Examining the role of the diaspora in addressing the interconnections between human health and environmental change: The case of northern Senegalese communities.

Diaspora communities are a growing source of external assistance and resources to meet unmet needs and to strengthen existing health systems in their home countries. Although a growing number of articles have been published in this realm, very few have looked at diaspora communities' role and the place translocal communities give to health (care) in the various remittance dynamics, whilst including power relationships and environmental change. This article examines the motivations and practices through which Senegalese diasporas engage with the health system in their origin country and what barriers they face in their interventions. The results of the migration-environment-health nexus are critically discussed with a political ecology approach. We found that households and villages with a critical number of members abroad, and with strong political and/or international networks, are better off and less exposed to health risks in the face of adverse extreme climate impacts.

Collaborative care: Primary health workforce and service delivery in Western New South Wales-A case study.

OBJECTIVE: To explore how four small towns in rural New South Wales known as the 4Ts are addressing challenges accessing quality care and sustainable health services through a collaborative approach to workforce planning using the collaborative care framework. DESIGN: Descriptive case study approach. SETTING: The collaborative care project was developed as a result of ongoing partnerships between 2 rural Local Health Districts, 2 Primary Health Networks and a non-governmental health workforce organisation. The collaboration works with 5 subregions each comprising 2 or more rural communities. This paper focuses on the 4Ts subregion. PARTICIPANTS: Stakeholders of the collaborative design including organisations and the community. INTERVENTION: A place-based approach to co-designing health services with community in one sub-region of Western New South Wales. MAIN OUTCOME MEASURES: A synthesis of field observations and experiences of community and jurisdictional partners in implementation of the 4Ts subregional model. Mapping of implementation processes against the collaborative care framework. RESULTS: The collaborative care framework is a useful planning and community engagement tool to build health workforce literacy and to impact on system change at the local level. We identify key elements of effectiveness in establishing the 4Ts model, including the need for coordinated health system planning, better integrating existing resources to deliver services, community engagement, building health workforce literacy and town-based planning. CONCLUSION: This study adds to the body of knowledge about how to successfully develop a collaborative primary health care workforce model in practice. The findings demonstrate that the implementation of a collaborative primary health care workforce model using the collaborative care framework can improve service access and quality, which in turn might facilitate workforce sustainability.

Can Development Programs Shape Cooperation? : Results from a Framed Field Experiment in Indonesia.

Empirical studies among small-scale societies show that participation in national development programs impact traditional norms of community cooperation. We explore the extent to which varying levels of village and individual involvement in development policies relate to voluntary cooperation within community settings. We used a field experiment conducted in seven villages (208 participants) from an indigenous society in Indonesia known for their strong traditional cooperative norms, the Punan Tubu. We framed the experiment in terms of an ongoing government house-building program. The results indicate that there were synergistic and antagonistic interactions between existing cooperative norms and government development policies. Participants' cooperation in the experimental setting was low, probably because the Punan Tubu are used to cooperating and sharing both under demand and in a context in which uncooperative behavior is largely unpunished. Variation in experimental behavior was related to both village- and individual-level variables, with participants living in resettlement villages and participants living in a house constructed under the government program displaying more cooperative behavior. The cooperation evident in resettled villages may indicate that people in these villages are more comfortable interacting in anonymous settings and less committed to the demand-sharing norms still prevalent in the upstream villages. The more cooperative behavior among villagers who have previously received a house might indicate that they recognize that they are now better off than others and feel more obliged to cooperate. Policies aiming to capitalize on existing cooperative behavior to stimulate community collective action should consider the specific conditions under which cooperation occurs in real settings since traditional norms that regulate cooperative behavior might not translate well to cooperation in government-led programs.