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The management of the COVID-19 crisis and, in particular, the Next Generation EU fund have shown that European leaders can find integrationist policy solutions despite increasing politicisation at home where democratic constraints may lead to a feared 'multilevel politics trap'. Therefore, we ask whether and how national governments can manage such constraints and thus spring or avoid the trap. Theoretically, we argue that the agency of governments is a crucial factor for understanding the varying dynamics of politicisation in regional integration, as governments can raise or lower domestic audience costs by strategically interacting with their parliament or media. Empirically, we probe the plausibility of our theoretical propositions by examining constraint management and position-taking in Austria and the Netherlands in the context of European fiscal solidarity. Our results show that there is no inevitably self-reinforcing multilevel politics trap but that the effects of domestic constraint are, to a considerable extent, contingent on the agency of national governments.

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The objective of the article was to investigate the possible inducing factors that contributed to determine the frequency of social conflicts at the subnational level in Peru between 2016 and 2021, including income inequality, social exclusion, fiscal centralism, corruption and revocation of authorities, for which four regression models were built. Disaggregated official data from the 24 departments and the provinces of Lima and Callao were analyzed. Economic inequality was associated with the Gini coefficient. To establish the association between social conflict and the inducers, it was estimated using Spearman's Rho correlation coefficient. Statistical calculation was also employed to appreciate the collinearity between the inducers. The results showed that the revocation of subnational authorities determines 42.5% of social conflict. On the other hand, corruption and fiscal centralism determine 28.5% of the perception of suffering social exclusion. Inequality and social conflict determined 21.8% of the relevance of the execution and quality of public spending by the national government in the regions. Sixty percent of social conflicts in Peru are of an environmental nature. The population that has declared the greatest discrimination corresponds to Puno (28%). 55.6% of those surveyed consider corruption to be one of the country's main problems. Corruption and social exclusion have a negative impact on the effectiveness of economic results and promote social conflicts. Inefficient use of fiscal resources translates into low quality of services and diminished credibility of the national and subnational governments. This situation highlights the need to design public policies that reduce conflicts and promote adequate governance.

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Both market-oriented and government-led spatial agglomeration of factories profoundly affect China's carbon emission intensity. However, few studies have comprehensively examined the effect of spatial agglomeration of factories driven by different motivations on carbon emission intensity, and often ignore the moderating effect of local government attention to the environment. This study attempts to incorporate market-oriented and government-led spatial agglomeration of factories into the same analytical framework and examine their interaction effects on carbon emission intensity. We first calculate an Agglomeration Index based on the geographic coordinates of micro-factories to measure market-oriented agglomeration of factories, and take development zone policies as a proxy for government-led agglomeration of factories. Based on city-level data from 1998 to 2013, we empirically analyze their impacts on carbon emission intensity and further explore regional heterogeneity and mechanisms. The results show that both the market-oriented and government-led spatial agglomeration of factories can significantly reduce carbon emission intensity through scale effect, innovation effect and structure effect. However, the agglomeration of factories caused by government forces has weakened the original effect of market-oriented agglomeration of factories in reducing carbon emission intensity. Heterogeneity analysis indicates that government-led agglomeration of factories is more effective in reducing carbon emission intensity in less-developed regions. Furthermore, the improvement of the governments' attention to the environment can further exert the positive effect of spatial agglomeration of factories on carbon emission intensity. Our study deepens the understanding of the effects of spatial agglomeration of factories caused by different motivations, and provides a reference for China and other developing countries to formulate relevant policies for reducing carbon emission intensity.

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BACKGROUND: Governments and public health agencies worldwide experienced difficulties with social media-mediated infodemics on the internet during the COVID-19 pandemic. Existing public health crisis communication strategies need to be updated. However, crisis communication experiences of governments and public health agencies worldwide during the COVID-19 pandemic have not been systematically compiled, necessitating updated crisis communication strategies. OBJECTIVE: This systematic review aims to collect and organize the crisis communication experiences of senders (ie, governments and public health agencies) during the COVID-19 pandemic. Our focus is on exploring the difficulties that governments and public health agencies experienced, best practices in crisis communication by governments and public health agencies during the COVID-19 pandemic in times of infodemic, and challenges that should be overcome in future public health crises. METHODS: We plan to begin the literature search on May 1, 2024. We will search PubMed, MEDLINE, CINAHL, PsycINFO, PsycARTICLES, Communication Abstracts, and Web of Science. We will filter our database searches to search from the year 2020 and beyond. We will use a combination of keywords by referring to the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, and Research type) tool to search the abstracts in databases. We intend to include qualitative studies on crisis communication by governments and public health agencies (eg, officials, staff, health professionals, and researchers) to the public. Quantitative data-based studies will be excluded. Only papers written in English will be included. Data on study characteristics, study aim, participant characteristics, methodology, theoretical framework, object of crisis communication, and key results will be extracted. The methodological quality of eligible studies will be assessed using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A total of 2 independent reviewers will share responsibility for screening publications, data extraction, and quality assessment. Disagreement will be resolved through discussion, and the third reviewer will be consulted, if necessary. The findings will be summarized in a table and a conceptual diagram and synthesized in a descriptive and narrative review. RESULTS: The results will be systematically integrated and presented in a way that corresponds to our research objectives and interests. We expect the results of this review to be submitted for publication by the end of 2024. CONCLUSIONS: To our knowledge, this will be the first systematic review of the experiences of governments and public health agencies regarding their crisis communication to the public during the COVID-19 pandemic. This review will contribute to the future improvement of the guidelines for crisis communication by governments and public health agencies to the public. TRIAL REGISTRATION: PROSPERO CRD42024528975; https://tinyurl.com/4fjmd8te. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/58040.

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BACKGROUND: Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding "How" to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs. METHODS: Using purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants' experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration. RESULTS: Context and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership's influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish "central management units" for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency. CONCLUSION: This study offers multiple solutions to enhance local implementers' engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.

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In 2015, the central government of China established the Central Environmental Protection Inspection (CEPI) system for oversight of local governments. It enhanced local government enforcement of environmental regulations, which had a considerable influence on the health of the local older adult population. This study quantifies the effects of local government regulation brought about by CEPI on the health of the older adult. It examines the impact mechanism using the DID model and panel data from the China Health and Retirement Longitudinal Study (CHARLS). The results show that (1) local governments' environmental protection regulations implemented by CEPI have a positive impact on the general health of the older adult. The results of the study passed the parallel trend test, PSM test, replacement variable test, and placebo test and remained significant; (2) in terms of the impact mechanism, CEPI has promoted local governments' environmental governance initiatives, which has reduced industrial wastewater emissions, industrial sulfur dioxide emissions, and industrial fumes emissions. This has improved air quality, thereby creating a good living environment for the older adult and improving their overall health; (3) according to heterogeneity research, the health of older adult living in the Yangtze River Basin, urban older adult, and older adult without chronic diseases is more significantly affected by the environmental protection regulations of the local governments brought about by CEPI.

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In the past decade, the importance of the smart city applications has gained popularity by the city governments to use their resources in an efficient and effective way, present better services and quality of life for their residents, make their cities more competitive, provide better disaster management. As the world has experienced crisis such as energy and grain in the recent past due to the COVID-19 pandemic and the war between Russia and Ukraine, the management of the resources has become more important for the countries and local governments, as well. In this study national government plans of Turkiye, such as Eleventh Development Plan and 2020-2023 National Strategy and Action Plan for Smart Cities, have been addressed as reference documents and the actions of some city governments, including the most populous city, Istanbul and the capital, Ankara, have been examined with the purpose of determining the level of smart city willingness. This study peruses the degree of enthusiasm of the local governments to become smart and maintain sustainable city services considering the main smart city characteristics. Based on the information gathered concerning the selected cities, it has been observed that the cities having populations quite lower than the great metropolitans such as Istanbul and Ankara are more enthusiastic and successful to provide services for their citizens that can be associated with the smart city concept.

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Exploring the effect of local government multi-objective competition on the transfer of polluting industries is of great practical significance for promoting the high-quality development in the Yangtze River Economic Belt. This paper adopted the extended shift-share analysis method to measure the scale of inter-provincial transfer of polluting industries in the Yangtze River Economic Belt from 2008 to 2020. Considering local governments' economic, innovation, talent and environmental protection competition, the paper examined the effects of local government multi-objective competition on the transfer of polluting industries in the region, and tested its spatial spillover effects. The results showed that: 1. Different competitions had different effects on the transfer of polluting industries. Economic competition intensified the transfer of polluting industries, while talent, innovation, and environmental protection competition all restrained it, among which environmental protection competition had the strongest restraining effect. 2. Compared with the transfer of polluting industries, the direction of economic competition and environmental protection competition on the transfer of industries did not change, but the degree of influence was reduced, talent competition instead promoted industrial transfer of the research region to some extent. 3. From the basin level, government competition in the upstream region more obviously intensified the transfer of polluting industries; while from the economic scale level, the restraining effect of government competition in the developed region on the transfer of polluting industries was much stronger. 4. Both innovation and environmental protection competition had positive spatial spillover effects. Therefore, it is necessary to optimize the promotion and assessment mechanism of local officials, adopt differentiated competitive constraint mechanisms in accordance with local conditions, guide local governments to transform their development concepts, promote the sharing and common use of technological innovations, and promote the orderly transfer of industries in the Yangtze River Economic Belt.

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Resumo: O artigo resgata os aspectos centrais dos governos de Fernando Henrique Cardoso, Luiz Inácio Lula da Silva, Dilma Rousseff, Michel Temer e Jair Bolsonaro, os modelos econômicos e sociais predominantes e as crises políticas-econômicas e sanitária. Objetiva demonstrar que a inserção das mulheres no mundo do trabalho é permeada pelas desigualdades de gênero e étnico-raciais. A metodologia utiliza o estudo estatístico, descritivo e comparativo dos dados, e evidencia a desigualdade de gênero e étnico-racial no país.

Abstract: The article highlights the central aspects of the governmentes of Fernando Henrique Cardoso, Luiz Inácio Lula da Silva, Dilma Rousseff, Michel Temer and Jair Bolsonaro, the predominant economic and social models and the political-economic and health crises. It aims to demonstrate that the insertion of women in the world of works is permeated by gender and ethnic-racial inequalities. The methodology uses statistical, descriptive and comparative data study and highlights gender and ethnic-racial inequality in the country.

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Background: The issue of crowd crushes has been not only very complicated but also uncertain. This article aimed to evaluate how situations such as the Itaewon Halloween crowd crush in South Korea in 2022 can be better managed to reduce human loss. Methods: Qualitative analysis was the key methodology used to compare emergency planning for ordinary events with contingency planning for special events, focusing on four stakeholders, namely governments, businesses, voluntary organizations, and other local communities. Results: The key finding was that all stakeholders would need to supplement emergency planning for ordinary events with contingency planning for special events for the nation. They must embody cooperation, cutting-edge technologies, routinized updates, situation awareness, political rationality, training and exercise, and others, based on inclusion. Conclusions: This is a pioneer study that examined the Itaewon crowd crush more comprehensively than others in particular by including many disaster management principles.

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The Harm Reduction Act, a groundbreaking piece of legislation in New Mexico, provided for the legal use of paraphernalia by New Mexican residents so long as they could present their yellow sharps cards. Unfortunately, tribal governments in New Mexico were not consulted in these changes in harm reduction practices. As a result, Native American persons in New Mexico cannot access harm reduction services as freely as any other New Mexican can-and harm reduction programs are desperately needed in New Mexico. In this commentary, I examine the impact that the Harm Reduction Act has had on Native American populations in New Mexico and suggest opportunities for improving collaboration between state and tribal governments and community-based organizations.

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This study analyzes what has changed in the road safety management systems (RSMS) of local governments after evaluating the related indicators continuously from 2015 to 2019. It has evaluated 24 indicators in four areas of RSMS such as institutional management, intervention, intermediate outcome, and the final outcome, according to Han and Lee (2020). It seems that continuous evaluation of indicators of RSMSs in local governments for five years has helped to improve road safety performance in local governments. The result shows that the average overall scores have increased from 77.92 to 83.89, a 7.7% increase. This improvement should have resulted from the competition between local governments, which do not want to be at the bottom in the score comparison. The most remarkable increase has been identified in the areas of institutional management and intervention. They have increased by 13.3% and 16.0%, respectively. In terms of types of local governments, it has been found that the increase in overall scores is higher in provinces which include most rural areas than in metropolitans. However, it has been found that the improvement of institutional management and interventions are not directly associated with the increase of the intermediate and final outcomes, at least during the five years. Further studies examining the relationship between the four areas of RSMS are needed.

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Resumen Los gobiernos municipales de Costa Rica tienen un papel significativo en el Sistema Nacional de Gestión del Riesgo (SNGR) para enfrentar las múltiples amenazas y riesgos que afectan al país desde sus territorios. Los distintos marcos y políticas que trabajan en el enfoque de la Gestión del Riesgo de Desastres (GRD) promueven la realización de análisis de riesgos como proceso que contribuye a su reducción y mitigación, y destacan el enfoque de género como principio o eje para visibilizar la necesidad de realizar revisiones y acciones diferenciadas por género. El presente artículo recoge la investigación realizada que responde a la pregunta "¿Cuáles son los elementos psicosociales que influyen en la puesta en práctica de la transversalización del enfoque de género en los procesos de la GRD de las oficinas municipales?" Esta pregunta se respondió desde la Psicología Social Comunitaria y la Psicología Social Feminista. Se realizó un estudio con enfoque cualitativo y diseño fenomenológico, en el que se aplicaron entrevistas a representantes institucionales en GRD y género. Se identificaron doce elementos psicosociales que influyen en la transversalización del enfoque de género en la GRD municipal, que deben visibilizarse y pueden ser trabajados para abordar los riesgos de dos poblaciones históricamente discriminadas: mujeres y población LGTBIQ+. Trabajar las desigualdades de género como causa subyacente del riesgo es prioritario para la GRD.

Abstract The city governments of Costa Rica have a significant role in the National Risk Management System (SNGR in Spanish) to face the multiple threats and risks that affect the country from their territories. The different frameworks and policies that work with the Disaster Risk Management approach, among which are international (e. g., Sendai Framework for Action), regional (e. g., Central American Policy for Comprehensive Disaster Risk Management), and national instruments (e. g., National Risk Management Policy), promote risk analysis as a process that contributes to their reduction and mitigation, which, together with specific policies focused on gender (e. g., Convention on the Elimination of All Forms of Discrimination Against Women [CEDAW]), highlight the gender approach as a principle or axis, making the need to carry out reviews and actions differentiated by gender visible. The growth of inequalities in events such as disasters emphasizes the fact that there are gender differences in the perception of risks, the levels of vulnerability that exist and the capacities to cope. This article collects the research carried out that answers the question: "What are the psychosocial elements that influence the implementation of mainstreaming the gender approach in DRM processes in municipal offices?" from Community Social Psychology and Feminist Social Psychology. A study with a qualitative approach and phenomenological design was carried out, in which interviews were applied to institutional representatives in DRM and gender. The first seeks to promote processes of social transformation, considering the psychosocial processes that permeate community dynamics, which, in turn, are influenced by specific contexts. As for Feminist Psychology, it promotes the identification of inequalities and the creation of options for change. The relationship between feminist political perspectives and psychological practices and sexual and gender differences were considered as causes of inequalities, generating certain psychosocial analyzes not widely developed so far. A subjective perspective to the lived experience of the people participating in the research was considered in order to emphasize the meanings and knowledge as a process, based on interviews with institutional representatives of municipal offices and national institutions both focused on DRM or gender. Twelve psychosocial elements that influence the mainstreaming of the gender approach in municipal DRM were identified: the need for training and awareness, the requirement of political will, the naturalization of gender roles and stereotypes, the recognition of gender differences, resistance to mainstreaming gender, subjectivity, the presence or absence of inter and intra-institutional articulations, the social participation of women, the recognition of gender violence, the recognition of vulnerable populations, the cultural context and social inequalities. Moreover, gender inequalities are recognized as an element that affects and emphasizes the vulnerabilities of specific populations, such as women of different ages, transgender people, people with disabilities, among others. The research allowed an approach to ten different territorial contexts where DRM is put into practice from an office or as a process, and how the experience of the people who lead them understands the gender approach, contrasting with the institutional perspective applied at the national level. It is concluded that these should be made visible and can be worked on to address the risks of two historically discriminated populations: women and LGTBIQ+ population. Considering gender inequalities as an underlying cause of risk is a priority for Disaster Risk Management.

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Resumen La corrupción es un fenómeno complejo. Los diagnósticos empleados para justificar medidas anticorrupción usualmente tienden a desestimarla. En línea con el modelo de bote de basura (Cohen, March, & Olsen, 1972), donde las soluciones buscan problemas, en este caso, el problema de corrupción se caracteriza de forma que sea "atendible" con la política en cuestión. Esta situación tiene graves consecuencias. Entre ellas, que la política implementada sea falible. El artículo revisa el fenómeno de la falibilidad de las políticas anticorrupción. Argumentamos que cuando la política anticorrupción se diseña sin tomar en cuenta que el tipo de corrupción que enfrenta es parte de un sistema más amplio de corrupción sistémica, esta tiene altas probabilidades de fracasar. Trazamos nuestro argumento a lo largo de una serie de implicaciones que se desprenden del marco de consolidación de la corrupción (Corruption Consolidation Framework - CCF) (Meza & Pérez-Chiqués, 2021). Apoyados en el CCF derivamos una serie de implicaciones con la intención de reorientar la discusión y futuras líneas de investigación en torno a entender y atender el fenómeno de la corrupción sistémica.

Resumo A corrupção é um fenômeno complexo. Os diagnósticos usados ​​para justificar medidas anticorrupção costumam descartá-la. Em consonância com o modelo da lata de lixo (Cohen, March, & Olsen, 1972), onde as soluções procuram os problemas, neste caso, o problema da corrupção é caracterizado de tal forma que é "endereçável" com a política em questão. Esta situação tem consequências graves. Entre eles, que a política implementada é falível. O artigo revisa o fenômeno da falibilidade das políticas anticorrupção. Argumentamos que quando a política anticorrupção é desenhada sem levar em conta que o tipo de corrupção com a qual ela lida faz parte de um sistema mais amplo de corrupção sistêmica, ela tem uma alta probabilidade de falhar. Traçamos nosso argumento por meio de uma série de implicações que emergem do quadro de consolidação da corrupção (Corruption Consolidation Framework - CCF) (Meza & Pérez-Chiqués, 2021). Com o apoio do CCF, extraímos uma série de implicações com a intenção de reorientar a discussão e futuras linhas de pesquisa em torno da compreensão e abordagem do fenômeno da corrupção sistêmica.

Abstract The diagnoses made to justify anticorruption measures tend to minimize the complexity of the phenomenon of corruption. In line with the garbage can model (Cohen, March, & Olsen, 1972), where solutions look for problems, the corruption problem is characterized as something "addressable" by the anticorruption policy, which brings serious consequences, such as the implementation of a fallible policy. The article reviews the phenomenon of the fallibility of anticorruption policies. We argue that anticorruption policies are likely to fail when they are designed without recognizing that the type of corruption faced is embedded in a wider scheme of systemic corruption. We trace our argument along a series of implications that emerge from the Corruption Consolidation Framework (CCF) (Meza & Pérez-Chiqués, 2021). Supported by the CCF, we derive a series of implications to reorient the discussion and future lines of research around understanding and addressing the phenomenon of systemic corruption.

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Objectives　This study aimed to examine the status of implementation and details of population-based approach projects that primarily target fathers nationwide. It also seeked to discuss the possibility of providing childcare support to fathers in the community.Methods　This study analyzed the overall results of two surveys undertaken. The primary survey was conducted between December, 2020 and February, 2021 by administering a mail questionnaire within 1,741 municipalities across Japan. A secondary interview survey was then conducted from August to September, 2021, among the municipalities that responded that they are "implementing projects mainly for fathers," and those that obtained consent to participate in this survey.Results　The 837 municipalities (response rate = 48.1%) that responded to the primary survey were included in the analysis. Many municipalities provided paternal and family support in addition to childcare support for mothers, at the time of issuing maternal and child health handbooks and in parent classes. This support was inclusive of distributing leaflets and pamphlets for fathers (P=0.036), encouraging fathers to participate in parent classes (P<0.001), setting dates and times that are easy for fathers to participate in (P<0.001), and including content for fathers (P<0.001). There were significantly more responses from local governments of the municipalities with a total population of 70,000 or more. The number of municipalities that "implemented childcare support that primarily targeted fathers instead of mothers" was 54 or 6.5% of the total. However, about 70% of the municipalities that had not implemented such programs recognized the need for their implementation. In the 21 municipalities where the interviews were conducted, there were 10 projects implemented during pregnancy, 12 during the childcare period after delivery, and 1 implemented across both. The contents of the implemented programs varied widely, with each municipality devising its own programs based on regional characteristics, which had generally favorable evaluations from the participants. In contrast, many municipalities mentioned that the small number of participants was an issue.Conclusion　Although fathers are encouraged to participate in childcare and housework within households, it is rare for them to be given opportunities to gain the required knowledge and skills. Most projects provide support for fathers as supporters of mothers. Going forward, in addition to surveys targeting fathers, there is a need to present project models that can be implemented by the local governments.

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This paper analyzes how Digital Transformation (DT) processes have influenced the Attitude of local governments (LGs) toward the COVID-19 pandemic and their effect on achieving the United Nations' Sustainable Development Goals (SDGs). The data were collected from LGs in Spain (n = 124) through a questionnaire in which the IT skills of their workers, the DT processes, budgets, degree of regulatory compliance, and implementation of trust seals were measured, together with the IT security measures adopted. The contrast between the proposed model and the results showed that the direct influence of IT security influences the government's attitude toward COVID-19 and DT implementing actions to achieve SDGs. The findings of this work are of great value both for the actors involved in the design and implementation of public policies and for those responsible for local governance in their objective to improve citizens' experience of the services provided and in exceptional situations such as the one experienced as a result, of-COVID-19.

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The purpose of this paper seeks to investigate the impact that environmental target constraints imposed by local governments have on the quality of economic development. In this paper, the city-level economic high-quality development index was measured, and data on environmental target constraints were compiled from the governmental work reports submitted by 230 cities between the years 2004 and 2013. Using the DID model and the instrumental variable method, it is found that (1) when environmental performance is factored into the performance evaluation of governmental officials, environmental target constraints contribute significantly to the high-quality growth of the local economy and (2) environmental target constraints are heterogeneous across regions and have a greater promoting effect on cities in eastern China than in central and western China. These conclusions are supported by a number of robustness tests. Resultantly, this paper provides a novel perspective for understanding the relationship between environmental protection and the quality of economic development. In addition, it offers the government theoretical and empirical support to strengthen the development of an environmental protection system and promote high-quality economic development. Moreover, this study delivers crucial empirical evidence for developing countries to simultaneously achieve environmental pollution control and economic growth.

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SETTING: Kerala State, India, implemented decentralising reforms of healthcare institutions 25 years ago through transfer of administrative control and a sizeable share of the financial allocation. OBJECTIVE: To describe the main impacts of decentralisation in Kerala on local policy formulation, programme implementation and service delivery for sustainable health systems. DESIGN: This was part of a broader qualitative study on decentralisation and health in Kerala. We conducted 25 in-depth interviews and reviewed 31 government orders or policy documents, five related transcripts and five thematic reports from the main study. RESULTS: Liaising between health system and local governments has improved over time. A shift from welfare-centric projects to infrastructure, human resources and services was evident. Considerable heterogeneity existed due to varying degrees of involvement, capacity, resources and needs of the community. State-level discourse and recent augmentation efforts for moving towards the UN Sustainable Development Goals (SDGs) strongly uphold the role of local governments in planning, financing and implementation. CONCLUSION: The 25-year history of decentralised healthcare administration in Kerala indicates both successes and failures. Central support without disempowering the local governments can be a viable option to allow flexible decision-making consistent with broader system goals.

CONTEXTE: L'État du Kerala, en Inde, a mis en œuvre des réformes de décentralisation des établissements de santé il y a 25 ans, en transférant le contrôle administratif et une part importante de l'allocation financière. OBJECTIF: Décrire les principaux impacts de la décentralisation au Kerala sur la formulation de politiques locales, la mise en œuvre de programmes et la prestation de services pour des systèmes de santé durables. MÉTHODE: Cette étude faisait partie d'une étude qualitative plus vaste sur la décentralisation et la santé au Kerala. Nous avons mené 25 entretiens approfondis et examiné 31 décrets ou documents de politique du gouvernement, cinq transcriptions connexes et cinq rapports thématiques de l'étude principale. RÉSULTATS: La liaison entre le système de santé et les gouvernements locaux s'est améliorée au fil du temps. Une réorientation des projets centrés sur le bien-être vers les infrastructures, les ressources humaines et les services était évidente. Une hétérogénéité considérable existe en raison des différents degrés d'implication, de capacité, de ressources et de besoins de la communauté. Le discours au niveau de l'État et les récents efforts d'augmentation en vue d'atteindre les objectifs de développement durable (SDG) de l'ONU soutiennent fortement le rôle des gouvernements locaux dans la planification, le financement et la mise en œuvre. CONCLUSION: Les 25 ans d'histoire de l'administration décentralisée des soins de santé au Kerala révèlent à la fois des réussites et des échecs. Un soutien central sans déresponsabiliser les gouvernements locaux peut être une option viable pour permettre une prise de décision flexible et cohérente avec les objectifs plus larges du système.

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This paper aims to empirically test the dynamics of budget outcomes of Italian municipalities in the aftermath of floods by accounting for heterogeneous levels of resilience and vulnerability to natural disasters. Our findings are based on a dynamic difference-in-differences model after propensity score matching. They point to substantial impacts in terms of increased capital expenditure and revenues from transfers, which depend on the degree of resilience and vulnerability. Through our analysis, we account for multiple aspects of risk to support policy decisions related to both ex-ante and ex-post disaster occurrence management.

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