[Individual and Contextual Reasons for Drop-outs in Vocational Retraining]. / Individuelle und kontextbezogene Ursachen von Abbrüchen beruflicher Qualifizierungsmaßnahmen.

BACKGROUND AND AIMS: The study focusses on the explanation of the individual, process-driven, and institutional factors and their interplay, and on the subjective accounts for the high drop-out rates in vocational retraining which are reported by the German statutory pension insurance scheme. METHODS: 454 participants of 2-year lasting vocational retraining schemes in 3 vocational promotion centers and 3 education providers took part in the questionnaire survey. Furthermore, experts, dropouts and participants were interviewed and group discussions with experts and participants were conducted. RESULTS: Drop-out is not a definite term. Instead, it consists of different dimensions. 3 personal factors for predicting a drop-out could be identified: suffering from depression, negative health assessment and lack of social support. Generally speaking, drop-out of vocational retraining is a complex and mainly situational process which can hardly be predicted by personal factors, job-biographies or foregoing unemployment.

The national health care system in the welfare state.

The German national health care system has for some time shown signs of being in difficulty. Their manifestations are the overloading of the system in terms of consumer demand, the monopoly of functions, ascribed and acquired, by various groups of services providers, and the divided authority and obligations regarding health care and financing, between the federal government and the semi-autonomous German states and localities. At a deeper level of analysis it would appear that the underlying ideological themes that have guided the development of the national health care system need to be questioned. Alternative models of health care can rest on medical sickness models, as is currently the case, or on community centered health care, including primary prevention. The latter is based on the conviction and the insight that health and sickness is not an individualistic, autonomous, and independent set of phenomena but instead is a communal condition that needs to be addressed as such. The expected result is that health and sickness would be re-defined, along with professional intervention.