already possess social, economic, cultural and other forms of capital and social power. At the macro level, values (such as voluntarism, trust and solidarity) and power relations inhering in social networks of CBHI stakeholders are also found to help explain low levels of CBHI enrolment at the micro level. The results imply the need for a fundamental overhaul of the current CBHI model. It is possible that the needed reforms would require local institutions to develop new capacities and resources that are so demanding that alternative public sector policies such as national social health insurance might emerge as a preferable alternative.

Today, researchers and policy makers alike are increasingly concerned about the “double burden of malnutrition” in low and middle income countries (LMICs). This ‘double burden’ is understood to be the coexistence of under- and overnutrition within one population. The definition of a ‘double burden’ relies upon the existence of chronic undernutrition among children (indicated by stunting – where children are shorter than expected for their age) and the existence of overnutrition in children or adults (child overweightness as indicated by a greater weight than expected for a given height and adult overweightness/obesity as indicated by a greater weight than height). However, research has failed to consider that children can be concurrently stunted and overweight – known here as ‘stuntingoverweightness’. In failing to consider stuntingoverweightness, the prevalence of stunting and overweightness among children has been overestimated at the population level. Stuntedoverweight children have been ‘double counted’ – once as stunted and once as overweight. This has severe implications for our understanding of malnutrition in LMICs today. The polarisation of malnutrition among children of under- and overnutrition has been exaggerated and a whole group of children have become hidden – the stuntedoverweight. This research addresses this issue. Recalculating stunting and overweightness prevalence accounting for stuntingoverweightness this research shows that, today in LMICs, up to 10.42% of children under-five are stuntedoverweight – yet no policies or programmes exist to understand the determinants of stuntingoverweightness, its effects or how to alleviate them. An individual level analysis of Albania shows stuntedoverweight children are a separate socioeconomic group and should thus be targeted for interventions separately from their stunted and overweight peers. Furthermore, failing to recognise stuntingoverweightness has led to overestimations of the burden of stunting by up to 88.54% (in Albania) and of overweight by up to 295.26% (in Benin) and skewing our understanding of the ‘burden of malnutrition’ in LMICs. The thesis shows that for nutritional strategies to be effective – research needs to consider the diverse burden of malnutrition observed in LMICs today.

This thesis proposes a reconstructed, critical cosmopolitanism that uses the identified core components of the normative branch of cosmopolitanism rooted in (Kantian) moral philosophy and the works of a wide variety of critical theorists that include feminist, postcolonial, and queer perspectives. I pay particular attention to those theorists influenced by poststructuralist deconstructions of the stable subject who focus either on the normative theory directly or on components essential to it. Normative theorists, exemplified by Thomas Pogge, Simon Caney and others, usually focus on global distributive justice, taking as a given, for example, who counts as human. Critical theorists, such as Judith Butler, question that premise. This postmodern turn has implications for what I argue are the three necessary components of cosmopolitanism: autonomy, universality, and its anti-nationalist position. However, the first two have been problematised because of their liberal conceptualisations, which then has implications for cosmopolitanism’s anti-nationalist position as well. I propose a reconfiguration of cosmopolitanism that retains the core normative concepts, but rejects their more liberal interpretations. I argue that the atomistic individual as the basis for liberal autonomy is flawed, and that liberal cosmopolitan conceptualisations of univeralism do not recognise its particularity. I also argue that that the normative theory does not fully take into account nationalism’s dependence on the marginalisations of non-normative populations within the nation state, and how those dependencies might be complicit with nationalism’s othering of those across borders. In addition to a number of normative theorists, the thesis references such multidisciplinary thinkers as Butler, Linda Zerilli and Hannah Arendt. I examine the works of different theorists to develop a reformulation of each of these concepts and integrate an intersubjective approach into these reformulations in order to assemble a feminist, intersubjective, critical cosmopolitan theory. I suggest the adoption of a ‘cosmopolitan intersubjectivity’ in order to show how these concepts can be reconfigured to work together more cohesively and give cosmopolitan theory greater internal consistency.

This thesis addresses the training needs, experiences and aspirations of a group of young Black and White women on the One Year Youth Training Scheme (YTS) in the mid-1980s. The thesis takes as its starting point the role of the State and the Manpower Services Commission in fostering a new training scheme, based on social market principles and a deficiency-centred model of young people. In turn this process of labelling young people as deficient is subjected to a critical analysis, especially in relation to the youth labour market and the rise in youth unemployment from the late 1970s up to the beginning of the research period in 1984. Thereafter, the issue of training in the context of the sample's past experiences of schooling and the labour market is examined in order to identify the most salient factors involved in their selection of the Youth Training Scheme. A focus on two case study training schemes is undertaken, where the main objective is to explore the nature of relationships between the various actors involved, ie. Black and White female trainees and staff. In doing so the central argument pursued by this thesis is that the nature of such relations determined the quality of the training received by the sample group on the two schemes in an area of West London between the summer of 1984 and 1985. In conclusion the thesis argues that based on the research evidence, the labelling of young people as deficient in employment skills is misleading, because it fails to take into account the complexity surrounding the transition from school to work.

Half of health care in sub-Saharan Africa is privately provided, however, for mental health, the literature is all but absent on these services. Kenya provides a useful case-study, as it has a wellorganized non-state sector and data are readily available. My thesis asks what contribution do non-state actors make to coverage for mental disorders in Kenya? Non-state mental health care is conceived along two axes: for-profit vs. not-for-profit and formal vs. informal. Four empirical chapters use mixed-methods to examine: 1) not-forprofit NGO care; 2) for-profit inpatient care; 3) for-profit outpatient care; and 4) traditional and faith healing. Data were collected on 774 service users and 120 service providers from four primary sources, and two secondary sources, as well as from a wide range of key-informant interviews. The first two chapters set the research question within the context of existing knowledge in the fields of health economics and health services research. The third chapter provides an overview of methods, focusing on cost-effectiveness analysis, case study method, and crosscultural psychiatric epidemiology. The first empirical chapter presents an NGO intervention called the model for Mental Health and Development, evaluated qualitatively and quantitatively, using cost-effectiveness analysis. The second empirical chapter offers a case study of a growing private psychiatric hospital, using regression analysis on the effects of insurance on charge and service use. The third chapter is a short descriptive analysis of a questionnaire completed by psychiatric nurses about their participation in mental health care, and structured interviews with specialist outpatient providers. The final empirical chapter contains qualitative and quantitative data on traditional and faith healing, analysed for similarities and differences. The conclusion ties together findings thematically according to capacity, access and cost, estimating the degree of mental health care coverage offered by non-state actors in Kenya, and offering lessons for policy and research.

The purpose of this thesis is to explore the history of covert ethnography in Britain between the 1880s and 1980. During this century, a range of academic and non-academic social researchers have used the method of covert ethnography. The starting point for this thesis is the observation that there is no adequate and sustained explanation of covert ethnography as a historical phenomenon. It is argued that the fragmented nature of the existing historiography precludes a full understanding of this important historical phenomenon. It is the intention of this thesis to bridge the gaps in the historiography, as it stands, and to promote an inclusive historical account of covert ethnography in Britain across time. Through an analysis of covert ethnographic projects undertaken in Britain between the 1880s and 1980, with particular attention being paid to the structure and language used by covert ethnographers, this thesis will locate the use of this research method in its historical context. This thesis will chart the changes and continuities over time in the use of covert ethnography and demonstrate how key forces, such as the establishment of new models of ethnographic research and the development of ethical concern regarding covertness, shaped the use of covert ethnography significantly. This thesis will contribute a more comprehensive account of covert ethnography to the existing historiography.

During the postwar period the economy of urban housing in Greece has undergone a major transformation. The great bulk of housebuilding in the 1950's could be described as "precapitalist". "Speculative" building, i.e. the production of housing as a commodity for the market under the control of capitalists, prevailed, albeit in ~ rather primitive form, in the limited sector of middle-class apartment housing. By the 1970's, however, the latter economic form has grown into the dominant mode of housing production and distribution. The generality and significance of this transformation for the early stages of capitalist urbanisation has seldom been recognised. Thus, the study begins with a theoretical model of the different modes of housing production and housing sectors relevant to such a historical context, and the concept of the "dual" system where both speculative-capitalist and precapitalist modes operate. Analysis of postwar housebuilding on the basis of this model establishes rigorously the extent, character, and sociospatial correlates of each mode. It is argued that popular precapitalist owner-building is not reducible to a residual phenomenon of socially marginal "squatter" housing, but constitutes a major historical form based on distinctive aspects of Greek society and autonomy vis-a-vis capitalist relations and modern administrative controls. Thus, the decline of this sector has not been the outcome of voluntary assimilation into the market but the result of political and economic constraints. This hypothesis is corroborated by a detailed analysis of demand and allocation of housing in Athens. Given the decline in the role of precapitalist housing, the growth of speculative building is a corollary of trends in aggregate residential investment. The rest of the study examines the formation of the latter, first, in relation to the pattern of Greek economic development, and then, with the help of a model of household behaviour and the economics of the early capitalist housing system as a whole.

This thesis investigates the collection of levies by the state from Colombian coffee and Philippine coconut producers and the delegation of authority, to mobilise and regulate the uses of the levies, to producers associations in these sectors. The thesis suggests that these activities constitute an “institutional framework” for state-engineered rents, whereby public authority is appropriated by private agents. It asks why similarly-designed institutions for allocating rents yielded different outcomes: Colombian coffee levies are associated with growth-enhancing and producer welfare-promoting investments in coffee production and marketing, while Philippine coconut levies are depicted as non-developmental rent capture by associates of a president. The thesis explains the variation in outcomes by examining the basis in political economy of the power exercised by the leading sectoral organisations, FEDECAFE in Colombia and COCOFED in the Philippines, and how they articulated this power in the mobilisation of the levies. It finds that the conditions for collective action and the exercise of power were more robust for Colombian coffee than Philippine coconut producers. This meant that while FEDECAFE directly intermediated between coffee producers and the state in the mobilisation of rents associated with coffee levies, COCOFED shared the power of mobilising rents with other individual political brokers. This variation led to differences in rent mobilisation: a process that was production-enhancing in Colombia but not in the Philippines. This work thus shows how variations in the political organisation of rent-seeking may be linked to variations in the developmental outcomes associated with the collection and deployment of such levies. Doing so, it seeks to contribute to the understanding of the political conditions under which state-engineered rents may be production-enhancing – an important question in late developing countries, where corruption may be endemic, but state-allocated rents nevertheless necessary for promoting development.

This study explores and compares the rationales behind, and justifications for, intentions about whether or not to have a second child among Polish fathers and mothers living in the UK and Poland. Drawing on semi-structured interviews (n=42) contextualised by media and statistical analyses, the thesis interrogates the Theory of Planned Behaviour (TPB) and explores the extent to which aspects related to the theory (i.e. attitudes, subjective norms and perceived behavioural control) permeate informants’ narratives. This thesis emphasises that researching fertility intentions requires more complex and context-specific operationalisations of theoretical constructs as drawing on standardised definitions and concepts across different populations could impact data validity and reliability, and I suggest ways in which survey questions could be modified. The findings demonstrate the importance of transnational groups of reference for Polish individuals’ understanding of resources deemed as adequate to have a second child, suggesting that the notion of economic wellbeing is more variable and complex than current evidence suggests. The study also illustrates that kin assistance in Poland is relevant for reproductive decisions since it relates to economic constraints to childbearing and to perceived requirements to provide children with kin support and inheritance. Moreover, individuals in both settings communicate beliefs related to childbearing intentions discursively, fine-tuning ambivalent and inconsistent cognitions while constructing a coherent narrative. The findings question the TPB assumption that people reach decisions primarily as a result of causal, regular and law-governed forces acting on theoretical constructs independent of individuals’ agency, and I point to possibilities to expand and refine theories used in demographic research. Although my empirical findings focus on Polish nationals, I argue that this research has broader implications for theorising, researching and interpreting findings on childbearing intentions.