Browsing by Subject "REFORM"

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  • Blukacz, Alice; Cabieses, Baltica; Markkula, Niina (2020)
    Mental health in a context of international migration is a particularly pressing issue, as migration is recognised as a social determinant of physical and mental health. As Chile is increasingly becoming a receiving country of South-South migration, immigrants face mental health inequities, with regards to outcomes and access to care. In order to identify and synthetize mental healthcare inequities faced by international migrants with regards to locals in Chile, a narrative review of the literature on national mental healthcare policies in Chile and a narrative review of the literature on migrants' mental healthcare in Chile were conducted, with a focus on describing mental health outcomes, policy environment and persisting gaps and barriers for both topics. The existing literature on mental healthcare in Chile, both for the general population and for international migrants, following the social determinant of health framework and categorised in terms of i) Inequities in mental health outcomes; ii) Description of the mental health policy environment and iii) Identification of the main barriers to access mental healthcare. Despite incremental policy efforts to improve the reach of mental healthcare in Chile, persisting inequities are identified for both locals and international migrants: lack of funding and low prioritisation, exacerbation of social vulnerability in the context of a mixed health insurance system, and inadequacy of mental healthcare services. International migrants may experience specific layers of vulnerability linked to migration as a social determinant of health, nested in a system that exacerbates social vulnerability. Based on the findings, the article discusses how mental health is a privilege for migrant populations as well as locals experiencing layers of social vulnerability in the Chilean context. International migrants' access to comprehensive and culturally relevant mental healthcare in Chile and other countries is an urgent need in order to contribute to reducing social vulnerability and fostering mechanisms of social inclusion. International migration, social determinants of mental health, mental health inequities, social vulnerability, review.
  • Sims, Margaret; Alexander, Elise; Nislin, Mari; Pedey, Karma; Tausere Tiko, Lavinia; Sajaniemi, Nina (2018)
    We contend that the conventions, practices and philosophies underpinning working with infants and toddlers provide an alternative way of viewing early childhood work, and such a perspective may well help to challenge the 'wicked problem' of neoliberalism. It is in this context that we propose that a deeper understanding of the perspectives of those professionals working with our youngest children in a range of different countries may inform a wider resistance to neoliberalism across all of early childhood. We seek, in this article, to share the voices of early childhood professionals reflecting on the manner in which they understand work with infants and toddlers, and how this relates to their understanding of issues related to education and care. We hope this exploration will lead us into further refining our argument that infant and toddler pedagogy has the potential to challenge the hegemony of neoliberalism in early childhood. Our dream is to steer early childhood away from the tyranny of standardisation, accountability and economic rationality into a space where children are valued for being, where individuality and diversity flourish, where learning academics is one (relatively unimportant) element amongst many others and where relationships and participation (and dare we say, happiness) reign supreme.
  • Ramdani, Rijal; Lounela, Anu K. (2020)
    Tropical peatland suffers from rapid degradation due to expansion of palm oil plantations. In Indonesia, Environmental Non-Governmental Organizations (ENGOs) have an important role in peatland protection. This paper discusses the implications of responsibilization in the relation between advocacy and service ENGOs in the context of tropical peatland protection and the expansion of palm oil in Sumatra, Indonesia. Drawing on the scholarly discussion on responsibilization in environmental management we show that responsibilization in peatland protection increases distrust among the ENGOs by generating a diversity of actors with different material support, burdens and principles of work, and even polarized opposition between the networks. Such distrust has a bearing on the effect of the actions, networks, and material support of advocacy and service ENGOs. Advocacy ENGOs share similar interests with their donors, which allow them to perform their expected actions autonomously, while service ENGOs are more dependent on donors' programmes and aims. The research utilized methods such as face-to-face semi-structured interviews with advocacy and service ENGOs, state and non-state actors, palm oil farmers, palm oil associations and three leaders of local communities, combined with participant observation. We argue that responsibilization should be explored case by case because different responsibilization processes lead to differing burdens among different types of ENGOs. Contrary to expectations, responsibilization in peatland protection may thus decrease the possibilities for peatland protection in the area.
  • Kumpulainen, Kristiina; Kajamaa, Anu; Rajala, Antti (2018)
    This study investigates agency-structure dynamics in students and teachers' social activity in a novel design and making environment in the context of the Finnish school system, which has recently undergone major curricular reform. Understanding that agency is an important mediator of educational change, we ask the following questions: How are agency-structure dynamics manifested in the social activity of students and their teachers in a novel design and making environment? How do agency-structure dynamics create possibilities and obstacles for educational change? The data comprise 65 hours of video recordings and field notes of the social activity of students aged 9-12 years old (N = 94) and their teachers collected over a period of one semester. Our study shows how the introduction of the novel learning environment created a boundary space in which traditional teacher-centered activity patterns interacted and came into tension with student-centered modes of teaching and learning. Our study reveals three distinctive agency-structure dynamics that illuminate how the agentive actions of both teachers and students stabilized existing teacher-centered practices and, at other, times ruptured and broke away from existing patterns, thus giving rise to possibilities for educational change.
  • Suominen, Anna L.; Helminen, Sari; Lahti, Satu; Vehkalahti, Miira M.; Knuuttila, Matti; Varsio, Sinikka; Nordblad, Anne (2017)
    Background: During the 2000s, two major legislative reforms concerning oral health care have been implemented in Finland. One entitled the whole population to subsidized care and the other regulated the timeframes of access to care. Our aim was, in a cross-sectional setting, to assess changes in and determinants of use of oral health care services before the first reform in 2000 and after both reforms in 2011. Methods: The data were part of the nationally representative Health 2000 and 2011 Surveys of adults aged >= 30 years and were gathered by interviews and questionnaires. The outcome was the use of oral health care services during the previous year. Determinants of use among the dentate were grouped according to Andersen's model: predisposing (sex, age group), enabling (education, recall, dental fear, habitual use of services, household income, barriers of access to care), and need (perceived need, self-rated oral health, denture status). Chi square tests and logistic regression analyses were used for statistical evaluation. Results: No major changes or only a minor increase in overall use of oral health care services was seen between the study years. An exception were those belonging to oldest age group who clearly increased their use of services. Also, a significant increase in visiting a public sector dentist was observed, particularly in the age groups that became entitled to subsidized care in 2000. In the private sector, use of services decreased in younger age groups. Determinants for visiting a dentist, regardless of the service sector, remained relatively stable. Being a regular dental visitor was the most significant determinant for having visited a dentist during the previous year. Enabling factors, both organizational and individual, were emphasized. They seemed to enable service utilization particularly in the private sector. Conclusions: Overall changes in the use of oral health care services were relatively small, but in line with the goals set for the reform. Older persons increased use of services in both sectors, implying growing need. Differences between public and private sectors persisted, and recall, costs of care and socioeconomic factors steered choices between the sectors, sustaining inequity in access to care.
  • Räsänen, Katariina; Pietarinen, Janne; Pyhältö, Kirsi; Soini, Tiina; Väisänen, Pertti (2020)
    Teacher turnover has been recognized as a significant problem in the education worldwide. This study focuses on exploring reasons behind the turnover intentions, and persistence of such intentions in 5-year follow-up among Finnish teachers. Longitudinal survey data were collected from Finnish comprehensive school teachers in 2010 (T1n = 2310) and 2016 (T2n = 1450). The results showed that 50% of the teachers had turnover intentions. Turnover intentions were remarkably persistent, but the reasons for them varied significantly. Lack of professional commitment and factors related to the school system and workload were the main reasons for teacher turnover intention. The results suggest several factors that should be improved simultaneously in the teaching profession to increase teacher job satisfaction and retention.