News from Project B08

In "Social Policy & Administration", 7 CRC 1342 projects have presented case studies of social policy dynamics in the Global South. Their synthesis shows: The concept of causal mechanisms is particularly well suited for analysing such dynamics.

Seven projects of CRC 1342's project area B have published a Special Regional Issue of "Social Policy & Administration": Causal mechanisms in the analysis of transnational social policy dynamics: Evidence from the global south. The main research question the authors address is: Which causal mechanisms can capture the transnational dynamics of social policy in the Global South?

In order to find answers to this question, the authors present in‐depth case studies of social policy dynamics in different countries and regions in the Global South as well as different fields. All articles focus on the interplay of national and transnational actors when it comes to social policy‐making. (The papers of this Special Issue are listed below.)

The key findings of the authors are:

  • Explanations of social policy‐making in the Global South will remain incomplete unless transnational factors are taken into account
  • However, this does not mean that national factors are no longer important. In social policy decision‐making, national institutional settings and actors are key
  • Mechanism‐based research can plausibly trace the interplay between transnational and national actors and its impact on shaping social policy outcomes. The articles identify a variety of causal mechanisms that can capture this interplay
  • The output of social policy‐making is complex and can often not be explained by a single mechanism. Examining the combination and possible interaction of several causal mechanisms can provide more in‐depth explanations 
  • The concept of causal mechanisms can also be applied in comparative analyses
  • Mechanisms can be traced inductively in one case and then be applied to another case.


Johanna Kuhlmann & Tobias ten Brink (2021). Causal mechanisms in the analysis of transnational social policy dynamics: Evidence from the global south. Social Policy & Administration.

Armin Müller (2021). Bureaucratic conflict between transnational actor coalitions: The diffusion of British national vocational qualifications to China. Social Policy & Administration.

Johanna Kuhlmann & Frank Nullmeier (2021). A mechanism‐based approach to the comparison of national pension systems in Vietnam and Sri Lanka. Social Policy & Administration.

Kressen Thyen & Roy Karadag (2021). Between affordable welfare and affordable food: Internationalized food subsidy reforms in Egypt and Tunisia. Social Policy & Administration.

Monika Ewa Kaminska, Ertila Druga, Liva Stupele & Ante Malinar (2021). Changing the healthcare financing paradigm: Domestic actors and international organizations in the agenda setting for diffusion of social health insurance in post‐communist Central and Eastern Europe. Social Policy & Administration.

Gulnaz Isabekova & Heiko Pleines (2021). Integrating development aid into social policy: Lessons on cooperation and its challenges learned from the example of health care in Kyrgyzstan. Social Policy & Administration.

Anna Safuta (2021). When policy entrepreneurs fail: Explaining the failure of long‐term care reforms in Poland. Social Policy & Administration.

Jakob Henninger & Friederike Römer (2021). Choose your battles: How civil society organisations choose context‐specific goals and activities to fight for immigrant welfare rights in Malaysia and Argentina. Social Policy & Administration.

Dr. Johanna Kuhlmann
CRC 1342: Global Dynamics of Social Policy
Mary-Somerville-Straße 7
28359 Bremen
Phone: +49 421 218-58574

Prof. Dr. Tobias ten Brink
CRC 1342: Global Dynamics of Social Policy, Research IV and China Global Center
Campus Ring 1
28759 Bremen
Phone: +49 421 200-3382

Intensive care unit (Foto: Vadim/Adobe Stock)
Intensive care unit (Foto: Vadim/Adobe Stock)
SFB member Mirella Cacace, collaborating with experts from her network, has conducted a comparative study of Germany, Denmark, Sweden, Spain, and Israel.

Large differences in number of hospital and intensive care beds before the pandemic

Before the onset of the pandemic, the four countries showed significant differences: In terms of hospital beds per 1,000 inhabitants, Germany had the highest value at 8.0, Spain and Israel followed with 3.0, while facilities in Denmark (2.4) and Sweden (2.1) were the lowest (values from 2018 in each case). However, the supposed advantage for patients in Germany is severely compromised by the high occupancy rate of beds and the unfavorable ratio of patients to nurses and medical staff.

A similar picture emerged for the provision of intensive care beds: Germany had by far the most intensive care beds per 100,000 inhabitants (33.9). Israel and Spain had only about a third of that (10.3 and 9.7, respectively), followed by Denmark (7.8) and Sweden (5.2).

Increasing intensive care capacity

Cacace writes in her study that all countries succeeded in rapidly increasing intensive care bed capacity (regardless of whether capacity planning was centralized, such as in Israel, or decentralized, such as in Spain). Sweden was also able to quickly reduce intensive care bed capacity when the pandemic subsided, thus saving costs. "Indispensable for this flexibility is the current availability of data on existing and built-up capacity, especially in intensive care. Sweden was the only country in our sample that had information on the number and location of intensive care beds at the onset of the pandemic," Cacace writes in the results chapter of the study. As a result, Sweden had clear advantages for expanding and contracting intensive care capacity as needed.

No data available on nursing staff in intensive care units

In addition to the number of beds, however, the number of intensive care nursing staff is also crucial for the quality of (intensive) care. The availability of (highly) qualified nursing staff is a crucial bottleneck in the adequate care of patients during the pandemic in all countries studied, Cacace writes. It is all the more astonishing that "as of today, no data are available on intensive care staff in any of the countries."


The study was published in February and is available online free of charge at the Bertelsmann Stiftung website (in German only): Krankenhausstrukturen und Steuerung der Kapazitäten in der Corona-Pandemie. Ein Ländervergleich

Prof. Dr. Mirella Cacace