There is an increasing awareness among researchers and others that marginalized and vulnerable groups face problems in accessing health care. Access problems in particular in low-income countries may jeopardize the targets set by the United Nations through the Millennium Development Goals. Thus, identifying barriers for individuals with disability in accessing health services is a research priority. The current study aimed at identifying the magnitude of specific barriers, and to estimate the impact of disability on barriers for accessing health care in general. A population based household survey was carried out in Sudan, Namibia, Malawi, and South Africa, including a total of 9307 individuals. The sampling strategy was a two-stage cluster sampling within selected geographical areas in each country. A listing procedure to identify households with disabled members using the Washington Group six screening question was followed by administering household questionnaires in households with and without disabled members, and questionnaires for individuals with and without disability. The study shows that lack of transport, availability of services, inadequate drugs or equipment, and costs, are the four major barriers for access. The study also showed substantial variation in perceived barriers, reflecting largely socio-economic differences between the participating countries. Urbanity, socio-economic status, and severity of activity limitations are important predictors for barriers, while there is no gender difference. It is suggested that education reduces barriers to health services only to the extent that it reduces poverty. Persons with disability face additional and particular barriers to health services. Addressing these barriers requires an approach to health that stresses equity over equality.

What explains support for violence against the state? The surge in survey-based studies in (former) conflict areas has improved our understanding of the determinants of armed conflict. Yet, the potential interaction between grievances and political opportunity structure has received little attention in microlevel studies. Integrating common arguments from the civil war literature with the political behavior tradition, this article argues that perceived political efficacy, a central component of the political opportunity structure, moderates the association between individual and group grievance and people’s support for political violence. It represents a first individual-level test of the argument that perceived political opportunity structure and grievances combine to explain internal armed conflict. Using original survey data from Guatemala, Nepal, and Northern Ireland (2016), we find robust empirical evidence that support for violence increases with perceived grievance and decreases with political efficacy; and some evidence of an interaction between the two.

This paper explores differences in experienced environmental barriers between individuals with and without disabilities and the impact of additional factors on experienced environmental barriers. Data was collected in 2011–2012 by means of a two-stage cluster sampling and comprised 400–500 households in different sites in South Africa, Sudan Malawi and Namibia. Data were collected through self-report survey questionnaires. In addition to descriptive statistics and simple statistical tests a structural equation model was developed and tested. The combined file comprised 9,307 participants. The Craig Hospital Inventory of Environmental Factors was used to assess the level of environmental barriers. Transportation, the natural environment and access to health care services created the biggest barriers. An exploratory factor analysis yielded support for a one component solution for environmental barriers. A scale was constructed by adding the items together and dividing by number of items, yielding a range from one to five with five representing the highest level of environmental barriers and one the lowest. An overall mean value of 1.51 was found. Persons with disabilities scored 1.66 and persons without disabilities 1.36 (F = 466.89, p < .001). Bivariate regression analyses revealed environmental barriers to be higher among rural respondents, increasing with age and severity of disability, and lower for those with a higher level of education and with better physical and mental health. Gender had an impact only among persons without disabilities, where women report more barriers than men. Structural equation model analysis showed that socioeconomic status was significantly and negatively associated with environmental barriers. Activity limitation is significantly associated with environmental barriers when controlling for a number of other individual characteristics. Reducing barriers for the general population would go some way to reduce the impact of these for persons with activity limitations, but additional and specific adaptations will be required to ensure an inclusive society.

Comparative work on reconstruction and peace building in wartorn countries is dominated by a macro-oriented approach, focusing on structural political reforms, legal issues, disarmament, demobilization and reintegration of (rebel) soldiers, and repatriation of the displaced. This article offers a different perspective, examining micro-level determinants of reconciliation. Earlier research indicates that political attitudes in post-ethnic conflict societies are shaped by ethnic affinity. A large literature on the importance of contextual conditions for human behavior would suggest that ethnic composition of the local population and physical proximity to the conflict zone also should affect individual support for peace and reconciliation. To test these propositions, we draw on a geo-referenced survey of the Macedonian population that measures respondents' perception of the 2001 civil conflict. Contrary to expectations, the spatial and demographic setting exerts only feeble impacts on individuals' support for the Framework Agreement. Several years after the conflict was settled, the survey data reveal a strongly divided Macedonian society