The role of national machineries, as a way to promote the status of women, acquired international relevance during the World Conference on the International Women's Year, in Mexico City in 1975. This book reflects Division for the Advancement of Women's (DAW) long-standing interest in the area of national machineries, bringing together the experiences, research and insights of experts. The first part of the book sets out the major issues facing national machineries at the conceptual level. It reflects upon five aspects of democratization: devolution or decentralization; the role of political parties; monitoring and auditing systems; and the importance of increasing the presence of women within institutions of the state and government. The second part is a comparative analysis and sets out the major issues facing national machineries at the political level. A combination of factors, including civil society, state bodies and political actors, need to come together for national machineries to function effectively in the interest of gender equality. Next comes the 'lessons learned' by national machineries in mainstreaming gender. National machineries should have an achievable agenda, an important part of which must be 'a re-definition of gender issues. The third part contains case studies that build upon the specific experiences of national machineries in different countries. The successful experience of Nordic countries in gender mainstreaming is also discussed.
precise protocols and undertaking institutional audits. Nationally, elite professional bodies and leading specialists produced guidelines to inform local developments, and sought to establish national datasets and auditsystems. Through these changes, previously informal measures regulating clinical activity became explicit, and the rhythms and content of care became subject to new forms of structure and review.
The Conservative governments of the 1980s and 1990s had also become interested in guidelines and medical audit. Motivated by historic
’ — and ends with a
Part I sets out the major issues facing national machineries at the conceptual level. In chapter 1, Shirin M. Rai
examines the major issues that need to be considered in the
evaluation of national machineries. Rai argues that national
machineries are part of the process of democratizing the
state and hence of good governance. She reflects upon five
aspects of democratization that are critical for national
machineries: devolution or decentralization; the role of
political parties; monitoring and auditingsystems of the
the temporality and content of clinical activity in order to integrate dispersed labour. Amid professional and popular anxiety about the quality of British medical practice, elite specialists and GPs also developed the first national guideline and auditsystems, designed to inform local care and structure national provision. In doing so, these practitioners incorporated previously academic tools for research and healthcare assessment into routine care. Moreover, acting through statutory bodies associated with the NHS and the standard-setting bodies of the Royal
lobbied ministers, and policy networks produced quantified measures of the costs of the disease and its complications. 64 With the government interested in new forms of professional management, chronic diseases like diabetes provided promising subjects for piloting new programmes. Healthcare teams were already using many of the tools required for implementation, whilst elite professional bodies and international organisations were creating standards documents, clinical guidelines, and model auditsystems. There were alternative routes to promoting managed medicine
. Guidelines had been mooted as a sensible way to steer practitioners in certain situations, and local protocol had already been devised in some locations to manage care. A drive for better monitoring of care as an educational aid also encouraged the development of standards. In the case of diabetes, tentative guidelines (and allied auditingsystems) began with service facilities and staffing before moving on to process and outcomes. This shift itself marked a significant transformation in the nature of medical regulation and autonomy. However, attention also needs to be
clinical pathology and hence are fitted for reasons of primary prevention.
Made by men for men
The UK’s auditsystem of ICDs and CP uses data to explore how different areas in the UK are performing in terms of the number of active cardiac device procedures being undertaken compared to the national averages (Buxton et al., 2006 ). In the UK, a Health Technology Assessment conducted in 2006 highlighted that approximately 80 per cent of ICDs were implanted into men and 20 per cent into women (Buxton et al., 2006 ). More recent and additional data on age and ethnicity