Will Boys Always Be Boys? The Criminalization of Street Harassment in Portugal.

Albeit one of the most pervasive forms of gender violence, street harassment tends to be either not considered a crime or to be faulty criminalized. This investigation contributes to better understand the overall inefficiency of existing laws through an analysis of the criminalization of street harassment in Portugal. Particularly, it searches for obstacles to implementation among those responsible for the process-the street-level bureaucrats of the Portuguese Public Security Police. Through 14 semi-structured interviews, three groups of obstacles to implementation were identified: perceptions of the legislation's content, a masculinist institutional culture, and personal characteristics. These are new findings that contribute to an understanding of the perpetuation of gender violence through state's institutions and workers.

Nurse champions as street-level bureaucrats: Factors which facilitate innovation, policy making, and reconstruction.

Background: Nurse champions are front-line practitioners who implement innovation and reconstruct policy. Purpose: To understand through a network theory lens the factors that facilitate nurse champions' engagement with radical projects, representing their actions as street-level bureaucrats (SLBs). Materials and methods: A personal-network survey was employed. Ninety-one nurse champions from three tertiary medical centers in Israel participated. Findings: Given high network density, high levels of advice play a bigger role in achieving high radicalness compared with lower levels advice. High network density is also related to higher radicalness when networks have high role diversity. Discussion: Using an SLB framework, the findings suggest that nurse champions best promote adoption of innovation and offer radical changes in their organizations through professional advice given by colleagues in their field network. Healthcare organizations should establish the structure and promote the development of dense and heterogeneous professional networks to realize organizations' goals and nurses' responsibility to their professional employees, patients, and society.

Discretion: Whether and How Does It Promote Street-Level Bureaucrats' Taking Charge Behavior?

The extant pieces of literature on discretion has mainly focused on its effect on policy implementation and public service delivery, but few studies have looked at its influence on street-level bureaucrats' work behavior, such as taking charge behavior (TCB), which is of great importance for government reforms, especially in developing and transitional countries. Based on the self-determination theory, this study examines whether and how discretion promotes street-level bureaucrats' TCB. Two studies were conducted among street-level bureaucrats in China. First, a survey experiment (n = 355) suggests that discretion positively predicts street-level bureaucrats' TCB. Then, a survey questionnaire study (n = 442) shows that discretion is positively related to TCB through the mediator of public service motivation (PSM). We concluded with implications for theory and practice.

How can we best help this patient? Exploring mental health therapists' reflections on medication-free care for patients with psychosis in Norway.

BACKGROUND: Since 2015, Norwegian Regional Health Authorities have followed new government policy and gradually implemented medication-free services for patients with psychosis. The aim of this qualitative study was to explore the tension between policy and practice, and how health care workers in Bergen reflect on their role in implementing medication-free treatment. METHODS: We performed three focus group discussions including 17 therapists working within medication free services, asking about their experiences with this new treatment program. We used Systematic Text Condensation for data analysis. The findings were discussed using Michael Lipsky's theoretical framework on the role public health workers play in policy implementation. FINDINGS: Following Norway's new policy was challenging for the therapists in our study, particularly balancing a patient's needs with treatment guidelines, the legal framework and available resources. Therapists had an overarching wish to help patients through cooperation and therapeutic alliance, but their alliance was sometimes fragile, and the therapists worried about patients' conditions worsening. CONCLUSIONS: Democratization of treatment choices, with the aim of empowering patients in mental health care, challenges the level of professional discretion given that patients and therapists might have conflicting goals. Balancing the desire to help, professional responsibility, the perceived lack of resources, and certain patient choices created conditions that can leave therapists feeling disempowered in and alienated from their work. TRIAL REGISTRATION: N/A.

Dois pesos e duas medidas na sala de aula: análise das redes sociossemânticas de categorização operadas por professores / Dos pesos y dos medidas en el aula: análisis de redes de categorización sociosemántica operadas por docentes / Double standard in the classroom: analysis of socio-semantic categorization networks operated by teachers

Resumo Este artigo analisa categorias operadas por burocratas ao classificar tipos de usuários e seus efeitos em distribuição de serviços, observando contextos de alta desigualdade e políticas universais. Para tanto, analisa de que modo professores, como burocratas de nível de rua, implementam a política categorizando diferentes tipos de alunos. Adotamos aqui a lente analítica de esquemas culturais, que considera que indivíduos internalizam associações entre categorias oficiais e sociais (informais). Os dados analisados foram coletados de vinhetas aplicadas com 40 professores da rede municipal de São Paulo. Investigamos o uso de categorias por meio de redes sociossemânticas e semânticas de categorizações e construção de cadeias de encaminhamentos. Os resultados apontam que os professores mobilizam de forma concomitante categorias oficiais e sociais, bem como que a introdução da variável "vulnerabilidade" nos casos abre espaço para introdução de categorias sociais que geram diferentes tipos de tratamento para alunos com comportamentos similares.

Resumen Este artículo analiza las categorías operadas por los burócratas al clasificar los tipos de usuarios y sus efectos en la distribución de servicios, observando contextos de alta desigualdad y políticas universales. Para ello, analiza cómo los docentes, como burócratas a nivel de calle, implementan la política categorizando diferentes tipos de estudiantes. Adoptamos aquí la lente analítica de los esquemas culturales, que considera que los individuos internalizan las asociaciones entre categorías oficiales y sociales (informales) a partir de sus experiencias. Los datos analizados se recolectaron a través de viñetas aplicadas a 40 docentes de la red municipal de São Paulo. Analizamos el uso de categorías a través de redes sociosemánticas y semánticas de categorización y construcción de redes de referencia. Los resultados muestran que los docentes movilizan simultáneamente categorías políticas y sociales y que la introducción de la variable "vulnerabilidad" en los casos abre espacio para la introducción de categorías sociales que generan diferentes tipos de tratamiento para estudiantes con comportamientos similares.

Abstract This article analyzes categories operated by bureaucrats when classifying types of users and their effects on the distribution of services, observing contexts of high inequality and universal policies. We analyze how teachers, as street-level bureaucrats, implement the policy by categorizing different types of students. We adopt an analytical lens of cultural schemes, which considers that individuals internalize associations between official and social (informal) categories from their experiences. The analyzed data were collected through vignettes applied to 40 teachers from the municipal education system of São Paulo, Brazil. We analyzed the use of categories through socio-semantic and semantic networks of categorizations and the construction of referral networks. The results show that teachers simultaneously mobilize political and social categories and that the introduction of the variable vulnerability in cases opens space for the introduction of social categories that generate different types of treatment for students with similar behaviors.

Doing peer work in mental health services: Unpacking different enactments of lived experiences.

Mental health services are increasingly employing peer workers (PWs), individuals who have lived experiences with mental health problems, to support patients and be part of mental health care teams. While the employment of PWs continues to increase, little is known about how the function unfolds in practice. This paper explores the broader context in which the PWs navigate and the concrete outcomes and everyday issues that exist at the individual level. Methodologically, the paper draws on 22 interviews with PWs employed in the mental health services in Denmark. Theoretically, it combines Lipsky's (1980) theory on street-level bureaucrats with sociological discussions concerning the lay-expert divide. The analysis shows that PWs experience both role ambiguity and goal uncertainty and that they use substantial discretion in determining the nature, amount and quality of their peer practices. This - combined with the PWs' diverse lived experiences - calls for a heterogeneous understanding of peer work and therefore the analysis presents three categories of peer workers: PWs as (1) a representative of patients' lifeworld, (2) an interdisciplinary professional and (3) an 'expert by experience'. These categories display PWs different enactments of their lived experiences and reveal ambiguities tied to the lay-expert divide.

Risking Lives to Save Others During COVID-19: A Focus on Public Health Care Workers in Bangladesh and Egypt.

The coronavirus (COVID-19) pandemic has been spreading around the world, causing a major public health crisis that has already claimed hundreds of thousands of lives. Street-level bureaucrats--health workers, teachers, street cleaners, police officers-, and so forth-are at the forefront in fighting against the pandemic. Of these, public health care workers, due to the nature of their involvement, should know and understand why they are risking their lives to save others during this pandemic. Based on the preliminary data gleaned from interviews with public health care workers in Bangladesh and Egypt, this ongoing research suggests they are risking their lives for reasons such as altruistic behavior, service to profession, adherence to bureaucratic accountability, and a desire to help mankind. The findings contribute to the existing literature about street-level bureaucratic behavior in atypical times such as these of the pandemic. This study is unique in that it comprehends that public health care workers of two culturally and geographically distinct countries are risking their lives for the same public-spirited cause.

Coping with Denialism: How Street-Level Bureaucrats Adapted and Responded to COVID-19 in Tanzania.

CONTEXT: This article aims to highlight challenges and adaptations made by local health officials in Tanzania in working to contain and manage COVID-19. METHODS: The study takes an inductive approach, drawing on the reported experiences of 40 officials at different levels of government across four purposefully selected regions in July 2020. Interviewees were asked about the guidance they received to contain COVID-19, the source of that guidance, their challenges and successes in implementing the guidance, and if and how they adapted the guidance to their particular setting. FINDINGS: The interviews depict considerable challenges, including a lack of supplies and resources for implementing infection control, surveillance, and mitigation practices and dealing with fear and stigma. At the same time, they also provide evidence of innovation and adaptation among street-level bureaucrats. Respondents overwhelmingly praised the president, whose limited national response is seen as helpful for reducing fear and stigma. CONCLUSIONS: Other scholars have highlighted the potential dangers of street-level discretion if local officials "make policy" in ways that contradict their agencies' stated goals. In contrast, our study suggests benefits of autonomy at the street level-particularly in contexts where the central state was relatively weak and/or acting against the public interest.

Demand smoothing response by street-level bureaucrats (SLB) in delivering public services during COVID-19 scenario: A system dynamics modeling study.

During such unprecedented time as COVID-19, despite stretched to its limit, public service delivery remains crucial to societies' well-being. Street-level bureaucrats (SLBs), specifically, become the most visible outreach of public policies to citizen. However, as the literature suggests, unintended outcomes of SLBs-citizen interfacing have been discretion, inefficiency and accountability, an issue lies at the heart of the standard public governance. No scholarly attempt has been made in the past to address this shortcoming. This research by proposing a conceptual model using system dynamics captures the complexity, and in so doing posits testable hypotheses that instigate an alternative visualization of public affairs, thereby closing the gap in the SLB scholarship.

Shaping migration at the border: the entangled rationalities of border control practices.

This article analyses how border guards as members of a state organisation shape the movement of non-nationals into the territory of a nation state. Based on ethnographic fieldwork on the Swiss Border Guard (SBG), it explores the rationalities-understood as stabilised ways of reasoning and acting-that characterise practices within this state organisation. Combining organisational and structuration theory with a street-level bureaucracy perspective allows for a differentiated analysis of the various facets of border guards' everyday work. Four rationalities of border-control practices are identified and compared: security, humanitarian, cost-calculation, and pragmatic rationality. I argue that, by considering both the specific goals and imperatives of border control and the characteristics of street-level bureaucrats acting within a state organisation, these entangled logics explain the complex and incoherent social reality of border control. More generally, the results contribute to organisational theory by pointing to the importance of taking into account that multiple entangled rationalities structure the practices of an organisation's members.

Challenges in implementing emergency obstetric care (EmOC) policies: perspectives and behaviours of frontline health workers in Uganda.

Uganda is among the sub-Saharan African Countries which continue to experience high preventable maternal mortality due to obstetric emergencies. Several Emergency Obstetric Care (EmOC) policies rolled out have never achieved their intended targets to date. To explore why upstream policy expectations were not achieved at the frontline during the MDG period, we examined the implementation of EmOC policies in Uganda by; exploring the barriers frontline implementers of EmOC policies faced, their coping behaviours and the consequences for maternal health. We conducted a retrospective exploratory qualitative study between March and June 2019 in Luwero, Iganga and Masindi districts selected based on differences in maternal mortality. Data were collected using 8 in-depth interviews with doctors and 17 midwives who provided EmOC services in Uganda's public health facilities during the MDG period. We reviewed two national maternal health policy documents and interviewed two Ministry of Health Officials on referral by participants. Data analysis was guided by the theory of Street-Level Bureaucracy (SLB). Implementation of EmOC was affected by the incompatibility of policies with implementation systems. Street-level bureaucrats were expected to offer to their continuously increasing clients, sometimes presenting late, ideal EmOC services using an incomplete and unreliable package of inputs, supplies, inadequate workforce size and skills mix. To continue performing their duties and prevent services from total collapse, frontline implementers' coping behaviours oftentimes involved improvization leading to delivery of incomplete and inconsistent EmOC service packages. This resulted in unresponsive EmOC services with mothers receiving inadequate interventions sometimes after major delays across different levels of care. We suggest that SLB theory can be enriched by reflecting on the consequences of the coping behaviours of street-level bureaucrats. Future reforms should align policies to implementation contexts and resources for optimal results.

Balancing professional autonomy and authority at the margins of a fragile state: Front-line health workers' experiences in Burkina Faso.

The availability of diagnostic equipment, medical products and basic infrastructure is limited in most low-income societies. Poor motivation among health workers as well as recruitment and retention problems are key factors contributing to poor health care services in developing countries. The current paper describes how the front line cope with these difficult working conditions. Data for this study come from anthropological fieldwork in two districts of Burkina Faso and include a total of 27 unstructured and 40 semi-structured interviews with staff at dispensaries and medical centres in the two districts. Analytically, we make a distinction between their professional autonomy and their professional authority. We find that while the health workers experience a certain degree of professional autonomy, in the sense that they rely on their own clinical judgement and their discretion as decision makers and gatekeepers, their professional authority is constantly challenged when working at the margins of the state. Through improvisations and bricolaging, they compensate for the many shortcomings, but many of them feel that their skills are waning and that their professional identity threatened. Thus, massive strengthening of the front-line health worker's capacity is imperative for future improvement of health care services in Burkina Faso.

Street-level bureaucracy in the pandemic: the perception of frontline social workers on policy implementation / El nivel de calle en la pandemia: la percepción de los trabajadores de la primera línea de la asistencia social sobre la implementación de políticas / O nível de rua na pandemia: a percepção de profissionais da linha de frente da assistência social sobre a implementação de políticas

Abstract The COVID-19 pandemic highlighted the strategic role of social care policy to minimize the effects of this health crisis and its consequences on the poorest and most vulnerable population. This article analyzes the perception of street-level bureaucrats in the Brazilian social care network on how the pandemic has affected their performance and professional routine. The research was based on a survey, consultations with representatives of municipal social care services, and analysis of government regulations. The results show that social workers feel unprotected and unable to provide adequate responses to the pandemic's increasing and urgent demands, revealing a lack of institutional support to act appropriately. The professionals also reported substantial changes in their working dynamics, particularly in their relationship with the attended population, one of the main pillars of the Brazilian social care network. These elements directly affect the provision of social care services and their potential to combat the adverse effects of the crisis.

Resumen La pandemia de COVID-19 destacó el papel estratégico de la política de atención social para minimizar los efectos de esta crisis de salud y de sus consecuencias en la población más pobre y vulnerable. A partir de este entendimiento, este artículo analiza la percepción de los burócratas a nivel de calle en la red de atención social brasileña en relación a cómo la pandemia ha afectado su desempeño y su rutina profesional. Con base en una encuesta, en consultas con representantes de los servicios municipales de atención social y regulaciones gubernamentales, la investigación ha identificado que, en la pandemia, estos trabajadores se sienten desprotegidos e incapaces de dar respuestas adecuadas a las crecientes y urgentes demandas, además de reportar cambios sustanciales en su dinámica de trabajo, incluyendo uno de sus principales pilares de actuación, el vínculo establecido con los usuarios del servicio. Al mismo tiempo, carecen de apoyo institucional para actuar con seguridad. Estos elementos afectan directamente la prestación de servicios de atención social y su potencial para combatir los efectos adversos de la crisis.

Resumo A pandemia da COVID-19 ressaltou o papel estratégico da política de assistência social para minimizar os efeitos desta crise de saúde e de suas consequências sobre a população mais pobre e vulnerável. A partir desse entendimento, este artigo analisa a percepção de burocratas de nível de rua da rede socioassistencial brasileira sobre como a pandemia tem afetado sua atuação e seu cotidiano profissional. Com base em um survey, em consultas com representantes de serviços socioassistenciais municipais e em regulações governamentais, a pesquisa identificou que, na pandemia, esses trabalhadores se sentem desprotegidos e pouco capazes de dar respostas adequadas às demandas cada vez maiores e urgentes, além de relatarem mudanças substanciais nas suas dinâmicas de trabalho, incluindo um dos seus principais pilares de atuação, o vínculo estabelecido com os usuários dos serviços. Simultaneamente, sentem falta de apoio institucional para atuar com segurança. Esses elementos afetam diretamente a prestação dos serviços socioassistenciais e seu potencial de combater os efeitos adversos da crise.

Street-Level Bureaucracy in Tobacco Control: A Qualitative Study of Health Department in District Jalandhar, Punjab.

BACKGROUND: The implementers of the tobacco control policy in the field have been neglected by the policymakers. They are the ones who have first-hand knowledge and their experiences in the field are not being used to bring about changes in the area of tobacco control. OBJECTIVE: The objective of this paper is to critically examine how Michael Lipsky's concept of street-level bureaucracy can be used to address tobacco control in the health department in district Jalandhar of Punjab. METHODS: Semi-structured interview schedules were used to interview Senior Medical Officers/Nodal Officers and Health Supervisors/Sanitary inspectors in four out of ten Community Health Centers and District hospital in Jalandhar. Data so collected were subjected to the process of inductive analysis and themes developed within the framework given by Lipsky. RESULTS: The street-level bureaucrats (SLBs) were not given adequate training, and various organizational resources for tobacco control are missing in the district. There are threats and challenges which are faced by them in the field, and they do not exercise decision-making power to handle these barriers for effective implementation of the tobacco control program. CONCLUSION: The government needs to be inclusive in the process of policymaking meaning that it can be more accommodative of the suggestions given by the SLBs and provide them with discretionary powers to exercise their role efficiently.

Implementação da política de saúde pública e seus desafios na era digital / Implementación de la política de salud pública y sus desafíos en la era digital / Implementation of public health policy and its challenges in the digital age

Resumo Analisa-se a implementação da política pública de regulação de leitos em Unidades de Terapia Intensiva, considerando-se a política formulada, as condições institucionais e as estratégias utilizadas pelo estado e municípios baianos. Realiza-se revisão bibliográfica à luz do neoinstitucionalismo da escola da escolha racional e estudo de natureza qualitativa com três grupos de burocratas de médio escalão. Os resultados evidenciam um gap entre a política formulada e a implementada, a influência dos burocratas na implementação da política pública e uso das tecnologias da informação e comunicação, utilização de semelhantes estratégias de regulação, sendo a estratégia clientelística, associada ao uso do WhatsApp, encontrada na regulação paralela de leitos, indicativo de que, mesmo sob a égide do estado gerencial, persistem as práticas clientelísticas e patrimonialistas.

Resumen Se analiza la implementación de la política pública en materia de regulación de plazas en las unidades de cuidados intensivos, teniendo en cuenta la política formulada, las condiciones institucionales y las estrategias utilizadas por el Estado y los municipios. Se llevó a cabo una revisión de la literatura a la luz del neoinstitucionalismo de la escuela de la elección racional, y estudio cualitativo con tres grupos de burócratas a nivel de calle. Los resultados revelan una brecha entre la política formulada y aplicada, la influencia de burócratas en la implementación de la política pública y el uso de tecnologías de la información y la comunicación, con uso de estrategias de regulación similares. La estrategia clientelista, que se asocia con el uso de WhatsApp, fue encontrada en la regulación paralela de las plazas, lo que indica que, incluso bajo los auspicios del estado gerencial, persisten las prácticas clientelistas y patrimoniales.

Abstract This article analyzes the implementation of public policy on regulation of beds in intensive care units, considering the formulated policy, the institutional conditions and the strategies used by the state and municipalities of Bahia, Brazil. A literature review is carried out, based on the rational choice institutionalism, as well as a qualitative study with three groups of street-level bureaucrats. Results show a gap between the policies formulated and implemented and the influence of bureaucrats in the implementation of public policies in health. In addition, the research observed the use of information and communication technology such as social media (WhatsApp) as regulation strategies. The informal control and assignment of beds using WhatsApp is a clientelistic strategy, indicating that, even under the aegis of the managerial state, clientelistic and patrimonial practices persist.

Working with Stories: Street-Level Bureaucrats and Their Work with Individuals with Psychiatric Disability Exposed to Interpersonal Violence.

The focus of our attention is the meeting between street-level bureaucrats and individuals with psychiatric disability exposed to interpersonal violence. Based on 11 interviews, we illustrate how stories are understood, used, and made meaningful to the street-level bureaucrat. The contribution of this article is first of all that of being a framework, from a storytelling point of view, for the work and organizational experiences of street-level bureaucrats. Second, by paying attention to the story part of these relationships, we can better understand the situation of individuals with psychiatric disability exposed to interpersonal violence given their interaction with different street-level bureaucrats.

Are civil-law notaries rent-seeking monopolists or essential market intermediaries? Endogenous development of a property rights institution in Mexico.

As the fourth contribution in the 'Land' section, this paper forms a research 'diptych' with the next paper by Levy. Whereas she focuses on the notarial institution in mid-nineteenth century Mexico, this contribution examines it in a contemporary context. The notary is one of the chief components of property rights protection in civil-law systems, performing various public functions such as writing deeds for real estate property. Yet notaries are considered an 'inefficient' institution by many, due to the perception of rent-seeking behavior enabled by their near-monopoly over validating property rights claims. This study examines notaries in Mexico to unpack the apparent contradiction in the role of notaries in economic development. I use a combination of interviews with notaries and clients, and data on notarial practice and bureaucratic outcomes across the country, to examine notaries' social function. The theoretical lens of endogenous development and institutional functionalism reveals an alternate explanation for their seemingly high-cost services, as well as their role in economic development. Mexican notaries have a dual social function: public representative and private service provider. They perform diverse and essential activities, which in other countries are performed by multiple actors such as real estate agents, escrow offices and title insurance companies. Thus, what is perceived as inefficiency by some can be interpreted as an efficient response to the context in which they operate, and their semi-privatized nature can overcome problems found in other bureaucratic arrangements.

Inspecting environmental management from within: the role of street-level bureaucrats in environmental policy implementation.

In this paper, we assert that an important element is largely missing in much of the current environmental policy literature regarding different management ideals: street-level bureaucrats (i.e., the practicing and, typically, anonymous civil servants at the very end of the environmental policy chain). Thus, we aim to enhance a deeper understanding of the role that street-level bureaucrats play within different management ideals, and through this discussion, we indicate how they affect the functionality of governing structures and processes. We do so by interviewing street-level bureaucrats carrying out their role in different management settings, enabling evaluations of the degree to which their practices correspond with the ideals expressed in the literature and in official directives. We find a rather poor match between these ideals on one hand and the way street-level bureaucrats actually perceive that they are internally steered and how they carry out their commissions on the other hand.

Prison staff and the health promoting prison.

PURPOSE: This paper aims to discuss some of the obstacles to implementing policy and strategy related to health promoting prisons. It focuses on the role of prison officers and raises issues concerning their conditions of service, training and organisational culture in a situation where the prison system faces security issues, overcrowding and high levels of ill health among prisoners. DESIGN/METHODOLOGY/APPROACH: This paper emerged as a result of significant overlapping themes between two separate studies conducted by the authors. The paper draws on the authors' qualitative data from these studies. FINDINGS: The findings demonstrate the ambiguities and tensions in changing organisational cultures and among prison staff. Alongside the qualitative data, the paper draws on theory regarding policy implementation at the micro-level to show how staff can block or speed up that implementation. PRACTICAL IMPLICATIONS: Prison officers are an essential part of health promoting prisons, but have been relatively ignored in the discussion of how to create healthier prisons. ORIGINALITY/VALUE: The contribution that prison staff make to creating health promoting prisons has been under-explored, yet pertinent theory can show how they can be more effectively involved in making changes in organisational culture.