FSI's research on the origins, character and consequences of government institutions spans continents and academic disciplines. The institute’s senior fellows and their colleagues across Stanford examine the principles of public administration and implementation. Their work focuses on how maternal health care is delivered in rural China, how public action can create wealth and eliminate poverty, and why U.S. immigration reform keeps stalling.
FSI’s work includes comparative studies of how institutions help resolve policy and societal issues. Scholars aim to clearly define and make sense of the rule of law, examining how it is invoked and applied around the world.
FSI researchers also investigate government services – trying to understand and measure how they work, whom they serve and how good they are. They assess energy services aimed at helping the poorest people around the world and explore public opinion on torture policies. The Children in Crisis project addresses how child health interventions interact with political reform. Specific research on governance, organizations and security capitalizes on FSI's longstanding interests and looks at how governance and organizational issues affect a nation’s ability to address security and international cooperation.
Geir H. Holom, MD, is a Visiting Scholar at Stanford School of Medicine (CHP/PCOR) from the University of Oslo. His research focuses on the expansion of private for-profit hospitals in the Nordic countries and its effect on prices, quality of care and selection of patients. He received a BSc in Economics and Business Administration from the Norwegian School of Economics and an MD from the University of Bergen. While in medical school, he conducted research on patients diagnosed with head and neck cancer who underwent head and neck reconstruction using microsurgery. Since receiving his MD, he has worked as a physician in both primary care and specialized health services. Prior to entering the field of medicine, he worked in the business and finance sector.
Adjunct Affiliate at the Center for Health Policy and the Department of Medicine
Stanford pediatrician Paul Wise stooped below the black tarp roof of a cinderblock house in Guatemala to offer his condolences to a mother who had just lost her child.
“Doctor Pablo,” as he is known in the communities around San Lucas Tolimán, talked softly as he relayed his sympathies to the mother, whose 9-year-old son had been a patient of his.
Stanford’s Children in Crisis Initiative seeks to save the lives of children in areas of poor governance. In Guatemala, their efforts work toward eliminating death by malnutrition for children under 5.
The boy’s genetic disorder would have been terminal anywhere, but thanks to Wise and local health promoters, the boy’s family had years with him instead of months.
While Wise spoke to the heartbroken mother, his Stanford research assistant Alejandro Chavez helped the promoters set up inside a local community center to measure the weight and height of local kids to determine their nutrition level.
Chavez and the promoters had worked together for months to create an app for tablets that will make it easier to find malnourished children.
The app they designed will decrease training time for new health promoters and allow the program to expand. The goal is to distribute the app globally to help programs in other countries tackle malnutrition.
Children in crisis
As recently as 2005, about one of every 20 children in this rural area of Guatemala died before their 5th birthday. Almost half the deaths were associated with severe malnutrition.
“The death of any child is always a tragedy, but the death of any child from preventable causes is always unjust,” said Wise, a Stanford Health Policy core faculty member.
Along with other faculty from the Freeman Spogli Institute for International Studies (FSI) and the School of Medicine, Wise created the Children in Crisis Initiative to save the lives of children in areas of poor governance. The program brings together Stanford researchers and students across disciplines.
Nowhere are their efforts better illustrated than in the rural communities around San Lucas Tolimán, in the central mountains of Guatemala.
The program’s effectiveness rests on a deep respect for the local communities merged with innovation by Stanford researchers.
“It’s absolutely essential to any program that the people in need be part of the solution,” said Wise. Unlike many nongovernmental organizations and health programs, Wise believes the way to create a sustainable health system is for the locals to run it, so the health promoters manage the program’s day-to-day activities.
Image
This leaves the Stanford team free to focus on innovation – such as the new app. They believe the technology could change child health programs around the world. Wise’s team has partnered with Medic Mobile – a nonprofit that creates open-source software for health care workers – which plans to distribute the app to other areas suffering from malnutrition.
The six Android tablets purchased by Children in Crisis are enough to monitor the program’s 1,500 kids through the app.
Role of nutrition
When done well, nutrition surveillance is very effective at decreasing child mortality in poor countries.
“Nutrition contributes enormously to health and well-being,” Wise said as he walked through Tierra Santa, a small community near San Lucas, making house calls. “So the focus of our work turned to improving young child nutrition. It’s not an easy thing to do in a place that’s extremely poor.”
Wise and his colleagues – Stanford medical student Tori Bawel and Stanford professor of pediatrics Lisa Chamberlain – made their rounds during their visit in March. Evidence of poverty was everywhere.
Here, clean tap water is a dream and even the sturdier homes often lack four walls or paned windows, though the children were neatly dressed in T-shirts or colorful traje, traditional Mayan clothing.
It’s hard to provide proper nutrition when most families can’t find enough work to buy adequate food. But a little help can make a big difference.
Bawel, a first-year medical student who plans a career improving health in areas of poverty, was struck by the impact the promoter program has had on the community.
“There are children who need supplements and nutrition to stay alive,” she said. “Without this program, that infrastructure does not exist.”
With FSI’s assistance, the nutrition program distributes Incaparina, a supplement of cornmeal, soy and essential nutrients. The sweet, mealy drink helps the program’s most malnourished children get back on track.
Image
Every two months, the promoters gather each community’s children to measure their weight and height. Children and their mothers sit patiently, waiting for their turn. The children enjoy a cup of Incaparina, and their mothers eagerly listen to the promoters’ tips for keeping their children healthy.
“It’s very important to me,” said Elsira Rosibel Samayoa, who brought her 2-year-old to be measured. “There are mothers who don’t understand the importance of monitoring their children’s weight, but I do.”
Since its implementation in 2009, the Stanford program has slashed nutrition-based mortality in the participating communities by about 80 percent and decreased severe malnutrition by more than 60 percent – saving hundreds of children’s lives.
However, nutrition surveillance and intervention isn’t easy. Tracking nutrition takes training and expertise, and when the local population rarely exceeds a fourth-grade education, learning these skills is especially challenging. Detailed graphs on a standard growth chart are essential to identifying malnourished children.
“The community health workers are extremely capable and smart, but some have never seen a graph before,” said Wise. “Think about what it is to try to explain a graph to someone for the first time.”
It takes the health workers about three years to learn to graph and then interpret the results for intervention.
Wise said, “So we all got together and said, ‘How do we make this easier to do?’”
The app was the answer.
‘Let’s create an app’
Enter Alejandro Chavez, a recent Stanford computer science graduate and Stanford Health Policy research assistant. He developed the app to collect child health data, then determine the child’s degree of malnutrition and suggest intervention.
“The major goal was to lower training requirements and make programs like this simpler to start and maintain,” said Chavez, who now lives and works in Guatemala, where he gets daily feedback from the health promoters.
“I feel like they’ve been very honest with me about things I need to improve,” he said.
Cesia Lizeth Castro Chutá is a senior coordinator for the program who has worked with Chavez to ensure that the app meets the promoters’ needs.
“The tablet automatically generates the information we need to know,” she said. “It becomes easier to confirm that a child is malnourished and needs supplements.”
Looking forward
Image
With the app’s launch, it looks like training time for the promoters will be reduced from three years to less than six months. That means new communities can be incorporated into the program quickly, creating broader access to care.
Meanwhile, many health programs around the world are waiting to see how well the Stanford app works in Guatemala.
Josh Nesbit, a Stanford alumnus and Medic Mobile CEO, said, “As more health programs recognize the importance of nutrition and implement community-based interventions, screening and surveillance tools will be critical. We must learn from Dr. Wise’s success.”
In the July/August edition of Foreign Affairs, Larry Diamond takes stock of the global democratic recession, and urges the next president to make democracy promotion a pillar of his or her foreign policy agenda.
Turkey's Prime Minister Recep Tayyip Erdogan addresses members of parliament from his ruling AK Party (AKP) during a meeting at the Turkish parliament in Ankara on June 11, 2013. | Adem Altan / Stringer - Getty Images
The United States is exceptionally secure. No country today presents a clear and imminent security threat in the way that Germany, Japan, or the Soviet Union did in the 20th century. In the short and medium term, there is also no alternative value system that could displace America’s conception of individual liberty and a market-oriented economy—principles that have been embraced by all of the world’s wealthy industrialized countries in Western Europe, North America, and East Asia.
MCFAUL SPEAKS ON AMERICA'S RELATIONSHIP WITH PUTIN'S RUSSIA
FSI director Michael McFaul, former US ambassador to Russia, testified in front of the House Foreign Relations Committee on June 14, 2016. Invited to provide his perspective on how the U.S. should move forward diplomatically with Putin's Russia, McFaul made a forceful case for deliberate and strategic engagement with the Russian government, its citizens, and Ukraine. "The best way to support reform, and those who care about democracy and markets in Russia, is to have Ukraine succeed," he said.
Watch the full hearing below, with McFaul's remarks at the 23-minute and 1-hour marks:
Prof. McFaul also provided written testimony to the Committee (available here). In it, he emphasizes the domestic factors that influence Russian foreign policy, particularly Putin's internal political concerns and the situation with Ukraine and Crimea. U.S. foreign policy does not need a "correction," in this case, he writes. Instead, he argues, we should hold fast to President Obama's current policy of supporting the current international order and refusing to condone Russia's territorial expansions.
In all the remarks, Prof. McFaul was careful to separate the policies of the Kremlin from the needs of the Russian people. "Many Russians in the government, business, and society quietly believe that Putin’s current course of confrontation with the West does not serve Russia’s long-term economic and strategic interests," he writes in the conclusion of his testimony. "The United States and our European allies should increase efforts to engage directly with the Russian people, including students through exchanges and scholarships, peer-to-peer dialogue with non-government organizations, and allowing Russian companies not tied to the state to continue to work with Western partners."
The history of human civilization has been about managing information, from hunting and gathering through contemporary times. In modern societies, information flows are central to how individuals and societies interact with governments, economies, and other countries. Despite this centrality of information, information governance—how information flows are managed—has not been a central concern of scholarship. We argue that it should be, especially now that digitization has dramatically altered the amount of information generated, how it can be transmitted, and how it can be used.
This book examines various aspects of information governance in Japan, utilizing comparative and historical perspectives. The aim is threefold: 1) to explore Japan’s society, politics, and economy through a critical but hitherto underexamined vantage that we believe cuts to the core of what modern societies are built with—information; 2) articulate a set of components which can be used to analyze other countries from the vantage of information governance; and 3) provide frameworks of reference to analyze each component.
This book is the product of a multidisciplinary, multinational collaboration between scholars based in the US and Japan. Each are experts in their own fields (economics, political science, information science, law, library science), and were brought together in two workshops to develop, explore, and analyze the conception and various of facets of information governance. This book is frontier research by proposing and taking this conception of information governance as a framework of analysis.
The introduction sets up the analysis by providing background and a framework for understanding the conception of information governance. Part I focuses on the management of government-held information. Part II examines information central to economic activity. Part III explores information flows crucial to politics and social life.
A British exit from the European Union would slow economic growth, reduce Europe's impact in world politics, and strengthen regimes such as Russia's that prefer a weaker, less united Europe, Stanford expert Christophe Crombez says.
The United Kingdom would lose more than it would gain if it left the European Union, a Stanford scholar said.
So would other European nations, and the real winners would be countries that seek to divide European unity, said Christophe Crombez, a consulting professor in Stanford’s Europe Center in the Freeman Spogli Institute for International Studies.
Britain is holding a referendum on June 23 to decide whether the country should leave or remain in the European Union.
“It would bring but an illusion of sovereignty,” said Crombez, who studies European Union politics, parliamentary systems, political economy and economic analysis of political institutions. He is an economist from Belgium.
The Stanford News Service recently interviewed Crombez on the upcoming vote, known as “Brexit.”
What is Brexit?
The term Brexit refers to the United Kingdom’s withdrawal from the European Union. Article 50 of the Treaty on European Union allows member states to withdraw.
What are the arguments for and against Brexit?
The campaign for the UK to leave the EU uses the following main arguments: leaving would save UK taxpayers money, since the UK is a net contributor to the EU budget; the UK would no longer have to comply with EU laws it does not want, whereas currently it can be outvoted in EU institutions and forced to adopt laws it opposes; and it would allow the UK to better control migration, whereas EU citizens are currently free to move and work throughout the EU.
These three arguments can easily be refuted, however. The UK does indeed contribute to the EU budget, but the benefits it derives from being part of the EU market far outweigh the budgetary contributions. Moreover, (if Britain were to withdraw) the EU would require the UK to pay into its budget, if it wants to remain part of the EU’s internal market, as it has done with Switzerland and Norway.
Also, about half of UK exports are destined for the EU. If the UK were to leave, it would no doubt want to continue to trade with the EU. UK products would have to conform to EU rules for them to be sold in the EU. UK companies that want to export to the EU would thus continue to comply with EU rules. The difference would be that the UK would no longer be involved in setting those EU rules. Post-Brexit, the rules would thus be less to the UK’s liking than prior to it, and UK companies would comply to these less advantageous rules.
Finally, the EU would impose requirements on immigration and free movement of people on the UK in exchange for free trade with the EU, as it has with other countries in similar situations, such as Norway and Switzerland. Moreover, member states may no longer feel inclined to stop refugees from moving on to the UK if the UK were to leave, which may lead to higher rather than lower immigration.
In addition to these arguments, the Britain Stronger in Europe campaign (which supports the UK remaining in the EU) argues that Britain carries more weight in world politics as part of the EU than on its own, in trade negotiations as well as on security issues, and that a united Europe is better at dealing with (Russian President Vladimir) Putin and other authoritarian rulers, terrorist threats and international crime.
What do you think is the best decision for the United Kingdom to make on this vote?
I see no advantages to leaving the EU. It would bring but an illusion of sovereignty – consider the points above. The vote would have a negative impact on growth in the UK and the rest of the EU and, in fact, the world, and it would weaken the UK, the EU and the West in world politics.
What happens economically to Britain if the country leaves the European Union?
Trade and hence gross domestic product would be negatively affected, especially in the short term. Uncertainty would reduce investment and trade. The UK and the EU would be consumed with the negotiations on the break-up for years. This would prevent both the UK and EU from tackling more important economic and security issues. In the long term, the economy would readjust, but the result would be suboptimal.
What happens to the EU if Britain leaves?
The EU is less dependent on trade with the UK than vice versa. There would be an economic impact, but it would be less substantial. The effect would be more significant for a few countries that trade more with the UK, such as Ireland, Belgium and the Netherlands.
Brexit would, however, deliver a major blow to the idea of European unification. It would weaken the EU impact in world politics and strengthen such rulers as Putin and (Turkish President Recep Tayyip) Erdogan in their dealings with the EU.
Could a British exit open up a Pandora’s Box of other EU countries exiting or spark other regional independence movements, like Catalonia?
That is quite possible. A number of other countries may want to hold referendums on the EU. Moreover, Brexit is likely to lead to a break-up of the UK. Scotland would likely hold another referendum and decide to leave the UK in order to stay in the EU. The same may be true for Northern Ireland in the long run. Scottish secession may then give other EU regions, such as Catalonia, further incentives to secede.
Stanford’s Center on Democracy, Development and the Rule of Law congratulates its undergraduate honors class for completing their original research and undergraduate theses. They graduated from Stanford University on June 12 with honors in their respective disciplines.
Graduates include Vehbi “Deger” Turan, who was awarded the Firestone Medal for his thesis entitled “Augmenting Citizen Participation in Governance through Natural Language Processing.” Turan’s project employed existing literature on democratic participation, case studies and an original algorithm in order to devise a means by which government agencies can evaluate public comments received via the Internet on political issues.
The Firestone Medal for Excellence in Undergraduate Research recognizes Stanford's top ten percent of honors theses in social science, science and engineering among the graduating senior class.
Turan decided to explore this topic shortly after joining the Fisher Family CDDRL Honors Program.
According to the program’s Director Stephen Stedman, “After listening to a research seminar at our Center, Deger believed that he could develop an aggregation tool to help policy makers understand such immense data.”
Francis Fukuyama, the Mosbacher Director of CDDRL also noted, “Deger is perhaps the best example to date of why interschool honors programs are valuable. He is a computer science major who came to us expressing an interest in using his background in artificial intelligence to help solve critical public policy problems.” Fukuyama together with Associate Professor of Political Science Justin Grimmer advised Turan on his honor’s thesis.
Turan will be starting a new position at Atomic Labs’ Zenreach start-up after graduation.
The CDDRL Award for Outstanding Thesis was given to Rehan Adamjee whose thesis explored the different factors at play in choosing between healthcare providers in a rural area of Pakistan.
Adamjee and Turan are just two members of a the 2016 cohort of 11 honors students, many of whom traveled to foreign countries to collect original data, conduct interviews and research their thesis topics. Their topics range from timely case studies on the use of social media as a tool of empowerment to a glimpse at the effects of regional politics on healthcare reform in Post-Soviet Russia.
The 2016 class joins 76 graduates from CDDRL’s honors program since its launch in 2007.
The Fisher Family CDDRL Honors Program trains Stanford students from diverse majors to write theses with global policy implications on a subject related to democracy, development and the rule of law. Students attend a class on research methods the spring quarter of their junior year. During their senior year, in tandem with the CDDRL research community and their faculty advisor, students conduct both local and international research in order to write their theses. Students travel to Washington, DC for the annual honors college to meet policymakers and members of the development community to enrich their thesis topics.
A list of our graduating students along with links to all their theses can be found below.
The graduating class of 2015-2016 CDDRL senior honors students take a group photo with CDDRL Mosbacher Director Francis Fukuyama and the Fisher Family CDDRL Honors Program Director Stephen Stedman. From left to right: Didi Kuo (CDDRL honors program mentor); Jelani Munroe; Stephen Stedman; Tebello Qhotsokoane; Paul Shields; Shang-Ch’uan Li; Hannah Potter; Hadley Reid; Vehbi Deger Turan; Sarah Johnson; Hannah Meropol; Rehan Adamjee; Anna Blue | Alice Kada
Fifty years have passed since the beginning of China’s Cultural Revolution, a mass political movement led by Mao Zedong that lasted a decade and provoked widespread violence and social upheaval. Stanford sociologist Andrew Walder, a noted expert on contemporary Chinese society, offered his commentary and analysis to various media outlets, cited below.
In the years just following Mao’s death in 1976, the Communist Party showed an “incredible openness” toward addressing the horrors caused by the Cultural Revolution, he told The Guardian. The Communist Party denounced the Cultural Revolution and some within the Party led efforts to document the chaos and bloodshed under Mao’s tenure, Walder recounted on CNN International.
In the 1980s, however, young Chinese activists began to shift their attention from the legacy of the Cultural Revolution to the lack of government reform in China. The Tiananmen Square protests of 1989, despite being short-lived, disquieted the regime more than the Cultural Revolution did, he told The Guardian.
The Chinese government today, compared to the 1970s and early 80s, is much less inclined to discuss Mao’s historical record. Yet, when compared to other socialist regimes that experienced rebellion such as the Soviet Union, China has been much more open to confronting its dark historical past, Walder said in an interview with The Globe and Mail.
Larry Diamond, the former director of Stanford’s Center on Democracy, Development, and the Rule of Law, was awarded Stanford’s Kenneth M. Cuthbertson Award for exceptional service to Stanford University. Diamond was honored for nearly two decades of enthusiastic service to Stanford alumni, as well as for his visionary leadership as the faculty director of the Haas Center for Public Service. Diamond will receive the award during Stanford’s 125th Commencement ceremony on June 12, 2016.
