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Indian democracy has noble features of decentralization, devolution, and de-concentration. The 73rd Constitutional Amendment Act (CAA) of the early 1990s is a landmark for democratic decentralization which accorded constitutional status to Panchayati Raj or Local Governance system within the country. Wherein Gram Panchayat (village level) is the basic unit of grassroots governance, Panchayat Samiti (block level) at the middle level and Zila Parishad (district level) is the highest level of local administration. With 73rd CAA, 29 functional items were put under Panchayats, relating to Sustainable Development Goals, such as Poverty Alleviation, Zero Hunger, Good Health & Well-being, Quality education, Gender equality, Clean water and Sanitation, Clean energy etc. The UNDP identifies Local Governments as vital partners in implementation. This paper analyzes the major challenges of Indian rural local government in achieving the sustainable development goals and examines its viable perspectives. The research methodology followed is descriptive research with narrative and qualitative analysis. The findings indicate significant challenges in attaining the SDGs in rural India and limited resources with rural local governments like. The silver lining, however, lies with the government willingness to translate the digital gains into productive information, mass awareness creation, and push for greater effective role of women the local governance. [ABSTRACT FROM AUTHOR]

The Energy-Water-Food (EWF) nexus is a complex and multidimensional system, in which the energy, water and food resources are strongly interconnected. EWF nexus systems are seriously threatened by natural hazards (e.g., climate change and extreme weather events) along with other human-driven threats, including rapid population growth, urbanization, terrorism, and geopolitical uncertainty. As such, integrated analysis, as encouraged by the EWF nexus can facilitate the identification of essential connections and potential conflicts that may arise in the planning and operation of resource systems. Moreover, in order to consider immediate shocks and long-term pressures, it is imperative to prioritize the strengthening of EWF system resilience by incorporating robust and efficient resource management strategies, which consider various dimensions of sustainability and security such as technical, environmental, economic, and societal aspects. Decentralization is one concept that has the potential of improving the resilience of nexus systems faced to the multiple risks governing them through reducing single points of failure and enabling swifter responses to sudden shocks and continuous volatilities. However, in order to achieve a holistic system resilience through decentralization, the assessment of the different risks impacting each nexus sector is fundamental, yet it can be particularly challenging. Therefore, the objective of this study is to review the currently available resilience assessment methods for the EWF nexus system. The systematic literature review will connect various assessment methods used within decentralization studies that are applied to improve the resilience performance of the EWF nexus system. A total of 84 journal papers were evaluated. The review demonstrates that the deployment of multi-criteria decision-making framework based on composite indicators can be effective in addressing risks and uncertainties within EWF systems. Furthermore, findings of this review illustrate complementary connections between decentralization and resilience concepts, which when integrated with the EWF nexus approach, can be effectively utilized for integrated sustainable resource management. [ABSTRACT FROM AUTHOR]

While industry and regulators' interest in decentralized clinical trials (DCTs) is long-standing, the Covid-19 pandemic accelerated and broadened the adoption and experience with these trials. The key idea in decentralization is bringing the clinical trial design, typically on-site, closer to the patient's experience (on-site or off-site). Thus, potential benefits of DCTs include reducing the burden of participation in trials, broadening access to a more diverse population, or using innovative endpoints collected off-site. This paper helps researchers to carefully evaluate the added value and the implications of DCTs beyond the operational aspects of their implementation. The proposed approach is to use the ICH E9(R1) estimand framework to guide the strategic decisions around each decentralization component. Furthermore, the framework can guide the process for clinical trialists to systematically consider the implications of decentralization, in turn, for each attribute of the estimand. We illustrate the use of this approach with a fully DCT case study and show that the proposed systematic process can uncover the scientific opportunities, assumptions, and potential risks associated with a possible use of decentralization components in the design of a trial. This process can also highlight the benefits of specifying estimand attributes in a granular way. Thus, we demonstrate that bringing a decentralization component into the design will not only impact estimators and estimation but can also correspond to addressing more granular questions, thereby uncovering new target estimands. [ABSTRACT FROM AUTHOR]

Decentralized autonomous organizations (DAOs)--collectively owned human-machine systems deployed on a blockchain that self-govern through smart contracts and the voluntary contributions of autonomous community members--exhibit the potential to facilitate collective action in managing digital commons. Yet the promise of decentralization and collective action is difficult to sustain. To this end, this paper critically examines the transformational potential of DAOs in the case of decentralized finance. Using a polycentric governance lens, we contribute to the literature on technology-enabled forms of organizing with a model explaining the transformational potential of DAOs to facilitate collective action in digital commons. Our study highlights that (1) DAOs are a new form of organizing enabled by blockchain technology in which individuals are free to pursue their objectives within a general system of rules enforced by smart contracts, (2) collective action for managing digital commons can be sustained through a set of three mechanisms--sustained participation, collective direction, and scaled organizing, and (3) DAOs tend to strike a balance between centralized and fully decentralized or community-based governance by implementing a polycentric governance system involving a combination of human and machine agency that creates skin in the game. [ABSTRACT FROM AUTHOR]

This paper aims to give a short description of Swedish healthcare provision for persons with intellectual and developmental disabilities (IDD). Swedish persons with IDD should have access to the general healthcare system on the same terms as the general population, and thereby enjoy equal opportunities for healthcare of good quality. Reports from government agencies and interest groups, however, describe a decentralised and fragmented healthcare system that requires significant coordination; a lack of adjustments; a lack of specialised healthcare professionals; and gaps in healthcare provision. Research in recent years has reported unequal access to planned healthcare; excess mortality and premature deaths; and insufficient or inadequate support in end‐of‐life care. We conclude that health inequalities and healthcare challenges faced by Swedish persons with IDD might be caused by obstacles at several structural levels. Allowing persons with IDD to access timely and adequate healthcare requires the development of better opportunities for coordination of healthcare and social services, as well as training for healthcare professionals and direct support staff. [ABSTRACT FROM AUTHOR]

During China's reform era, dominant narratives described a transition away from centralised planning in favour of mutually reinforcing processes of liberalisation and decentralisation. Under Xi Jinping, the talk has increasingly been of the recentralisation of authoritarian-state powers and party discipline. Questioning both reform-era transition narratives and equally simplifying claims about their recent reversal, the paper argues for an enriched treatment of party–state spatiality, understood as a polymorphic and multi-scalar process, rather than simply a more complex one. In the emergent Greater Bay Area megaregion, 'new era' zoning strategies are being repurposed as drivers of pathfinding reforms animated by the party–state, in contrast to received readings of zones as single-purpose instruments of liberalisation. [ABSTRACT FROM AUTHOR]

To achieve Sustainable Development Goal 5 for gender equality by 2030, it is crucial for health and development professionals and governmental officials to understand how legal systems empower or oppress populations on the basis of gender worldwide, including opportunities and challenges of statutory provisions created by legal pluralism. Using Ethiopia as a case study, this paper examines how local laws applied in Sharia and Customary Dispute Resolution courts impact gender equality and the health of women and girls inspite of the inculcation of human rights statutes into national legislation, including the Constitution. We identify several key issues with the substantive law and its enforcement. First, laws which have been instituted at the national level to improve gender equally have been poorly enforced at the local level. Second, there is a sustained enforcement of laws that oppress women and that protect male perpetrators of gender-based violations. Third, local courts limit female representation and uphold patriarchy. To improve the health of women and girls, stakeholders must take into consideration the ways in which legal systems uphold harmful gender norms and obstruct and/or advance progress towards equal representation, opportunities, and constitutionally-mandated protections for all. [ABSTRACT FROM AUTHOR]

Interorganizational partnerships can spur innovation, but their value may be diminished by friction in knowledge flows between firms. We consider how a partner's organizational structure may influence the knowledge that is accessible via partnerships. We focus on how a partner's structure trades off localized autonomy for its managers, which facilitates timelier decision making, and unified control, which facilitates integration. By shaping this balance, centralization of decision rights within the partner organization shapes access to its knowledge. Centralized structures generate wide-ranging internal knowledge pathways that enable access to a broader array of a partner's knowledge. However, the reduced managerial autonomy afforded by centralization makes decision making more cumbersome, which constricts the rate of access to a partner's knowledge. We find evidence of this tradeoff in the context of corporate venture capital relationships between incumbents and startups in the pharmaceutical industry. An increase in the incumbent's diversity of knowledge or in the knowledge required by the startup enhances the value of a greater breadth of access, whereas the degree to which the startup can leverage social ties (affinity) or hierarchical fiat (authority) alleviates the costs of a reduced access rate. Each of these features makes an incumbent organization's centralization more valuable to the startup. By highlighting this tension related to centralization, our findings suggest that new firms striving to maximize their partnership benefits may need to carefully consider their partners' internal structures. [ABSTRACT FROM AUTHOR]

The sustainable, integrated, and representative management of water is one of the main challenges faced by governments worldwide, especially where water resources are not abundant, such as the Ebro River basin in Spain. The Spanish state has granted powers in matters related to water that has adhered river basins. The main objective of this study is to examine the specific case of water management in Catalonia, a region within the Ebro basin, through literature review and interviews conducted with key informants in water organizations operating in Catalonia. [ABSTRACT FROM AUTHOR]

Aim: The centralization of Finnish maternity services can mean longer journeys when women are in labor. The aim of this study was to describe women's experiences of having an unplanned out-of-hospital delivery (OHD) and to produce a deeper understanding of how to support them when this happens. Design: Qualitative descriptive study design with narrative inquiry method. Methods: Individual interviews were carried out with 15 women who had an unplanned OHD and the data were analyzed using a narrative method. Results: Three narratives described the women's experiences of an unplanned OHD with a common plot being their sense of control. In the first narrative, a sense of control was maintained; in the second, the sense of control fluctuated; and the third narrative centered on a loss of control. All the narratives were related to the women's experiences of what was happening to their body, the people around them during delivery, and the situation after the childbirth. Conclusion: Having an unplanned OHD forced women to reconsider their preconceptions and expectations of childbirth and focus on how to handle the situation at hand. A key factor was the sense of control they felt while giving birth, which should be considered a core principle in maternity care practices, from antenatal care to delivery. [ABSTRACT FROM AUTHOR]

The Occupational Safety and Health Administration (OSHA) is decentralized, wherein field offices coordinated at the state level undertake inspections. We study whether this structure can lead to interstate frictions in sharing information and how this impacts firms' compliance with workplace safety laws. We find that firms caught violating in one state subsequently violate less in that state but violate more in other states. Despite this pattern, and in keeping with information frictions, violations in one state do not trigger proactive OSHA inspections in other states. Moreover, firms face lower monetary penalties when subsequent violations occur across state lines, likely due to the lack of documentation necessary to assess severe penalties. Finally, firms are more likely to shift violating behavior into states with greater information frictions. Our findings suggest that internal information within regulators impacts the likelihood and location of corporate misconduct. [ABSTRACT FROM AUTHOR]

This research hinges upon the relationship between fiscal decentralization and life satisfaction. It contributes to the field by performing an empirical analysis focused on the case of Chile, by merging the national household survey (CASEN) with municipal level information. This analysis is based on a hierarchical empirical model, in which data from both sources are integrated. Our results show a significant positive effect of municipal level fiscal decentralization on individual subjective wellbeing. Nonetheless, we also show that said result is contingent upon residents' political representation, which is in line with the hypothesis that citizens' oversight of local authorities is a necessary condition for the effect of fiscal decentralization to emerge. From the viewpoint of how fiscally decentralized measures should be implemented in practice, above evidence suggests that said process should be accompanied by the strengthening of local residents' participation in community relevant matters. Further confirmation of this is presented in this research, by showing that residents' membership in organized groups further increases individual subjective well-being. [ABSTRACT FROM AUTHOR]

Background: Universal health coverage (UHC) improves national health outcomes while addressing social inequalities in access to quality healthcare services. The district health system (DHS) is critical to the success of UHC in South Africa through the National Health Insurance (NHI) scheme. Family physicians (FPs), as champions of primary care, are central to the DHS operation and implementation of NHI. Methods: This was a qualitative exploratory study that used semi-structured interviews to explore FPs views and engagement on NHI policy and implementation in their districts. Ten FPs were included through purposive sampling. Results: Most of the FPs interviewed were not engaged in either policy formulation or strategic planning. The NHI bill was seen as a theoretical ideology that lacked any clear plan. Family physicians expressed several concerns around corruption in governmental structures that could play out in NHI implementation. Family physicians felt unsupported within their district structures and disempowered to engage in rollout strategies. The FPs were able to provide useful solutions to health system challenges because of the design of their training programmes, as well as their experience at the primary care level. Conclusion: Healthcare governance in South Africa remains located in national and provincial structures. Devolution of governance to the DHS is required if NHI implementation is to succeed. The FPs need to be engaged in NHI strategies, to translate plans into actionable objectives at the primary care level. Contribution: This study highlights the need to involve FPs as key actors in implementing NHI strategies at a decentralised DHS governance level. [ABSTRACT FROM AUTHOR]

The mobilization of teacher leadership, simultaneous decentralization of power, and centralization of support for teacher-led initiatives is seen as important to educational improvement in post-Soviet Kazakhstan where hierarchical cultures and structures still prevail. The current study reports on results from the Teacher Leadership in Kazakhstan (TLK) initiative, which was based on the internationally recognized Teacher-led development work strategy that enabled teachers to lead individual development projects throughout one academic school year. The TLK initiative involved 16 principals, 32 school-based facilitators, and 150 teachers. Using a mixed-methods design, research for the initiative was conducted over one academic year and collected a wide range of data through questionnaire surveys, interviews, and focus groups. Analysis using structural equation modeling suggested that improved teacher program experience resulted in enhanced teacher leadership capacity, and that teachers from more collaborative school cultures enjoy more impactful initiatives. Semi-structured interviews and focus groups provide further insights into these findings. Implications for policy and practice and future directions are also discussed. [ABSTRACT FROM AUTHOR]

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