Volker Reissner
email: volker.reissner@uni-due.de

Meike Rosien

Kai Jochheim

Olaf Kuhnigk

Hans Dietrich

Alfons Hollederer

Johannes Hebebrand

Psychiatric disorders and health service utilization in unemployed youth

Keywords: youth unemployment, mental health, personality disorder, health service utilisation, SUPPORT25

ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction

Unemployment rates across Europe and the US are currently on the rise again. This is seen as a consequence of the 2008 financial market break-down and the consecutive stock market crisis plunging global markets and economies into recession. Especially adolescents and young adults are thought to be affected by such a development. As long-term youth unemployment fosters the different facets of social exclusion and increases

Blinded Manuscript

Click here to view linked References 2 costs for social security systems it is targeted by multiple programmes by the European Commission [START_REF] Kieselbach | Long-term unemployment among young people: the risk of social exclusion[END_REF].

Cross-sectional studies show a close relationship between unemployment and poor general as well as mental health (e.g. Reim et al. 2009;Wang et al. 2005). Some longitudinal studies support the hypothesis that suffering from a mental health problem causes unemployment (selection or drift hypothesis; e.g. [START_REF] Dooley | Depression and unemployment: panel findings from the Epidemiologic Catchment Area study[END_REF].

Alternatively, individuals develop psychiatric disorders as a result of unemployment (social causation hypothesis). Mental health and unemployment are two interacting variables influenced by different individual and environmental features such as work involvement, appraisal of the situation, coping strategies and others [START_REF] Mckee-Ryan | Psychological and physical well-being during unemployment: a meta-analytic study[END_REF].

Many research designs focussing on unemployed merely targeted "psychological well-being" or psychological symptoms which are measured according to their frequency or severity using questionnaires. This approach is however not sufficient for the interpretation of the psychiatric status and clinical and therapeutic relevance and prognosis. In studies that included unemployed individuals of all ages, psychiatric symptoms and disorders diagnosed were depression (e.g. [START_REF] Stankunas | Duration of unemployment and depression: a cross-sectional survey in Lithuania[END_REF], substance use (e.g. Hämäläinen et al. 2005;[START_REF] Mossakowski | Is the duration of poverty and unemployment a risk factor for heavy drinking?[END_REF]) and suicidal behaviour (e.g. [START_REF] Morrell | Suicide and unemployment in Australia 1907-1990[END_REF]) among others. Single investigators have determined rates of Axis-I or non-personality disorders in both unemployment-specific (Claussen 1999 using DSM-III) or large non-specific epidemiological studies (e.g. [START_REF] Dooley | Depression and unemployment: panel findings from the Epidemiologic Catchment Area study[END_REF] using DSM-III).

Unemployed young adults have been shown to have a higher risk for mental illness. In the limited number of psychiatric studies among this group, the major finding was an elevated rate of alcohol disorders (e.g. [START_REF] Claussen | Alcohol disorders and re-employment in a 5-year follow-up of long-term unemployed[END_REF]. In one study [START_REF] Fergusson | Unemployment and psychosocial adjustment in young adults: causation or selection?[END_REF] exposure to unemployment was significantly associated with suicidal ideation, substance abuse and criminal behaviours. Fergusson and colleagues (1997) demonstrated that unemployed at the age of 18 showed a higher prevalence of psychiatric disorders; higher rates for major depression, anxiety, conduct and substance use disorders were prevailing. Other Axis-I disorders and especially personality disorders were not examined in these as well as in other studies on young unemployed.

Adolescents and young adults are especially vulnerable to failure in the transition periods from adolescence to adulthood and from school to work (e.g. Hammer 1992). Evidently, non-integration into the job-market at a young age has profound long-term implications. [START_REF] Hammarstrom | Early unemployment can contribute to adult health problems: results from a longitudinal study of school leavers[END_REF] showed for a 14 year follow-up cohort that early unemployment among young men and women had a significant explanatory effect on smoking, alcohol use and anxiety as well as depressive symptoms.

We are not aware of any studies that have determined both Axis-I and -II DSM-IV diagnoses. Particularly, the lack of data pertaining to Axis-II or personality disorders (PD) merit consideration because such disorders begin in early adolescence [START_REF] Beauchaine | Multifinality in the development of personality disorders: A Biology x Sex x Environment interaction model of antisocial and borderline traits[END_REF]. Thus they may have a profound impact on job (re-) integration.

Because of the particular relevance of psychiatric disorders for initial integration into the job market, we focussed on young unemployed aged 16 to 24.9.

The goals of this analysis were to  establish the prevalences of both DSM-IV Axis-I and II disorders in a sample of unemployed adolescents and young adults from a joint psychiatric and vocational counselling service,  examine the level of symptom severity, psychopathology and psychosocial functioning,  asses somatic and mental health service use and  identify differences between probands with and without comorbid PD.

Methods

Recruitment and eligibility

In March 2007 an out-patient unit of the Department of Child and Adolescent Psychiatry of the University of Duisburg-Essen was established on the grounds of the vocational services centre Essen. This approach has proven successful to reintegrate unemployed with severe mental illness in a US-study [START_REF] Cook | Integration of psychiatric and vocational services: a multisite randomized, controlled trial of supported employment[END_REF]. For the purpose of our study case managers of the vocational services centre referred clients who they deemed to require a psychiatric evaluation. Counsellors initially received training to identify psychiatric symptoms by professional mental health service staff. In addition they received case-related feedback throughout the study.

Clients from the vocational service centre Essen eligible for study entry had to 1. receive unemployment benefit, 2. be aged between 16.0 and 24.9 years, 3. suffer from self-reported (to the case manager) or deduced mental problems, 4. participate voluntarily (informed written consent).

4

Between April 2007 and March 2008 diagnostic evaluation and counselling was recommended to 229 (55.5% female) unemployed youth by case managers. Participation was voluntary; 15 (6.6 %) did not consent to their proposed referral. The others were consecutively admitted to the study. All clients were asked to attend four diagnostic and counselling sessions; at each time point diagnostic issues were addressed. 49 (21.4%) subjects out of 229 attended the initial session only, and thus did not participate in the interviews scheduled for sessions 2-4. 165 (72 %) out of 229 probands who completed the diagnostic interviews were included in this analysis. For the questionnaires differences in sample size are due to missing data related to non-adherence to sessions 2-4.

Instruments

Structured face-to-face interviews were conducted including the following instruments:

(1) Sociodemographic and biographic information was assessed by the current version of the German Socio-Economic Panel Study (SOEP) Questionnaire. This instrument is issued by the German Institute for Economic Research (2007) and covers e.g. biographic data including social integration, childcare and level of education as well as current and past job status. Institutional upbringing was defined as living in an orphanage and/or foster family for at least one year before age 15. School truancy was defined as continuous absence from school for more than six days. Psychiatric treatment utilisation was assessed both prior to and after age 18.

(2) A psychiatric disorder according to DSM-IV criteria was assessed via the administration of the Structured Clinical Interviews (SCID-I and SCID-II). The SCID-I is a semi-structured interview based on a decision tree approach to establish Axis-I diagnoses. The SCID-II detects (co-morbid) Axis-II disorders. Assessments of both PD and Non-PD are reliable (Williams et al. 1992).

(3) The Symptom Checklist-90-R (SCL-90-R; [START_REF] Derogatis | The SCL-90 and the MMPI: a step in the validation of a new selfreport scale[END_REF]) evaluates a broad range of psychological problems and symptoms of psychopathology. The Global Severity Index used for the purpose of this study represents overall psychological distress.

(4) The Beck Depression Inventory (BDI) was utilized to assess the severity of depressive symptoms. A cut-off score of ≥18 classifies clinically relevant moderate to severe depressive syndromes. Reliability 5 5 and validity have been demonstrated to be sufficient in clinical and non-clinical samples [START_REF] Beck | Psychometric properties of the Beck Depression Inventory: 25 years of evaluation[END_REF]).

(5) The Client Socio-Demographic and Service Receipt Inventory (CSSRI; [START_REF] Chisholm | Client Socio-Demographic and Service Receipt Inventory-European Version: development of an instrument for international research. EPSILON Study 5. European Psychiatric Services: Inputs Linked to Outcome Domains and Needs[END_REF]: This instrument is feasible to collect standardized information on the patient´s use of health, social, education and criminal justice services. The structured interview retrospectively tracks the subjects´ contacts especially with medical and psychiatric services. The patient is asked which treatment units he visited and the frequency of use during the past three or six months.

(6) Apart from self-report inventories, interviewers rated severity of symptoms and psychosocial functioning:

The Global Assessment of Functioning (GAF; [START_REF] Endicott | The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance[END_REF] as defined in the DSM-IV (Axis V) is used to measure the general level of psychological, social and occupational functioning of a subject.

In this study the numeric scale from 0 to 100 represents the subject´s state at intake interview. Low numbers indicate low psychosocial functioning and vice versa.

The Clinical Global Impression -Severity scale (CGI-S; Guy 1976) is useful to judge symptom severity. The clinician assesses the subject´s state on a one-item, 7-point scale in relation to past clinical experience of patients suffering from the same diagnosis. Though CGI-S and GAF are criticized because of reliance on subjective judgments they are widely used and their validities for different disorders recognized [START_REF] Soderberg | Reliability of global assessment of functioning ratings made by clinical psychiatric staff[END_REF].

Interviewers were one psychologist with a master´s degree and one adult senior psychiatrist. They were appropriately trained to conduct the SCID I and II as well as the other questionnaires applied. Consensus diagnostic meetings were held every two weeks.

The study received approval by the Ethics Committee of the Medical School of the University Duisburg-Essen.

Data-analysis for group differences were done by T-Test for continuously distributed variables or Mann-Whitney tests. χ 2 -tests were computed for dichotomous variables; the nominal p-values were not corrected for multiple testing. A logistic regression was conducted and odds ratios (OR) and 95% confidence intervals (95% CI) were 6 calculated to determine risk-factors for success or failure in job reintegration programs. All calculations were performed using the statistical program SPSS v. 14.0.

Results

Sociodemographic and biographic data

Among 165 subjects 96 (58.2%) were female (Table 1). The unemployed young adults had a mean age of 21.4 years and were of German nationality (95.1%). 46.8% of probands reported a history of school truancy. 76.1% had never been employed after finishing school. Subjects were on average 19.0 years (SD = 2.24) when contacting vocational services because of unemployment for the first time. 163 reported on their vocational history: Between the date of registration as unemployed and inclusion into the study subjects achieved different levels of vocational reintegration as measured by the completion of job schemes. In the "Achievers-group" 12.3% completed all training schemes they were assigned to and 18.4% of subjects had finished at least one vocational reintegration course (total: 30.7%). The "Under-achievers" consisted of 50.9% who did not complete any programme and 18.4% who did not commence any programme at all (total: 69.3%).

Insert Table 1 here

Psychiatric morbidity

Axis-I and Axis-II disorders: All percentages given refer to the 165 probands: We categorized the spectrum of psychiatric disorders into four groups: Axis-I disorders only (Non-PD; 40.0%), Axis-II disorders only (PD-only; 8.5%), and comorbid Axis-I and II disorders (49.1%). Only 4 (2.4%) subjects did not meet the criteria of any psychiatric disorder (Figure 1).

Insert Figure 1 here

Mood and Anxiety Disorders were the most common non-PD diagnoses (47.9% and 33.4%). 27.3% of the unemployed fulfilled the diagnostic criteria of substance abuse or dependence (alcohol and illegal drugs). 57.6% of the sample suffered from one or more PD.

Insert Figure 2 here 5.4% of the sample suffered from a cluster A PD (odd or eccentric disorders) and 34.5% from a cluster B PD (dramatic, emotional, or erratic disorders). 17.5% belonged to the group with anxious or fearful disorders (cluster C). The criteria for a borderline PD were met by 28.5% of the whole sample. The second largest group of personality disordered probands were diagnosed with avoidant PD (13.9%; Table 2).

Insert Table 2 here

Axis-I and Axis-II disorders: A minimum of two disorders (Axes I and II combined) applied to the majority of subjects (107; 64.9%). 29.7% (49) of probands had at least three, 9.7% (16) four or more disorders.

Only few differences in the prevalences of Axis-I disorders were found between those with any PD and those without PD (Table 3).

Insert Table 3 here

Dimensional assessment of psychopathology and psychosocial functioning: For all SCL-90-R subscales and the Global Severity Index the unemployed young adults self-reported high mean scores comparable to hospitalized psychiatric samples (e.g. [START_REF] Baron | Disorders of functions and disorders of capacity in relation to sick leave in mental disorders[END_REF]. About two thirds of all clients (66.2%; n=154) had to cope with a clinically relevant depressive syndrome as measured by the BDI. In addition to these self-ratings, the interviewers perceived 56.9% of probands as at least "moderately ill" on the CGI-scale (CGI-Mean: 4.53, SD:

1.20). Psychosocial functioning was frequently impaired (GAF-Mean: 53.92, SD: 12,38). 41.2% of all subjects scored 50 or less due to serious symptoms or a serious impairment regarding social, occupational, or school functioning. Testing revealed that subjects with PD were more severely disturbed than those without (p-values < 8 0.05). This pertains to SCL-90-R subscales, BDI, CGI and GAF (Table 4). Apart from current psychosocial functioning our biographic data show that individuals with the diagnosis of PD had achieved significantly lower school degrees compared to their Non-PD counterparts (p = 0.032).

Insert Table 4 here

Health service use

Data from the SOEP-and CSSRI-Questionnaires show low treatment utilization. Prior to age 18, 40.1% of subjects (N = 147) had been in contact with psychiatric services at least once. After age 18, this applied to 36.1%. Probands with PD had contacted a psychiatrist or psychotherapist before and after 18 more often than those without PD (p = 0.006 and p = 0.20 respectively). Recent health service use was low: In the six-monthperiod prior to the study 7 probands (5.5%) had been treated in a psychiatric hospital or day clinic setting. Only 16 (12.4%) had been in touch with a psychiatric or psychotherapeutic out-patient unit within the last three months; only half of these received more or less regular treatment. 12 probands (9.3%) were currently taking psychoactive medication.

Risk factors for success or failure in job reintegration programmes

In the logistic regression model programme adherence was defined as the completion of at least one reintegration programme since the application for unemployment benefits ("Achievers") in contrast to those who had never engaged in or did not terminate any job scheme ("Under-achievers"). It was hypothesized that the variables gender, contact to psychiatric services before legal age, school truancy, number of years of institutional upbringing before age 16 and PDs serve as risk factors. The model terms were all present prior to the subjects´ unemployment and his success or failure in job reintegration schemes. This pertains also to PDs which by definition already develop and show their effects in early adolescence [START_REF] Grilo | Frequency of personality disorders in two age cohorts of psychiatric inpatients[END_REF]. Adolescent PD and PD in adulthood are similar with regard to structure (Westen et al., 2003), concurrent validity [START_REF] Levy | Concurrent and predictive validity of the personality disorder diagnosis in adolescent inpatients[END_REF], and stability [START_REF] Johnson | Age-related change in personality disorder trait levels between early adolescence and adulthood: a community-based longitudinal investigation[END_REF]. All terms were entered in one step. The resulting odds ratios were interpreted as the relative risk to experience major problems in job reintegration.

A diagnosis of a PD emerged as the sole risk factor. Probands suffering from a PD showed a 2.7 fold increased risk of failure in a job scheme (95% CI = 1.2 -6.4). All other variables did not reach statistical significance (Table 5).

Insert Table 5 here

Discussion

The study showed a very high psychiatric morbidity (Axis-I and Axis-II) amongst a preselected sample of young unemployed adults. Especially personality disorders were the most prevalent diagnostic entity which predicted a high risk for failure in job (re)integration. Despite severely impaired mental and psychosocial functioning subjects were currently mostly not seeking treatment. This is to our knowledge the first study to concomitantly asses Axis-I and Axis-II disorders in addition to both self and interviewer rated psychopathology and psychosocial functioning in unemployed individuals. Most of the previous aggregate and individual-panel-studies relied on self-reported symptom counts only. These measures do not differentiate between psychopathology in the normal range and clinically relevant disorders [START_REF] Dooley | Health and unemployment[END_REF]. Studies exploring unemployment on a disorder-level were often restricted to single or few Axis-I disorders. Our data provide thorough insights into the situation of young unemployed adults who were referred to our psychiatric unit on the premises of the vocational services center of the city of Essen by the respective case managers.

Particularly noteworthy is the high rate of PD (58.2%), especially the borderline (28.5%) and avoidant (13.9%) types. The prevalence of "any" PD in community surveys is between 4.4 to 13.0%; the rates for borderline and avoidant PD are between 0.7 and 2.0% and 0.8 and 5.0%, respectively [START_REF] Coid | Epidemiology, public health and the problem of personality disorder[END_REF]. In our study the diagnosis of one or more PD was associated with profound implications: These individuals had achieved significantly lower school degrees than their Non-PD counterparts. They showed a higher psychopathological loading and a poorer psychosocial functioning as assessed with SCL-90-R, BDI, CGI and GAF. In addition and importantly, the diagnosis of a PD entailed a 2.7 fold increased risk of not having commenced or completed a job integration programme of the vocational service centre. In one previous study classifying three broad categories of Axis-I-10 disorders, the 2-year-prevalences from 16 to 18 years were established in young long-term unemployed [START_REF] Fergusson | The effects of unemployment on psychiatric illness during young adulthood[END_REF]. Compared to the present study Fergusson and colleagues found a similar ranking of prevalence rates placing substance abuse disorders ahead of anxiety disorders and major depression both of which showed similar prevalence rates.

PDs begin in adolescence and early adulthood and often interpersonal and social negative effects persist during life-span [START_REF] Haw | Life problems and deliberate self-harm: associations with gender, age, suicidal intent and psychiatric and personality disorder[END_REF]. During the transition from school to work life the existence of a PD may be relevant for the individual´s vocational chances to become (re-) employed. Individuals with PD have significantly higher levels of psychopathological disturbance and social dysfunction compared to those suffering from an Axis-I disorders only. In the present study, the risk of an unemployed youth with PD either not to enter into the second labour market or to fail in a job-scheme or training-programme is about three times higher than for those without PD. The cross-sectional study design allows only for a conclusion about the association between low achievement and PD. We can not draw a conclusion on the causal pathways of unemployed with PDs regarding the selection vs. social-causation hypothesis [START_REF] Dooley | Depression and unemployment: panel findings from the Epidemiologic Catchment Area study[END_REF]. The hypothesis that young adolescents in transition from school to work suffering from PDs have a higher risk for unemployment should be tested by a longitudinal study design.

As Axis-II disorders in this sample contributed to high severity scores in the questionnaires and to a negative outcome regarding the individuals vocational career, they should be discussed as confounding factors in the interpretation of other studies on unemployment and psychological well-being. Though we analysed a highly selected sample, our study clearly documents the importance of assessing PDs in psychiatric studies of young unemployed subjects.

Multiple comorbidity, severe psychopathology, maladaptive psychosocial behavior and poor job performance characterize this sample. Nevertheless, recent health service use, especially regarding psychiatric services is unexpectedly low. Most studies point out that health service use in general is assumed to be high in unemployed [START_REF] Benavides | Unemployment and health in Spain: The influence of socio-economic environment[END_REF], but these results pertain predominantly to somatic disorders and to adults in general.

Drawing on Andersen´s (1995) behavioral model of health services use several factors explaining low utilisation can be relevant. Particularly predisposing characteristics of the individual and apart from the mental disorder itself, stigma might be relevant especially for young adults. By contacting a psychiatrist or psychotherapist the proband has to cope with a second stigma in addition to unemployment [START_REF] Jorm | The public's stigmatizing attitudes towards people with mental disorders: how important are biomedical conceptualizations?[END_REF][START_REF] Alonso | Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys[END_REF]. Avoiding psychiatric diagnosis and treatment by not using mental health services potentially means avoiding reduced self-esteem [START_REF] Link | Stigma and coercion in the context of outpatient treatment for people with mental illnesses[END_REF]) and a lower risk of unemployment [START_REF] Hinshaw | Stigma as related to mental disorders[END_REF].

Lack of sensitivity for mental health may also contribute to the low health care utilisation. Finally, treatment in 11 outpatient services in Germany generally requires the payment of a surcharge of 10 euros due at the initial visit to doctor's office every three months. For those living on unemployment benefit paying an "ordination fee" is a financial strain many often simply can not afford or will not accept. The introduction of this co-payment has reduced the number of outpatient-contacts. In the age group of those between 20 and 39 years first-contact rate was reduced by 16% compared to the status before the implementation of the fee [START_REF] Brenner | Diagnoses as the subject of health service research to analyse the morbidity of outpatients[END_REF]).

The major methodical limitation of our study pertains to the pre-selection of probands: The sample is highly selected and not representative for unemployed youth in general. Subjects were referred by case managers on the grounds of their judgement of psychological or psychosocial dysfunction resulting in unsuccessful reintegration efforts. In addition to a general pre-study training, each referred case was extensively discussed with the counsellor. A low rate of false positive referrals shows a high specifity of the case managers screening. Selfreported low psychological well-being and high failure rates in job reintegration schemes obviously were the main reasons to refer subjects. On the other hand nothing is known about the sensitivity of case managers in detecting less prominent or concealed psychiatric symptoms. Second, nonparticipation may also threaten the internal and external validity of the study. As most subjects have a long history of discontinuing reintegration programmes the initial refusal rate of 6.6% and the drop out rate over the four sessions of 22.9% is deemed acceptable. As a consequence the sample is not representative for the unemployed aged under 25 of the city of Essen (total population of 580.000). Nevertheless, we assume that our major findings of a very high rate of psychiatric disorders and particularly PD would hold up in a low-threshold psychiatric outpatient unit based at any vocational service centre in Germany.

Our findings foster the implementation of supported employment programmes for patients with (comorbid) PD as they already exist for patients suffering from schizophrenia [START_REF] Burns | The Impact of Supported Employment and Working on Clinical and Social Functioning: Results of an International Study of Individual Placement and Support[END_REF]. Similar evidence-based models should be adapted and introduced for PDs to improve the psychological and occupational-related wellbeing of young adults and to ameliorate their chances of job integration. 14 Wang N, Iwasaki M, Otani T, Hayashi R, Miyazaki H, et al (2005)

FigureFig. 2 .

 2 Fig. 1. Axis-I and Axis-II disorders (Multiple diagnoses possible in 165 subjects; % of patients)

Table 1 . Sociodemographic and biographic data

 1

	Variable

a Immigrational background -At least one parent not born in Germany; b School degree: High -High school or higher

Table

Table 2 . Prevalence of personality disorders (multiple diagnoses possible in 165 subjects)

 2

	Personality disorder

Table 3 . Prevalence of Non-PD amongst 165 unemployed young adults with and without personality disorder (multiple diagnoses possible)

 3

	Diagnosis		No PD		Any PD	Total
			n	%	n	%	%
		Alcohol dependence / abuse	6	3.6	14	8.5	12.1
	Substance related
	disorders	Substance dependence /	11	6.7	18	10.9	17.6
		abuse
	Schizophrenia	Schizophrenia	3	1.8	2	1.2	3.0
	Mood Disorders	Minor Depression	16	9.7	17	10.3	20.0
		Major Depression	12	7.3	19	11.5	18.8
		Dysthymia	7	4.2	10	6.1	10.3
	Anxiety Disorders	Panic disorder	3	1.8	3	1.8	3.6
		Agoraphobia	5	3.0	3	1.8	4.8
		Social Phobia	4	2.4	8	4.8	6.2
		Generalized Anxiety	1	0.6	5	3.0	3.6
		Disorder
		Specific Phobia	2	1.2	0	0	1.2
		Obsessive-Compulsive	0	0	6	3.6	3.6
		Disorder a
		Posttraumatic Stress Disorder 3	1.8	8	4.8	6.6
	Eating disorders	Anorexia nervosa	1	0.6	2	1.2	1.8
		Bulimia nervosa	1	0.6	3	1.8	2.4

a Chi2-test (two-tailed): p = 0.03

Table 4 . Severity of Psychopathology and Psychosocial Functioning (N = 164)

 4

		No PD	Any		Total
			PD
		Mean	Mean	p	Mean	SD
	SCL-90-R
	Global Severity Index	1.0	1.5	0.000	1.3	0.8
	Beck Depression Inventory	18.8	24.5	0.002	22.2	11.3
	Clinical Global Impression-S	4.1	4.8	0.001 a	4.5	1.2
	Global Assessment of	56.1	52.2	0.044	53.9	12.4
	Functioning
	T-Test; a Mann-Whitney-Test

Table 5 . Logistic Regression Model of the Reintegration Programme Adherence

 5

	Variable	B	SE B	Wald	Sig.	OR	95% CI
	Gender	-0.095	0.415	0.052	0.820	0.910	0.403	2.052
	Any contact to psychiatric services	-0.423	0.443	0.915	0.339	0.655	0.275	1.559
	before age 18
	Number of years in institutional	-0.015	0.079	0.035	0.852	0.985	0.843	1.151
	upbringing before age 16
	School truancy	-0.030	0.413	0.005	0.943	0.971	0.432	2.183
	(> 6 consecutive days)
	Diagnosis:	1.002	0.432	5.379	0.020	2.722	1.168	6.346
	Personality Disorder
	N = 114; Nagelkerke R 2 = 0.072

Conflict of interest

The authors declare that they have no conflict of interest.


Catia Gregoratti
email: catia.gregoratti@manchester.ac.uk

'Global nuts and local mangoes: a critical reading of the UNDP Growing Sustainable Business Initiative in Kenya'

Keywords: UNDP, public-private partnerships, sustainable investment, Millennium Development Goals, poverty reduction, farmers. Catia

This article provides a conceptual and empirical assessment of UN brokered partnerships that seek to deepen or create inclusive and sustainable agricultural supply chains in sub-Saharan Africa. More specifically it appraises the decision-making mechanisms, processes of partnership brokerage and project implementation within the UNDP Growing Sustainable Business Initiative (GSB) in Kenya. The paper argues that the lack of bottom-up participation in decision-making mechanisms and the predominantly economic imperatives driving the partnership projects have failed to reach out to the partnerships' intended beneficiaries -Kenyan small producers of nuts and mangoes. In conclusion it is suggested that opening up the GSB platform might hold the promise of reconciling sustainable business models with (some) poverty reduction.

Introduction

In recent years, the relationship between the private sector and development has witnessed a resurgence of interest within academic and policy-making circles. Corporate philanthropy, the traditional form of private sector assistance to many lowincome countries, development initiatives and government-led efforts, has been progressively amplified [START_REF] Utting | Beyond Pragmatism, Appraising UN-Business Partnerships[END_REF]; new public-private partnerships between businesses, international organisations, donors, NGOs and trade unions have been formed in support of specific development priorities and the Millennium Development Goals (MDGs) and the practices of and pledges to corpora te social responsibility (CSR) are increasingly narrated within a developmental and progressive dimension. The intensification of these activities has also been accompanied by the emergence of a reinvigorated and recognisable consensus, namely one which views the private sector as a developmental agent by virtue of contributing to economic growth, creating jobs, raising income and empowering the poor by providing a range of products and services (UN Commission 2004;World Bank 2005;UNDP 2006).

Despite the steady proliferation of global partnerships and their increased localisation very little is known about the way in which partnership projects are formulated, how (or if) they affect their expected beneficiaries, and whether business realities and imperatives can be reconciled with the objectives of equitable and sustainable development [START_REF] Mcfalls | Testing the Limits of 'Inclusive Capitalism' -A Case Study of the South Africa HP i-Community[END_REF]. Based on primary research conducted in Kenya this paper offers a conceptual and empirical reading of the political processes and performance of partnerships brokered by the United Nations (UN) that primarily seek to deepen or create inclusive and sustainable agricultural supply chains in sub-Saharan Africa. More specifically, it appraises the local processes of decision-making, partnership formation and implementation within the United Nations Development Programme (UNDP) Growing Sustainable Business Initiative (GSB) in Kenya.

The Growing Sustainable Business Initiative was preliminarily conceptualised on the occasion of the UN Global Compact's second Policy Dialogue 'Business and Sustainable Development' and was officially launched in cooperation with UNCTAD (United Nations Conference on Trade and Development), UNEP (United Nations Environmental Programme) and UNDP at the Johannesburg Summit on Sustainable Development. At Johannesburg hopes were running high once Kofi Annan anticipated that the initiative would become one of the 'most promising pathway [s] in overcoming the poverty trap…and give hope and opportunity to the world's poorest' (UN Global Compact 2002). In September 2002, UNDP was mandated the responsibility of developing and decentralising the GSB concept to its Country Offices. The GSB aims and objectives were later defined and elucidated in an official document co-produced by the UN Global Compact and UNDP. At this point, the overall contribution of the GSB platform was identified as 'facilitating sustainable business and investment by the private sector through a process of multi-stakeholder engagement with governments, civil society, the UN family and other development organisations' (UN Global Compact and UNDP). For the GSB the notion of 'sustainable investment' assumes two specific connotations: it is understood as a standard business activity such as an investment, acquisition, new production or sale closely aligned with the MDGs, and it is a type of economic activity which is actively supported by state and non-state actors, including the beneficiaries of such interventions [START_REF] Sandbrook | Growing Sustainable Business for Poverty Reduction in Tanzania[END_REF].

Operationally the GSB is coordinated at global, regional and country levels. Globally a small team of UNDP advisors, based within the UNDP Business Partnership Division, are expected to encourage international companies to take action; they also assess the merits and weaknesses of local partnership proposals, manage country-level activities and share country experiences. Since 2007 the role of Business Outreach Coordinator and GSB Regional Coordinator were created as meso-level points of contact between the GSB headquarters in New York, the Regional Bureaux and the Country Offices. At country level, where the partnerships unfold, a GSB Delivery Mechanism comprising a GSB broker and a Coordinating Group are established in selected LDCs 'where stakeholders agree that there is a need for such programme and where the UNDP Country Office is committed to supporting it' [START_REF] Day | a. UNDP's Growing Sustainable Business Initiative: From Policies to Action[END_REF].

Since its creation the GSB has expanded its partnership portfolio to twelve developing countries 1 across the continents of Africa, Europe and Asia. The initiative's projects are primarily market led; this means that agricultural projects and food chains development for those at the 'bottom of the pyramid' [START_REF] Prahalad | The Fortune at the Bottom of the Pyramid -Eradicating Poverty through Profits[END_REF]) such as smallholders and rural poor are some of the principal areas of interest and potential intervention. In mid 2008, out of 48 local projects listed on the UNDP GSB website 20 focussed specifically on the development of local and global supply chains for fresh fruits, vegetables, nuts, seeds, diary, fish and one even proposed the establishment of a local fast food chain in Madagascar.

This paper provides a conceptual overview of the partnership rationale and sheds light on the criticisms that have been mounted against its assumptions and postulated effects. It then contextualises the initiative at the local level by looking at the actors that steer the meaning and determine the feasibility of sustainable business models for poverty reduction in Kenya. Thereafter, the paper narrates the unanticipated failure of two partnership projects targeting the export market for global macadamia nuts and the local market for mango fruit juice and discusses the implications of these outcomes. The overarching argument that transpires from the research is that the unchallenged economic rationale driving the partnership projects has not reached out or significantly benefited their intended beneficiaries -Kenyan nuts and mangoes producers. In conclusion, it will be suggested that the potential of the GSB needs to be rooted in more open and transparent deliberation and implementation processes to ensure that some of the spoils of public-private interventions are shared more equally.

The Public-Private Partnership Rationale

Partnerships and Participation

The concept of partnership includes a variety of co-operative arrangements. Commonly it does not entail an exclusive relation between the UN (or other international organisations) and the private sector, other actors such as governments, NGOs, trade unions, consultancies and academia are encouraged to work together with businesses and the UN to formulate policies or undertake specific projects as to collectively 'share risks, responsibilities, resources, competencies and benefits' (UN General Assembly 2003: 4). This is certainly true in the global context where partnerships are often justified as a means to narrow the democratic deficit in global governance [START_REF] Reinicke | Critical Choices: The United Nations, networks and the future of global governance[END_REF]. Notions of inclusivity and participation are not confined to global decision-making processes, once global partnerships move from policy to implementation, particularly in developing countries, in principle, they are premised upon the assumption that 'beneficiaries', 'communities', or the 'farmers groups' agree to the objectives of the partnership and co-participate in its execution. The resonance of this rationale is based on the emergence of recent academic and policy thinking on 'stakeholder democracy' which relies on ideas such as input and output legitimacy to assess the democratic credentials and delivery capabilities of global and local public-private interventions [START_REF] Bäckstrand | Democratizing Global Environmental Governance? Stakeholder Democracy after the World Summit on Sustainable Development[END_REF].

However, behind ideas such as greater pluralism and participation concerns for power relationships are often eclipsed. Partnerships are not only portrayed as infinitely inclusive but they also assume that all the actors partaking in the arrangement are 'equal' and hold the same interests and expectations, thus conveying the impression that some form of agreeable outcome will be reached. This thinking has and can be challenged on several grounds. First, the terms underpinning a partnership can act as a powerful disciplinary force which determines who is a 'key' stakeholder and who is not. If, for example, a partnership is defined as a strategic relationship between businesses and an intergovernmental organisation the farmers groups or communities potentially affected by the partnership might not be identified as the right or legitimate stakeholders. Furthermore, it has been noted that those at the receiving end of publicprivate interventions often find themselves in a double position of disadvantage: they often live in remote locations away from the centres where decisions about their livelihoods are made and they lack the political and material resources to access such spaces [START_REF] Zammit | Development at Risk -Rethinking UN-Business Partnerships[END_REF]Newell 2005). In the instances where the beneficiaries of these development interventions are given voice concerns have been raised about their ability to shape or challenge the issues that are discussed and the objectives that are identified [START_REF] Dolan | Seeking Common Ground: Multistakeholder Initiatives in the Kenya Cut Flower Industry[END_REF], and the possibility of neutralisation and incorporation of critical alternatives within dominant discourse (Thomas 2000:44).

However, it is plausible to argue that such observations obscure a more nuanced conceptualisation of beneficiaries as agents. While farmers and the rural poor might not often be included in formal decision-making processes ultimately, if sufficiently organised, within the spaces where projects unfold they can object to decisions that might be perceived as detrimental to their welfare and values. Viewing rural communities as passive recipients of new forms of market-based development reinforces a deterministic logic of no alternative. Equally, pronounced and increasing evidence of 'lack of inclusion' can threaten the legitimacy of any public-private arrangement and potentially induce the creation of mechanisms for bottom-up participation and political representation for the less powerful and marginalised. Existing global and local partnerships arrangements brokered by international organisations do not embody the characteristics of the kind of democratic and egalitarian 'new multilateralism' envisaged by [START_REF] Cox | The New Realism: Perspectives on Multilateralism and World Order[END_REF], however their tendency to replicate geographical and power imbalances leaves open the possibility for the contestation and transformation of public-private mechanisms of governance.

Partnerships and the 'win-win' Common Sense

The partnership rationale has gained prominence not only because of its inclusive features and its 'win-win' appeal, as the public and private actors involved in a partnership together with its intended beneficiaries stand to gain materially or in terms of reputation or efficiency [START_REF] Nelson | Building Partnerships -Cooperation between the United Nations System and the Private Sector[END_REF]. The efficiency and win-win rhetoric explicitly uttered within the partnership rationale acts as a discourse of selflegitimation which detracts attention away from the structural determinants that led to the emergence of these hybrid forms of governance. Against a background where states are retreating from their social obligations, operational partnerships have been conceived, and are commonly justified, as means to solve the inequalities ensuing from processes such as increased liberalisation, privatisation and competitive regulation but remain premised on the assumption that (more) market-based development and the creation of new markets in untapped areas will lead to greater prosperity (UNDP 2007). Noting the contradictory logic of this argument it has been suggested that partnerships leave intact the underpinning of the global neo-liberal order [START_REF] Bull | Development Issues in Global Governance-Public-Private Partnerships and Market Multilateralism[END_REF] and serve as instruments to widen and legitimise strategies of capitalist accumulation and its actors (Soederberg 2006).

A number of studies have appraised the more detailed consequences and implications of public-private partnerships for the practice of multilateralism and the way in which the development discourse is being recast. Bull, Bøäs and McNeil (2004) recount that the increased role of a broadly conceived private sector might lead towards a distortion in policy priorities, a reduction of developmental objectives to quantifiable targets as well as a geographical distortion of development interventions. However, rather than proposing that the multilateral system is being privatised, in a later publication, [START_REF] Bull | Development Issues in Global Governance-Public-Private Partnerships and Market Multilateralism[END_REF] acknowledge that multilateralism, can, under certain circumstance, modify the practices of private partners as to reconcile developmental goals with the needs of the private sector to be recognised as socially responsible. Whilst this reading wants to recognise the agency and leverage of international organisation it does not explicitly recognise that public-partnerships and other voluntary pledges in support of corporate social responsibility (CSR) might enhance the structural and discursive power of businesses [START_REF] Fuchs | Business Power in Global Governance[END_REF]) and legitimise their authority as agents of development. Businesses gain moral standing from the association with intergovernmental bodies as the effects of their activities and commitments to CSR are sanctioned as 'positive', 'developmental' and 'empowering', and also benefit from wider access to political network and funds.

What are the consequences of market-based public-private intervention for the beneficiaries they intend to serve? Newell (2005: 556) notes that corporate social responsibility and public-private partnerships can work for some people, in some places and for some time. When such interventions work and appear to achieve economic objectives such as offering employment opportunities, income and market linkages other contradictions re-surface. [START_REF] Dolan | Fields of Obligation -Rooting ethical sourcing in Kenyan horticulture[END_REF] finds that genuine improvements in the working conditions of urban dwellers and rural poor might be attained but they often come at the cost of displacing alternative conceptions of economic and social life. Referring specifically to the notion of ethical trade and sustainable business practices she argues that they 'not only exclude African (or otherwise 'local') constructions of social organization but also privilege the labour formations and production systems of advanced industrial economies, as rights can only be claimed through capitalist wage employment' (Dolan 2005: 382). However, it is important to note that partnerships might never move from the stage of conceptualisation, they can be abandoned at any point in time for lack of funding, commitment or because the expectations of economic returns do not materialise. In such circumstances, unless seed investments in organising, training or infrastructures have been made, the 'beneficiaries' gain little and lose their title.

Researching Public-Private Partne rships in Kenya

This research article critically examines the claims of inclusivity, political processes and outcomes of two public-private partnerships brokered as part of the UNDP Growing Sustainable Business Initiative in Kenya.2 It does so by analysing qualitative research material that was collected in Kenya between June and July 2006, follow-up email correspondence and additional desk-based research conducted between 2007 and 2008. In the first part of the paper I specifically draw on semi-structured interviews that were conducted with civil servants and temporary staff at UNDP Kenya and all the active members of the GSB Kenya Coordinating Group. The elite interviews with these members focussed primarily on the reasons for partnering with the UNDP, the perceptions on the legitimacy and effectiveness of the initiative and the experience of partaking within the decision making group.

In the absence of previous research on the initiative the insights gathered in the first phase of the field trip heavily guided the selection of the two partnership projects appraised in this paper. There is often a tacit disjuncture between the official claims emanating from the websites and press releases of international organisations and the actual practices of public-private partnerships formation and evolution. 3 The actual status of the partnerships could only be verified with the GSB Broker, the gatekeeper, who suggested that whilst it was too premature to investigate recently endorsed projects (See: Annex 1), or de-linked projects, the partnerships respectively led by Global Entrepreneurs and the Kenya Gatsby Trust (KGT) were the only ones that had made substantial progress.

Information on the two case studies selected were elicited through in-depth interviews with executive members and project managers, documentation supplied by the two lead organisations, update reports presented to the UNDP as well as the official minutes of the Coordinating Group meetings. Whilst the narratives presented in this paper rely primarily on the accounts of 'elites', the research also sought to apprehend the perspectives of a group of farmers. A three days visit to Embu was facilitated by Global Entrepreneur's Food Engineer. In the rural periphery of the town semistructured interviews were conducted with the management of Mt. Kenya Nuts and smallholders, namely fifteen members of ten households living in close proximity to the factory. The interviews with the farmers sought to determine whether the beneficiaries were aware of a partnership taking place, whether any changes had ensued since the partnership officially began in 2005, and what issues were affecting the livelihood and welfare of the producers. A commensurable visit to the expected beneficiaries of the KGT-led partnership could not be organised because at the time when the field-trip was conducted the target group of the intervention was changing. Rather than constituting a hindrance to the research this has been effectively treated as a clue to illuminate how beneficiaries are selected and for what reasons.

The 'case study' method employed in this research paper has culminated in a two-tier analysis which discerns the hierarchies and power-relations at work within the GSB Kenya and the politics of partnerships formation and evolution. Such method has been preferred not only for of its explanatory qualities [START_REF] Odell | Case Study Methods in International Political Economy[END_REF]) but also because it 'can expose tensions, strengths, weaknesses...or even contradictions' (McFalls 2007: 89) in new forms of development interventions as they are rolled out from global institutions throughout the developing world.

The Growing Sustainable Business Initiative in Kenya: Actors, Processes and Projects

Following consultation with the Kenyan government, the private sector, the NGO and the donor community, UNDP in partnership with UNIDO (United Nations Industrial Development Organization) and the ILO (International Labour Organization) launched the Global Compact and the GSB in Kenya on the 3 rd of May 2005. Both initiatives officially took off at the same time, however while the UN Global Compact Kenyan network was only established two years later, the GSB had already identified and presented to an invited audience three partnership projec ts and was keen to establish a Coordinating Group as soon as possible. Although the GSB broker was expected to run and coordinate both, existing Kenyan Global Compact's signatories (i.e. Tetra Pak and Vestergaard Frandsen) were encouraged to conceptualise and initiate sustainable business projects, while companies that expressed an interest in the GSB did not have to sign up to the Global Compact or, at times, they were not even made aware of the Compact and its principles. The initial, almost exclusive, focus on the systematic development of the GSB in Kenya was not solely based on the need to show that the idea was viable and 'pro-poor' but also because pushing two separate initiatives was proving to be an onerous task for a single civil servant.

The Brokers

Within the GSB mechanism and processes, the role of the broker is crucial in defining the 'success of the initiative' (UNDP 2007). The broker is not only expected to identify and coordinate individual projects while minimising the risks and cost associated with an investment he/she is also expected to make sure that these projects have a clear development dimension and are aligned with the goals of the UNDP, particularly the MDGs. In Kenya a new GSB broker was appointed on a yearly basis; the first two brokers fitted within the general UNDP job description of a candidate with extensive experience in the private sector, the capacity to provide analysis of business models including investment analysis and financial modelling, and the ability to convene coalitions of partners. Both brokers worked for a number of years in the private sector and although interested in development they did not have any experience of poverty reduction strategies and interventions. An interview with a broker confirmed that the kind of development sought after by the GSB was primarily, if not exclusively, economic, once a GSB civil servant stated that 'our priority is to develop new markets, creating employment and providing income…development will trickle down' (Interview, UNDP, 6 July 2006).

Brokers are also expected to establish the Coordinating Group, identify business partners interested in developing a sustainable business projects and forge linkages between businesses and local NGOs. The ability to act as a nodal point and partnership broker appears to necessitate an in depth knowledge not only of local market conditions but also of the various development institutions, groups and actors working in the country and often carrying out work away from the capital city where the UN compound is based. Although UNDP Kenya had a long tradition of collaboration with a wide range of local private and public groups all the appointed brokers have been foreign nationals who, upon appointment, have been required to map and thereafter make contact with 'key' partners.

The Kenyan Coordinating Group

The decision-making mechanism through which the GSB's targets are set, projects approved, and consensus on the meaning of sustainable business is reached, is the GSB Coordinating Groupan umbrella group made of government representatives, businesses, NGOs, international organisations and relevant bilateral and multilateral donors (UN Global Compact and UNDP 2002).The Kenyan Coordinating Group was established shortly after the GSB's launch, its members had a history o f institutional affiliation with the UN or were invited to become members by virtue of the scale of their involvement in private sector and development types of activities. The identification of the right or appropriate stakeholders did not seem to conform to the aspiration of closing the democratic deficit in global governance; rather, it mirrored concerns such as status, previous contacts with UNDP Kenya and the willingness to participate and devote time to the GSB processes. Official documentation suggests that these groups should be 'inclusive' however, on closer inspection, those who partake in formal decision making processes are largely private sector representatives, and a handful of local organisations with long-standing interests in facilitating market expansion and deepening4 such as African Management Services Company (AMSCO) and the Kenya Gatsby Trust. The participation of donors, international development institutions and NGOs was minimal whereas trade union and the Kenyan National Federation of Agricultural Producers had been simply forgotten (Interview, UNDP, 6 July 2006). Furthermore, despite recognising the importance of including government officials within the coordinating mechanisms, the participation of public officials was limited and inconsistent.

When questioned about the representativity of the group the emerging consensus was that the supposed beneficiaries of the partnerships did not need to be included in deliberations. One member of the Coordinating Group commented that 'when you bring the farmers in they tend to bring their own interests and they are not very objective. We, on the other hand have no direct or vested interest, we think about the whole community and not about individuals…I would feel as if I let the farmers down if I did not attend a meeting' (Interview, KGT, 14 July 2006). Another member from the private sector added that 'the Coordinating Group is broad enough and if a labour union was to be invited to join they would not represent the non-unionised farmers' (Interview, Export Promotion Council, 20 July 2006). Likewise, the GSB broker never questioned whether the group could be made more 'inclusive' or whether the projects' beneficiaries should be consulted at any point of the partnership processes, preferring instead to focus targets such as number of projects, commercial feasibility and potential outcomes rather than developing participatory mechanisms of deliberation and implementation.

Identification, Endorsement and Project Portfolio

During the early stages of institutional development UNDP New York contacted various foreign companies and multinational corporations who would be potentially interested in developing sustainable business models in Kenya and then passed on the details to the GSB Kenya. At the same time, the local broker was also urged to contact foreign companies and small and medium size enterprises (SMEs) in an effort to establish a preliminary project portfolio. Both strategies showed early signs of success which was further amplified once the Coordinating Group member started to 'spread the word' about the GSB business proposition and the possibilities of co-funding it offered for market research and socio-economic feasibility studies. The second broker was determined to reach out to a wider audience and, in collaboration with a small team of UNDP interns, contacts with the local media were made and boisterous articles on the GSB appeared on the Kenya Times and the Daily Nations in 2006, which were later followed by a nomination at the Africa Investor Awards 2006. At this point the broker was no longer on the lookout for potential business partners as the UNDP was being directly contacted by local enterprises (Interview, UNDP, 6 July 2006).

As expression of interest started to increase the GSB Kenya pioneered the development of more specific guidelines to assess the economic and social impact of proposed partnership projects. Initial screening was undertaken by the broker on the basis of a clear delineation of the business case and social impact of each initial proposal, 'a project which does not present a convincing business case, despite having strong social impact, cannot be considered a GSB project. Likewise, a project that makes business sense but cannot sufficiently demonstrate sustainable development impact will not be endorsed by the GSB' (Personal Communication, 7 July 2006). In order to be considered for formal GSB endorsement and potential co-funding every business was requested to outline in writing or verbally present to the Coordinating Group the project description, the business case and financial plan for engaging in a new venture or market development as well as indicating its supposed development impact, which for the majority of proposed projects equated to an assumption of potential rise in employment and income (See: Annex 1). It is important to note that businesses were ultimately left with the responsibility to select the supposed beneficiaries independently of whether these were 'poor' or not.

Between 2005 and 2007, 18 projects were presented and positively reviewed during the bi-monthly Coordinating Group meetings (See: Annex 1). Eight partnerships were subsequently de-linked from GSB Kenya and pursued without GSB assistance because companies did not need the platform and co-funding or were subsequently moved to other countries. For example, Tetra Pak moved to the GSB Tanzania to explore the development of an integrated supply chain for UHT milk. Out of the remaining (officially endorsed) ten partnerships, those 'dumped from UNDP New York' with MNCs such as Voxiva, Freeplay and Microsoft did not take off due to low commitment, diverging interests and communication problems arising from the fact that some of the companies did not have offices in Eastern Africa.

Unlike the original expectations, the currently active seven partnerships are those which might also hold the greatest developmental potential not only because they are led by Kenyan companies but also because they intend to create explicit linkages with local firms and, in the case of agricultural interventions, small producers (Jenkins 2005: 252). The preponderance of proposed and existing projects targeting the agricultural sector and smallholders is not casual; agriculture and food production constitute the backbone of Kenya's economy with more than two million outgrowers, labourers and brokers working to meet the demands of local consumption and the export market [START_REF] Dolan | Changing governance patterns in the trade in fresh vegetables between Africa and the United Kingdom[END_REF][START_REF] Brown | Global Supply Chains and Smallholder Farmers. Trade Knowledge Network[END_REF]. However, the sectoral concentration of agricultural and food projects did not arise primarily out of concerns for poverty mitigation in rural areas, where poverty is highest and agricultural production is the main form of subsistence [START_REF] Freeman | Livelihood and Rural Poverty Reduction in Kenya[END_REF], but because market demands and research established that substantial returns could be made from smallholders' flexible and cost-efficient production.

The Growing Sustainable Business Initiative in Action: Global Nuts and Local Mangoes

How do the GSB sustainable business models work? The approval and endorsement of two distinct projects, a global supply chain for macadamia nuts and a local supply chain for mangoes occurred in 2005; they were amongst the first group of projects formally endorsed by the GSB Kenya and the Coordinating Group and, as 2008, they are both still listed as 'active' in the GSB global website as well as the UNDP Kenya website. Although the GSB Kenya is still developing and testing the brokerage of partnerships, project implementation and supervision, the narratives and developments of both projects indicate that global and local market demands have resulted in both projects failing to bear any financial and non-financial benefits to their expected beneficiariesthe smallholders in Embu and Malindi.

Global Entrepreneurs, Global Nuts and Macadamia

Between 2002 and 2004, as part of its expansion strategy, the international trading company Global Entrepreneurs International (GEI) 5 set up a new office in Kenya -Global Entrepreneurs Africa -in an effort to open up opportunities for the export of locally produced spices, beans and nuts. In 2005 the company identified macadamia nuts as the prime product for its export activities. Research undertaken by the company showed that local production for exports had doubled between 2000 and 2005 raising from 4,900 metric tons to approximately 10,000 metric tons and that the local production and processing market in the hands of Kenya Nut Company had the potential to be made more competitive. Global forecast indicated not only that macadamia constituted 2% of the world market for nuts but also that Northern demands for healthier food products were set to rise. The global scoping exercise also found that the global market for the product was dominated by Australian and South African producers, and that highly fluctuating prices were primarily dictated by criteria such as quality and demand. Within this context the idea of developing a value-added niche market for organic macadamia nuts and oil emerged and the export company Global N uts was established in early 2005 as a Kenyan incorporated company wholly owned by Global Entrepreneurs Africa.

Once established, Global Nuts started to look for producers with sufficient supplies to initiate its export activities and establish market linkages with wholesale buyers in Europe. During this phase, the company was contacted by the financial arm of Embu Farmers Co-operative Society which owned Mt. Kenya Nutsa factory which buys macadamia nuts from 4000 farmers, processes and packages the nuts for sale to the international market. The factory, endowed with the technology to dry, grade, crack and package the nuts was not able to sell an overly generous surplus stock and, unable to meet loan re-payments it was risking bankruptcy and delayed payments to farmers. Global Nuts decided to source macadamia nuts from Mt. Kenya Nuts who 'promised extremely optimistic supply forecast' (Interview, 13 July 2008), however the first transactions were hampered by the fact that Northern buyers did not have much confidence in the quality of Kenyan nuts and Mt. Kenya Nuts was unable to deliver the specified quantity of 14 containers. By November 2005, thanks to a cash advance only 4 containers were shipped to Europe and the Middle East. Visits to the factory established that much of the inventory was made up of raw nuts (e.g. nuts originating from shaken trees), purchases of nuts from farmers and middlemen were made on an ad hoc basis, the equipment was not being used correctly as the factory staff did not know how to operate the machines and the factory was in need of thorough clean up. Global Nuts determined that capital and human resources were needed to resuscitate the fortunes of its main supplier.

Contacts had already been made with the GSB in the summer o f 2005 but neither Global Nuts nor the GSB broker could clearly determine how the UNDP could provide assistance, despite this the project was included in the portfolio's pipeline. The definition of a GSB sustainable business model with a development dimens ion occurred much later, by accident rather than design. While travelling for business Global Nuts was introduced to a Japanese consultant6 from HardNut International who had extensive experience in the Kenyan macadamia industry and had worked for Kenya Nuts Company7 where he oversaw propagation, grafting, harvesting, nuts collection and processing. With the possibility open of having a consultant to provide advice and production and processing, while the marketing was already being developed by Global Entrepreneurs (i.e. website, packaging, publicity, trade fairs), Global Nuts re-approached the GSB with a preliminary plan for co-funding the consultancy service and was encouraged by the GSB broker to finalise the project proposal.

The ex-ante project proposal was developed entirely by Global Nuts with input not being provided by smallholders or the factory board whose relations with Global Nuts were increasingly strained by signs of internal instability and poor management, the refusal of Global Nuts' financial tendering and the little room for manoeuvre accorded to a production and quality consultant installed in the factory by Global Entrepreneurs. The project proposal however, had, according to the GSB broker, a 'strong' business and development proposition (Interview, 13 July 2006). The business case was centred on the assumption that increased quality, direct supply from farmers as opposed to middlemen and improved knowledge of manufacturing processes and the long-term plan for an organic niche market would have an impact on macadamia prices; however it was acknowledged that globally more suppliers were entering the market. The development case had two components. First it assumed higher and more predictable sources of income for the co-operative's farmers through higher dividends and the premium ensuing from organic certification and higher income opportunities for non-cooperative farmers. Second it included, with little details and no clear partners in place, capacity building elements such as education on the industry, sustainable husbandry, 8 loyalty programmes and the organisation of farmers into groups (Personal Communication, Global Entrepreneurs Project Proposal, 14 July 2006). When it was clarified that the consultant's role would be that of determining profit sharing along the supply chain and designing training and loyalty programmes for 'the farmers', in June 2006 the Coordinating Group approved the project and a sum of $ 10,000 was set aside to co-fund 9 the consultancy (UNDP GSB 2006 a).

At the time when fieldwork was conducted in Embu, Global Entrepreneurs' Food Engineer had prepared a detailed report on the numerous deficiencies that were hindering the production processes but was not allowed to implement any changes as the factory did not grant her permission to do so. Mt. Kenya Nuts' Production Manager, who agreed to be interviewed outside the factory gates stated that 'we are a young factory, we need help but the board of directors is too political and it is unlikely anything will change' (Interview, 27 July 2006). The farmers interviewed for this study were wholly unaware of any partnership project taking place and had not noticed changes in their relationships with the factory. They continued to supply intermittent quantities of nuts to the middlemen and/or the co-operative for 15-20 KSh/Kg, 10 while intercropping coffee, beans, maize, bananas, and cassavas for income and consumption purposes. Trust that macadamia would provide higher income was dismissed in the light of the low number of trees per household (3 to 8), limited cultivation space, and the seasonality of the fruit. Such disillusionment was vividly expressed by one farmer who stated '...I prefer to give macadamia to the children instead of selling it...' (Interview, 26 July 2006). However, all the interviewees concurred that they would be better off if the co-operative paid a fairer price for the nuts, which was determined at around 80 KSh/Kg.

In Nairobi, while Global Nuts was already investing in its own processing factory in the capital's export processing zones, it continued to hold talks with the GSB Coordinating Group about Mt. Kenya Nuts and the Embu farmers but only signalled that for financial reasons the factory was unable to produce nuts for the new season (UNDP GSB 2006 b). The Coordinating Group agreed that the Minister of Cooperatives should be consulted but even with this intervention the project terminated in 2007 when the UNDP determined that 'the co-operative, despite initial assurance, was not interested in providing benefits to its members' (UNDP 2007: 47). 8 The sustainability aspect of the project was not only relegated to 'strict environmental and ecological guidelines' free fro m chemical and pesticides (Personal Co mmunication, Global Entrepreneurs Project Proposal, 14 Ju ly 2006), but it also envisaged the recycling of the nuts' shells and use them as fuel. 9 Additional funding to follow up on the consultant's recommendation was expected to come fro m NORAD (US$ 20,000) and Global Entrepreneurs Africa in the form of human resources (US$ 22,535). 10 The amounts varied depending on the distance to the collection centres and the need for cash.

Global Nuts continues its operations in Kenya, has signed up to the local Global Compact network, and it is still listed within the GSB project portfolio. However, in order to ensure the survival of its own business it withdrew its 'assistance' to Mt. Kenya Nuts and the co-operative's farmers. The GSB could not explain how the project could have been run differently, but it is plausible to infer that issue of ownership (Witte and Reinicke 2005: 44-46) was not adequately addressed and failure to bring Mt. Kenya Kenya Nuts and the beneficiaries to the discussion table might have largely contributed to the demise of the proposed project.

KGT, Kevian and mangoes

Unlike the partnership initiated by Global Entrepreneurs, the idea of initiating a supply chain for mangoes departed from work that the Kenya Gatsby Trust had undertaken in support of facilitating market access for small-scale mango producers in the coastal region of Kenya. The Gatsby Trust's interest in mango production developed before the GSB was created. The overarching objective of the Trust, in fact, is to catalyse sustainable wealth creation in the poorest areas of Africa and the coastal districts of Malindi and Magarini are two of them. In 2001 a series of participatory appraisal studies were initiated and found that in the region mangoes were overproduced and that they were not being sold due to poor quality (i.e. the fruits were infested) and little access to markets, farmers were not organised, a lack of secure sources of income incurred exploitative transactions with middlemen with each fruit being bought for as little as KSh 1, and that Ministry of Agriculture had provided little or no extension services or post-harvest facilities to smallholders.

Between 2003 and 2005, with funding secured from the Gatsby Trust and the JJ Charitable Trust, KGT first encouraged mango growers to engage in common marketing efforts and improved techniques, second, under an arrangement coordinated by the local KGT office, 61 youths were privately trained by Bayer and the Kenyan Agricultural Research Institute (KARI) in spraying trees against pest s while more than 200 farmers received advice on pruning and how to minimise the risk of infection (Gatsby Trust n/d). Within two years farmers were organised into13 groups with membership of 253 and 26 private extension service providers, furthermore thirteen demonstrations were set up, a system of farm input supplies with a credit component was put in place and a private extension manual was developed by KARI as part of the capacity building elements of the project; by 2005 KARI also enabled one group to receive quality assurance certification. During this first phase, funding from the Swiss sustainable development foundation Bio Vision also enabled a parallel research partnership between KGT and the International Centre of Insect Physiology and Ecology (ICIPE) in order to develop a non-chemical pest spray based on natural ingredients such as peppers and elements of the indigenous neem tree.

Once the farmers were trained and organised and the quality of fresh mangoes was deemed suitable for sale, even if quality assurance mechanisms needed to be better defined, grading was not possible and collection points remained rudimentary, the second phase of the project went ahead and focussed on linking the local mangoes market with buyers. Amongst the interested buyers contacted by KGT figured Del Monte and local supermarket chain Uchumi. The former did not finalise the agreement, however Uchumi did buy some of the mangoes but when it went bankrupt the farmers were temporarily left with no buyers. In a moment of 'panic', whilst looking for alternative buyers in 2005 the KGT was introduced to the GSB and the first broker put KGT in touch with the Nairobi-based juice producer Kevian (Interview, KGT, 14 July 2007). At the time, Kevian had invested in a fruit processing plant in Thika (50 Km North of Nairobi) in an effort to decrease high inventory costs and avoid heavy taxation on imported concentrate by producing its own concentrate for local consumption and export. The contacts established by the GSB proved to be successful as Kevian was interested in sourcing local mangoes; hence KGT took the lead in facilitating a meeting between Kevian, 26 group leaders and 3 extension workers with which the issues of quality, quantity and delivery dates were discussed.

The project was discussed and formally endorsed by the GSB Coordinating Group in October 2005 even if the factory had not been completed and uncertainties remained over who would supply mangoes to Kevian, though KGT hoped that a deal with the smallholders in Malindi could be finalised. This was reflected in the project description which vaguely mentioned that 'the key beneficiaries would be small scale farmers in specific districts in the Eastern, Central and Coastal and Rift Valley areas' and in the addition of Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) to the partnership11 . According to the GSB broker, the proposal also lacked overall specificity, as it was not clear whether the project would be economically viable and how the quality of the mangoes would be improved (Interview, 16 July 2006). When Kevian attended the GSB Coordinating Group meetings clearer information on the direction of the project could not be obtained but the company continued to build a case for the need to lobby the government to remove excise duties on tax and water (UNDP GSB 2005).

In summer of 2006 the factory was almost completed and with a mango creamer ready to be installed negotiations with the original beneficiaries, the producers in Malindi, were re-opened. Kevian was prepared to pay 13 Ksh/Kg or 6.5 Ksh/ per mango, however it also expected for the producers to pay for transport costs which, including packing, loading and unloading were estimated to be as high as 5 Ksh per mango thereby making a net gain of 1.5 Ksh/per mango. Even though extensive research with the eight most reliable transport companies was conducted no deal was struck. As the K GT project programme officer stated: '…If Kevian is not prepared to pay for the transport costs then the partnership would have to come to an end. The export market is much more lucrative as the farmers would gain a net profit of 6 Ksh per kg of mango and the farmers would not have to incur transport costs. The only way for the economic partnership to be resurrected would be for Kevian to consider absorbing the transport costs, however Kevian is not a philanthropist and this alternative would have to make business sense, especially considering the ascending costs of fuel. At the bottom line of the partnership economic considerations need to be prioritised. The processing factory is 50 km away from Nairobi…10 hours drive away from Malindi…' Despite the setback, and with no particular concerns for the smallholders in Malindi which continued to be independently assisted by KGT12 , the GSB continued to support the Kevian project. In 2006 members of Coordinating Group visited the factory and were pleased 'with the opportunity to see the factory processing passion fruit and the state of the art equipment' (UNDP GSB 2006 b). In the meanwhile GTZ was able to trace mango producers closer to Thika and the beneficiaries were reidentified according to cost and quantity criteria, and the districts of Emebere and Embu were chosen to start anew a farmers' training programme. However, even if new smallholders were identified and the Ministry of Agriculture had agreed to offer extension services, there was no defined capacity building plan in place that would have ensured that the 'new beneficiaries' would be in a position to meet the quality and quantity demands imposed by Kevian.

Discussion: the Implications of Market-Based Development Strategies

Both case studies illustrated that the project definition and the project direction was ultimately defined by businesses and dictated by economic priorities with UNDP not raising questions about the marginalisation of the beneficiaries, their role in the projects, their expectations and knowledge. At no point were the intended smallholders invited to the discussions taking place at UNDP and empowered to make basic decisions about their livelihoodseconomic opportunities were catapulted from the outside and changes to the project plans were defined in Nairobi. Omitting the question of who defines and drives sustainable business projects is to reinforce the apolitical notion that partnerships are 'neutral', infinitely inclusive and that all the 'stakeholders' and beneficiaries involved have an equal say. This observation echoes the arguments put forth by an emerging body of critical scholarship on corporate social responsibility and public-private partnerships which has observed that in multistakeholder forums and meetings those who normally don't have a voice in society are also the ones excluded from the discussions (Prieto-Carrón et al. 2006: 984).

Second, the question of distribution of benefits deserves some attention. As [START_REF] Blowfield | Reasons to be cheerful? What we know about csr's impact[END_REF] asks, what assumptions can be drawn about the impact of these interventions? Within the GSB model, lead companies gain from the association with the UNDP name and the publicity that comes with it, here the reputational gains are substantial and should not be underestimated. As the cases of Global Entrepreneurs and Kevian testify the GSB opened up to businesses opportunities for networking and partnerships formation, it offered free guidance on the development of a business plan, and was instrumental in allowing businesses to bid for or acq uire public or private funding and financing. The gains accruing to the private sector are not only implicit in the GSB value-proposition but are also cultivated because failing partnerships could potentially undermine the entire initiative, its expansion plans and donors' funds. (In)avertedly the GSB platform also created a political space, at the Coordinating Group meetings, where, on occasions, the private sector could discuss the kind of policy changes, which would be required to foster more profitable and efficient economic transactions (i.e. lower taxes).

Similar or commensurable benefits have not been shared with smallholders. At the bottom of the supply chains some opportunities for smallholders have been created and equally removed. The viability of a sustainable business model is, first and foremost, dependent on the market imperative of profit maximisation. Beneficiaries are 'picked' because they can produce what a company wants at a price and quality that is deemed favourable by the buyer. However, even if the prices paid tend to be higher than what middlemen offer, buyers have the power and capacity (i.e. resources and networks) to relocate their 'developmental responsibilities' towards more costefficient producers, as illustrated by the experience of Kevian. Interviews with the farmers in Embu suggested that smallholders' wages continued to be determined by formal and informal market transactions; employment opportunities remained seasonal and dependent on fluctuating demand. Incomes were dependent not only on old and new market linkages but also on family remittances, crops' diversification and, for some, the identification of work opportunities away from the country side. Hence, even the modest contributions that isolated sustainable business model and the GSB claim to bring in the advancement of the MDGs or sustained poverty reduction can be open to challenges. This however, is not to dismiss entirely the potential value that sustainable business models might yield for the processes of development and the livelihood of smallholders. The new GSB guidelines for agro-food partnerships specify that several capacity building components should be identified prior to the development of a supply chain and suggest that quality and productivity improve ments, building trust amongst smallholders and organising farmers groups should be explicitly integrated within project proposals (UNDP 2007: 43). With businesses or governments not always in a position to offer such services the delegation of this respons ibility is expected to fall in the hands of MaNGOs such as GTZ, USAID, CARE, Gatsby Trust and TechnoServe. The introduction of this requirement is to be welcomed as opposed to the previous approach, namely one that viewed farmers simply as targets of publicprivate interventions. The emphasis placed on organising disparate producers into groups might in fact offer scope for the producers to use voice during negotiations with buyers, as shown by the case of Kevian, and potentially even within the wider partnership.

The opportunity that the GSB Kenya has failed to foster is a closer and more systematic partnership with local authorities and higher-level governmental bodies, as Frynas and Newell (2007: 677) point out 'even in the most dysfunctional African states, with weak government authorities, the state continues to exert an important influence on development'. Incorporating more meaningfully public authorities in the processes of defining how business interests and developmental priorities might be reconciled could potentially contribute to the long-term impact of sustainable business models. For example, in the cases discussed lack of transport, inadequate infrastructures, information and credit were all identified as factors that hindered the furtherance of the partnerships' developmental dimension and inherently called for public policy intervention and the mobilisation of public resources.

Conclusions

The GSB epitomises an example of proliferating forms of public-private governance, and like some of its counterparts such as the now defunct DFID's Business Linkages Challenge Fund or the Sustainable Agriculture Initiative Platform, its mandate and current global project portfolio place in a unique position to affect the welfare of small-scale agricultural and food producers in LDCs. Notwithstanding the initiative's 'learn as you go' approach, the paper has sought to demonstrate that thus far its degree of inclusiveness has been limited, while from the perspective of the beneficiaries its development impacts have yet to materialise.

The two cases presented in the paper showed that at no point the expected beneficiaries were consulted or included in the processes of deliberation. Furthermore, neither the smallholders in Embu nor the mango growers in Malindi reaped the benefits postulated within the GSB development proposition. The farmers in Embu were caught in between a hostile relationship between a young cooperative and Global Nuts, while the mango growers in Malindi lost their status as beneficiaries because they were located away from Kevian's production facilities. Comparatively the GSB has nurtured very close relationships with the private sector representatives of the Coordinating Group and business partners, and has offered them considerable advantages such as political spaces, networking opportunities, publicity and assistance in conceptualising and co-funding specific projects. Within the context of debates on democratic legitimacy and sustainable and equitable development these asymmetries expose the fragility of the partnership rationale and the practice of public-private partnerships.

The GSB, however, could be perceived more legitimate and even prove to be more effective if all the expected beneficiaries were given more voice in the phases of project selection and implementation. Opening up the GSB's decision-making mechanism to representatives of the beneficiaries, other non-strategic and less complacent 'stakeholders' coupled with the consistent involvement of public authorities could improve the prospects of addressing (some of the) developmental needs of the beneficiaries, and the expectations, roles and responsibilities of different actors within each project. Integrating farmers and other recipients of public-private development assistance within the GSB structures could potentially narrow the participatory gap identified in this research paper, and offer a space for the agency of the (otherwise) politically marginaliseda space where knowledge, values, demands, and objections can be openly articulated.

Within the wider UN family examples of bottom-up engagement mechanisms with farmers groups do exist. The International Fund for Agriculture and Development (IFAD) bi-annual Farmer's Forum is a testimony that attempts to integrate sma ll farmers, groups of producers and governments within policy processes can be attained. This is not to say that participation generates 'win-win' outcomes and eradicates power asymmetries, but that allowing the beneficiaries to actively partake in decision making processes leaves open the possibility for partnerships to become more accountable and less technocratic.

Employment and income generation are some of the postulated benefits that sustainable business models hope to produce but these assumptions need to be verified and followed up while closer attention will progressively need to be placed on the capacity building elements and the quality of employment relationships that different partnerships promote, and the wider social investment they might attract. The GSB does not currently have disclosure, monitoring or impact assessment mechanisms, what is known about 'development' primarily comes from the information that lead-businesses disclose, but as the existing partnerships develop and new groups of beneficiaries are identified the UNDP will have to demonstrate how and whether the model works not only to the advantage of private partners but also for those it seeks to lift out of poverty.

Preliminary Acknowledge ments

I would like to thank Peter Utting for encouraging me to write this paper, Craig Murphy and Rorden Wilkinson for reading the paper and providing incisive comments. The paper also benefitted from the questions and comments made by the participants of the Symposium 'Private Governance in the Agro-Food System' held at the University of Münster in April 2008. Last, I would like to express my gratitude to the civil servants, farmers, businesses and NGOs that offered their time to answer my questions. Poverty reduction through employment creation (from the existing 250 to 5,000 jobs). Access to export markets through certification and quality controls.

Farmers.

Active.

2007

Honeycare Africa (HCA), UNDP.

Encourage small farmers to begin beekeeping and reach the consumers at the bottom of the pyramid by selling 20g honey jars in the slum areas in Kenya.

Poverty reduction through employment creation and diversified sources of income.

Small-scale farmers, beekeepers and consumers.

Active.

Source: Compiled by the author from the UNDP GSB, the UNDP GSB Kenya websites and interviews.

As of mid-2008 the in itiat ive was active in Madagascar, Tanzania, Kenya, Zambia, Malawi, Macedonia, Moldova, Mozambique, Serbia, Turkey, Cambodia, Indonesia. The GSB p latforms in Ethiopia, Angola and El Salvador were abandoned.

This article derives fro m research material elicited for a wider research on the UN Global Co mpact, an initiat ive wh ich is co mmonly portrayed as the premier global public-private partnership. Whilst conducting qualitative interviews in New York in December 2005 a nu mber of UN civil servants suggested looking mo re closely at processes of partnership formation and imp lementation in support of the MDGs at country level. Kenya and Tanzania were identified as locations where I could investigate the politics of foru ms such as the UN Global Co mpact Local Network Kenya and one of the Co mpact's ancillary initiat ives, the Growing Sustainable Business Initiative, which operates in both countries.

This is not to say that the information is not accurate, sometimes it is simp ly not updated because of lack of personnel and resourcesa commonly acknowledged problem in UN Country Offices. However, wh ilst conducting research on the GSB it was also found that once the partnerships database are updated 'failed' partnerships are removed without explanations as to why specific pro ject s were abandoned or de-linked fro m the GSB.

[START_REF] Shamir | The De-Radicalization of Corporate Social Responsibility[END_REF] defines these organisations as Market Non-Govern mental Organisations (MaNGOs).

Historically the GEI was established by AIESEC Executives and it co-funded by the Norwegian Agency for Development Cooperation (NORAD).

The bilateral relations between Japan and the Kenyan government dated back to the 1970s when Japan's funding was instrumental in creat ing the institutions, capacities and infrastructures needed for the creation of a Kenyan market for macadamia.

Global Nuts' main co mpetitor.

GTZ, with self-funding for the project (GTZ PPP Fund), was entrusted with the responsibility of looking for more suppliers of high quality mangoes in the Central districts

KGT lin ked the smallholders to a Belg ian wholesaler and was actively looking into donor's fund to set up a pulp-processing factory in Malindi, at the same time it had started to evaluate the possibility of establishing a more lucrative market for dried mangoes.