In vielen Entwicklungsländern findet Wertschöpfungskettenansatz (WSK-Ansatz) verbreitete Anwendung zur Wirtschaftsförderung von Kleinst-, Klein-, und Mittelunternehmen sowie ländlichen Produzenten. Viele Studien belegten, dass WSK-Upgrading von der vorherrschenden WSK-Governance stark abhängt. Jedoch beschränkten sich Diskussionen über WSK-Governance bisher auf Themen wie Koordinierung, Regulierung, Technologie, und Macht. Soziokulturelle Aspekte, die auf das individuelles Verhalten starke Einflüsse ausüben, wurde en passant erwähnt bzw. vollständig ignoriert. Aus diesem Grunde erweitert diese Studie das Governancekonzept durch die Einbeziehung institutioneller Perspektive, die regulative, normative, und kulturell-kognitive Elemente beinhaltet. Diese Erweiterung wird in den Fallstudien von Milch-WSK in Indonesien angewendet. Dabei wird die WSK mit erfolgreichen und erfolglosen Upgradingsresultaten verglichen. Mit einer explorativen Vorgehensweise werden Daten durch Beobachtungen, Interviews sowie den eigenen praktischen Erfahrungen in einem WSK-Förderungsprojekt gesammelt. Die Kausalität zwischen WSK-Governance und –Upgrading wird anhand der qualitativen Herangehensweise des Makro-Mikro-Modells erklärt. Dabei werden die Role von WSK-Operatoren, ihre Wahrnemung, und ihr Entscheidungsverhalten in dem Upgradingsprozess akzentuiert. Die Ergebnisse zeigen dass Regulierung und ihre effektive Durchsetzung von entscheidender Bedeutung sind. Paralel dazu haben aber gesellschaftliche Beziehungen, Werte, und Normen sowie Orientierung und Gewohnheit besonders starke Einflussnahme auf das individuelle Verhalten und somit die Interdependenz zwischen WSK-Operatoren. Deswegen sollen weitere Studien in ähnlichem Kontext, nämlich im ländlichen Raum wo soziokulturelle Aspekte von größerem Belang sind, das erweiterte Governancekonzept in die WSK-Analyse integrieren, um verbesserte Erklärung, Voraussage, und technische Empfehlung über die Förderung der Upgradingsprozesse zu generieren. / Value Chain (VC) approach has been widely applied in developing countries to promote economic growth particularly of micro, small and medium enterprises (MSMEs) and rural producers. Many cases have shown that VC upgrading is strongly determined by the prevailing governance structure. However, hitherto the discussion on VC governance has been limited mainly on coordination, regulation, technology, and power; whereas socio-cultural aspects, albeit influential in determining individual behaviour, are mentioned en passant or totally neglected. Thus, this study calls for the extension of governance concept by introducing a wider institutional perspective incorporating regulative, normative, and cultural-cognitive elements to portray a more realistic picture of the interaction between VC operators. Then, it applies the extended concept in case studies of dairy VCs in Indonesia, comparing the governance of successful and unsuccessful upgrading cases. Using an exploratory procedure, data were collected from observations, interviews, and author’s own experiences involved in a practical VC promotion project. The causalities between VC governance and upgrading are explained using the qualitative approach of Macro-Micro Model to accentuate the role of VC operators, their perception, and selected action in the upgrading processes. The results show that regulations and their effective enforcement are necessary; but also social relations, values, and norms, as well as orientation, common practices, and habit exert strong influences on determining the behaviour of and thus the interdependency between VC operators. Hence, further VC re-searches in similar context, i.e. rural areas where socio-cultural aspects are more influential, are to systematically integrate the extended concept of governance into the analysis in order to generate explanation, prediction, and technical recommendation on the facilitation of upgrading processes.

Background Physical and mental health is important for coping with the high requirements of medical studies that are associated with a higher risk for severe stress, insomnia, smoking, harmful alcohol consumption and easier access to drugs. Health behaviors of medical students influence not just their own health but also the health of their future patients. We examined whether socio-cultural factors can explain differences in students’ health status and health-promoting behaviors. Methods A multicenter cross-sectional survey in Germany (Dresden, Munich) and Hungary (Budapest, Pécs) enclosed international medical students in their 1st, 3rd and 5th academic years. The students were invited to voluntarily and anonymously complete a questionnaire on different aspects of health behavior during obligatory seminars and lectures in 2014. The response rate of the total sample was 56.2 % (n = 2935); the subgroup analysis enclosed data of German (n = 1289), Hungarian (n = 1057) and Norwegian (n = 148) students. Results A high number of Norwegian students (84.5 %) assessed their health status as very good/excellent. In comparison, only 60.3 % of the Hungarian and 70.7 % of the German participants reported a very good/excellent health status. The distributions were comparable between the study sites. Although gender, financial situation and nationality were significant health status predictors, they could explain only 8.2 % of the total variance of health status in the multivariable model. A comparably high number of Hungarian students (95.3 % vs. 67.4 % German and 56.7 % Norwegian) reported that they can currently do a lot/very much for their health. In contrast, a significant number of Norwegians (73.0 % vs. 63.7 % Hungarian and 51.5 % German) reported that they currently do a lot/very much for their health (chi2-test, p ≤ 0.001). Financial situation, study site and study year were the strongest predictors for health promotion activities (Nagelkerkes R2 = 0.06). Conclusions Based on our study, gender and study year played only a minor role in the health status and health promotion beliefs and activities of medical students. Structural (study site) and somewhat socio-cultural factors (nationality, financial situation) mainly explained the differences regarding health promoting behaviors. Obligatory, free-of-charge courses for health promotion (activity and relaxation) should be included in study curriculums.

Background Physical and mental health is important for coping with the high requirements of medical studies that are associated with a higher risk for severe stress, insomnia, smoking, harmful alcohol consumption and easier access to drugs. Health behaviors of medical students influence not just their own health but also the health of their future patients. We examined whether socio-cultural factors can explain differences in students’ health status and health-promoting behaviors. Methods A multicenter cross-sectional survey in Germany (Dresden, Munich) and Hungary (Budapest, Pécs) enclosed international medical students in their 1st, 3rd and 5th academic years. The students were invited to voluntarily and anonymously complete a questionnaire on different aspects of health behavior during obligatory seminars and lectures in 2014. The response rate of the total sample was 56.2 % (n = 2935); the subgroup analysis enclosed data of German (n = 1289), Hungarian (n = 1057) and Norwegian (n = 148) students. Results A high number of Norwegian students (84.5 %) assessed their health status as very good/excellent. In comparison, only 60.3 % of the Hungarian and 70.7 % of the German participants reported a very good/excellent health status. The distributions were comparable between the study sites. Although gender, financial situation and nationality were significant health status predictors, they could explain only 8.2 % of the total variance of health status in the multivariable model. A comparably high number of Hungarian students (95.3 % vs. 67.4 % German and 56.7 % Norwegian) reported that they can currently do a lot/very much for their health. In contrast, a significant number of Norwegians (73.0 % vs. 63.7 % Hungarian and 51.5 % German) reported that they currently do a lot/very much for their health (chi2-test, p ≤ 0.001). Financial situation, study site and study year were the strongest predictors for health promotion activities (Nagelkerkes R2 = 0.06). Conclusions Based on our study, gender and study year played only a minor role in the health status and health promotion beliefs and activities of medical students. Structural (study site) and somewhat socio-cultural factors (nationality, financial situation) mainly explained the differences regarding health promoting behaviors. Obligatory, free-of-charge courses for health promotion (activity and relaxation) should be included in study curriculums.