The food crisis of 2007/8, alongside rapid population growth, and the uncertainties of climate change propelled African agricultural transformation back into the development mainstream. New narratives of 'climate-smart agriculture' and 'sustainable intensification' underlie this contemporary transformation. We present a political economy analysis of agricultural policy and livelihoods in Malawi, Tanzania and Zambia, and use this to assess the challenge of achieving 'sustainable and inclusive intensification'. We find little evidence that agricultural institutions have the capacity to deliver sustainable intensification in agriculture, or that agricultural policy drives changes in agricultural livelihoods that will make them either more sustainable or inclusive.

No abstract

Acknowledgements: The authors would like to thank two anonymous reviewers for their guidance on improving this paper. We would also like to thank all the farmers around Morogoro who participated and shared their time and views.

Within current neo-liberal approaches to development, models of community-driven development assume that community-based workers (CBWs) are key actors in improved and accessible service delivery. We argue that use of CBWs is under-theorised and seems to be based largely on untested assumptions about community participation and responsibility. Drawing on case studies on potable-water management and home-based care for HIV/AIDS patients in Tanzania and South Africa, the article explores issues of accountability, professionalism, and personal motivations in systems involving CBWs. It argues that many assumptions in relation to the effectiveness of CBW programmes require re-visiting.Prestation de services à bon marché ? Les travailleurs communautaires dans les interventions de développement Dans le cadre des approches néolibérales actuelles du développement, les modèles de dévelop-pement impulsé par la communauté supposent que les travailleurs communautaires (TC) sont des acteurs clés dans la prestation améliorée et accessible de services. Nous soutenons que l'utilisation de TC est sous-théorisée et semble se baser largement sur des suppositions qui n'ont pas été mises à l'épreuve concernant la participation et la responsabilité de la communauté. Sur la base d'études de cas de la gestion de l'eau potable et des soins à domicile pour des patients atteints du VIH/du sida en Tanzanie et en Afrique du Sud, cet article examine les questions de redevabilité, de professionnalisme et de motivations personnelles dans les systèmes faisant intervenir des TC.Il soutient que de nombreuses suppositions concernant l'efficacité des programmes de TC doivent faire l'objet d'une nouvelle réflexion.Distribuição barata de serviços? Trabalhadores comunitários em ações de desenvolvimento Nas abordagens neoliberais atuais relativas ao desenvolvimento, os modelos de desenvolvimento orientados pela comunidade pressupõem que trabalhadores baseados na comunidade (CBWs) são agentes-chave na implementação de serviços melhores e acessíveis. Argumentamos que o uso de CBWs está sub-teorizado e parece estar baseado em grande parte em pressupostos não testados sobre a participação e responsabilidade da comunidade. Baseando-se em estudos de caso sobre gestão de água potável e cuidados em domicílio para pacientes portadores de HIV/AIDS na Tanzânia e Á frica do Sul, o artigo explora questões sobre accountability, profissionalismo e motivações pessoais em sistemas envolvendo CBWs. O artigo argumenta que muitos pressupostos em relação à efetividade de programas de CBW precisam ser repensados. ¿Entrega de servicios con el menor gasto? Trabajadores comunitarios en acciones de desarrollo En el marco actual de enfoques neoliberales en el desarrollo se da por supuesto que los trabajadores comunitarios (TC) son actores clave en los modelos de desarrollo comunitario para asegurar una mejor y más accesible entrega de servicios. Los autores de este ensayo argumentan que el empleo de TC tiene poco sustento teórico y parece fundamentarse en gran parte en supuestos de...

This article provides evidence of horizontal inequity in the distribution of the burden and benefits of healthcare in north‐western Ghana. A qualitative approach was used to collect and analyse the data on variation in perceptions of affordability of health services to rural and urban populations in the Jirapa Municipality of Ghana. The article argues that costs of transportation, food and lodging associated with seeking healthcare at the municipal referral hospital are disproportionately higher for rural residents. This leads to delayed medical treatment, self‐medication or reliance on traditional medicines, all of which can come with harmful consequences. © 2020 John Wiley & Sons, Ltd.