Sample records for promote private sector

  1. Working with the private sector for child health.

    PubMed

    Waters, Hugh; Hatt, Laurel; Peters, David

    2003-06-01

    Private sector providers are the most commonly consulted source of care for child illnesses in many countries, offering significant opportunities to expand the reach of essential child health services and products. Yet collaboration with private providers presents major challenges - the suitability and quality of the services they provide is often questionable and governments' capacity to regulate them is limited. This article assesses the actual and potential contributions of the private sector to child health, and classifies and evaluates public sector strategies to promote and rationalize the contributions of private sector actors. Governments and international organizations can use a variety of strategies to collaborate with and influence private sector actors to improve child health - including contracting, regulating, financing and social marketing, training, coordinating and informing the public. These mutually reinforcing strategies can both improve the quality of services currently delivered in the private sector, and expand and rationalize the coverage of these services. One lesson from this review is that the private sector is very heterogeneous. At the country level, feasible strategies depend on the potential of the different components of the private sector and the capacity of governments and their partners for collaboration. To date, experience with private sector strategies offers considerable promise for children's health, but also raises many questions about the feasibility and impact of these strategies. Where possible, future interventions should be designed as experiments, with careful assessment of the intervention design and the environment in which they are implemented.

  2. Private sector joins family planning effort.

    PubMed

    1989-12-01

    the Dominican Republic, Liberia and Ecuador. These projects have increased private sector involvement in family planning, thereby promoting service expansion at lower public sector cost.

  3. Tuberculosis Notification by Private Sector' Physicians in Tehran.

    PubMed

    Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

    2015-01-01

    A small proportion of physicians adhere to tuberculosis (TB) notification regulations, particularly in the private sector. In most developing countries, the private sector has dominance over delivering services in big cities. In such circumstances deviation from the TB treatment protocol is frequently happening. This study sought to estimate TB notification in the private sector and settle on determinants of TB notification by private sector physicians. A population-based study has been conducted; private physicians at their clinics were interviewed. The total number of 443 private sectors' physicians has been chosen by the stratified random sampling method. Appropriate descriptive analysis was used to describe the study's participants. Logistic regression was used for bivariable and multivariable analysis. The response rate of the study was 90.06 (399%). Among responders, who had stated that they were suspicious of TB over the recent year, 62 (16.45%) stated that they reported cases of TB at least once during the same period. Having reporting requirements and the number of visited patients was significantly related to TB suspicious (odds ratio = 2.84, confidence interval: 1.62-5, P < 0.01). Workplace and access to relevant resources are associated with TB notification (P < 0.05). In poor resource settings with a high burden of TB, the public health administration can promote notification activities in the private sector by simple and quick interventions. It seems that a considerable fraction of private sector physicians, not all of them, will notify TB if they are provided with primary information and primary resources. To optimize the TB notification, however, intersectoral interventions are more likely to be successful.

  4. Mobilizing the private sector. Indonesia.

    PubMed

    Ferraz-tabor, L

    1993-12-01

    The national diarrheal disease control program has made progress against diarrheal illness in Indonesia, but diarrhea still accounts for 130,000 deaths of under-5 year olds annually. The potential of the private sector had been virtually untapped until the PRITECH Project designed and implemented a private sector based program to complement government efforts to reduce childhood morbidity and mortality related to diarrhea. PRITECH wanted to motivate commercial firms to invest the capital necessary to commercialize oral rehydration salts (ORS) so that program self-sufficiency would be maximized over the long term without depending upon donor support. Sections describe the lack of commercial sector ORS promotion, supply and demand factors, raising interest in ORS, conditions for change, the potential market for ORS, demand, production capacity, previous collaborative efforts, areas for improvement, PRITECH's role as catalyst, coordination with commercial companies, marketing workshops, collaboration with the Indonesian Medical Association, the handwashing campaign, and program impact. Although the program has been in place for just 1 year, sales of ORS have increased along with the degree of sustainable collaboration among local institutions. The author stresses that for the model to be successfully replicated elsewhere, the government, medical and pediatric associations, the World Health Organization, UNICEF, groups which can promote oral rehydration therapy, and opinion leaders in the medical community must be involved. Finally, note is made that the image of ORS must be improved and that the work of the public and commercial sectors can be complementary.

  5. Promoting safe motherhood through the private sector in low- and middle-income countries.

    PubMed Central

    Brugha, Ruair; Pritze-Aliassime, Susanne

    2003-01-01

    The formal private sector could play a significant role in determining whether success or failure is achieved in working towards goals for safe motherhood in many low- and middle-income settings. Established private providers, especially nurses/midwives, have the potential to contribute to safe motherhood practices if they are involved in the care continuum. However, they have largely been overlooked by policy-makers in low-income settings. The private sector (mainly doctors) contributes to overprovision and high Caesarean section rates in settings where it provides care to wealthier segments of the population; such care is often funded through third-party payment schemes. In poorer settings, especially rural areas, private nurses/midwives and the women who choose to use them are likely to experience similar constraints to those encountered in the public sector - for example, poor or unaffordable access to higher level facilities for the management of obstetrical emergencies. Policy-makers at the country-level need to map the health system and understand the nature and distribution of the private sector, and what influences it. This potential resource could then be mobilized to work towards the achievement of safe motherhood goals. PMID:14576894

  6. Comparing employee health benefits in the public and private sectors, 1997.

    PubMed

    Long, S H; Marquis, M S

    1999-01-01

    Data from the 1997 Robert Wood Johnson Foundation Employer Health Insurance Survey provide new information comparing public- and private-sector employee health benefits. The federal government is ahead of other employers in adopting managed competition principles using financial incentives and consumer information to promote choosing efficient plans. Federal employees experience a $200 annual compensation gap relative to those in the private sector, but it is partly explained by advantage in purchasing power. In contrast, state and local governments make higher payments toward health insurance than private-sector employers do. Their premiums are equivalent, but they pay a greater share of the total cost.

  7. Privacy Issues and the Private Sector,

    DTIC Science & Technology

    1976-07-01

    GUIDE represents a large portion of the private sector of this country; at the moment, of course, the recordkeeping processes of non-Federal...the Privacy Protection Study Commission to examine the private sector and non-Federal government. The Commission is to recommend to Congress and the...President first, what aspects of the 1974 Act should be applied to the private sector ; secondly, to recommend to Congress and the President what further legislative safeguards are indicated for the private sector .

  8. Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

    PubMed

    Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Zodpey, Sanjay P

    2016-09-01

    India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low

  9. Use of Private Sector Temporaries.

    DTIC Science & Technology

    1995-01-01

    causing the reduction in personnel. My solution to this problem is to authorize and find the use of private sector temporaries to perform the workload...discuss cost factors, and describe the benefits Defense Finance and Accounting Service will receive by using private sector temporaries (AN)

  10. Cyclical absenteeism among private sector, public sector and self-employed workers.

    PubMed

    Pfeifer, Christian

    2013-03-01

    This research note analyzes differences in the number of absent working days and doctor visits and in their cyclicality between private sector, public sector and self-employed workers. For this purpose, I used large-scale German survey data for the years 1995 to 2007 to estimate random effects negative binomial (count data) models. The main findings are as follows. (i) Public sector workers have on average more absent working days than private sector and self-employed workers. Self-employed workers have fewer absent working days and doctor visits than dependent employed workers. (ii) The regional unemployment rate is on average negatively correlated with the number of absent working days among private and public sector workers as well as among self-employed men. The correlations between regional unemployment rate and doctor visits are only significantly negative among private sector workers. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Lessons Learned from the Private Sector

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Robichaud, Robert J

    This session is focused on lessons learned from private sector energy projects that could be applied to the federal sector. This presentation tees up the subsequent presentations by outlining the differences between private and federal sectors in objectives, metrics for determining success, funding resources/mechanisms, payback and ROI evaluation, risk tolerance/aversion, new technology adoption perspectives, and contracting mechanisms.

  12. Private sector contribution to childhood immunization: Sri Lankan experience.

    PubMed

    Agampodi, S B; Amarasinghe, D A C L

    2007-04-01

    The main service provider for childhood immunization in Sri Lanka is the government sector. However, utilization of private sector for childhood immunization is increasing rapidly. Existing national immunization data does not routinely include statistics on private sector immunization delivery adequately. To estimate the proportion of children immunized in the private sector; describe socio-demographic characteristics of private sector users and compare these with government sector users. A community-based crosssectional descriptive study was conducted using a pre-tested interviewer-administered structured questionnaire. This was done in the Colombo municipal council area using the WHO 30 cluster methodology. The total number of households in the sample was 553. Out of the 5,028 total immunizations reported in the present study, around one-third (2,544) was obtained through the private sector. Nineteen percent (104) of children were exclusively immunized from the private sector. The distribution of usual immunization provider was - government sector 72.3% (400) and private sector 27.7% (153). Significant differences were observed (P < 0.001) between private and government sector users with regard to family income, social class, ethnicity, religion and educational level of the mother. The age-appropriate immunization among the 12- to 23-month age group was 92.3% (144) in the government sector, whereas it was 95% (38) in the private sector. Among the 24- to 35-month age group, it was 91.7% (121) and 92.7% (76) respectively. The age-adjusted immunization coverage rates were almost same among the government and private sector users except for the measles vaccine, where the private sector users had significantly (P = 0.016) higher coverage. Utilization of private sector immunization services is high in the Colombo municipal council area.

  13. Infrastructure and Private Sector Investment in Pakistan

    DTIC Science & Technology

    1997-03-01

    manner in which the expansion in various types of infrastructural facilities interact with private sector investment, and whether there is a long run...passive role in the country’s development. That is public facilities have largely expanded in response to the needs created by private sector investment...tangible needs created by private sector expansion it has, no doubt, been very effective in alleviating real bottlenecks. (JEL F21, 053).

  14. Getting on Board: The Private Sector and Learning Readiness.

    ERIC Educational Resources Information Center

    Koprowicz, Constance; Myers, John

    Developed by the Women's NETWORK, a group representing women serving in state legislatures in the United States, this report examines how the private sector is involved in promoting learning readiness at the preschool level. The report begins with an introduction and a discussion of the importance of learning readiness as a national goal. The…

  15. Public-private partnerships in China's urban water sector.

    PubMed

    Zhong, Lijin; Mol, Arthur P J; Fu, Tao

    2008-06-01

    During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China's water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China.

  16. Africa's health: could the private sector accelerate the progress towards health MDGs?

    PubMed Central

    2011-01-01

    systems capacities; and implement roadmaps for accelerating the attainment of health MDGs relating to maternal and child health, reducing disease burden, and promoting social determinants of health. In order for governments to further explore the potential benefits of the private sector towards improved performance of health systems, there is need for accurate evidence on the private sector capacity in areas of prevention, promotion, treatment and rehabilitation; dialogue and negotiation; clear definition of roles and responsibilities; and regulatory frameworks. PMID:22118626

  17. Africa's health: could the private sector accelerate the progress towards health MDGs?

    PubMed

    Sambo, Luis G; Kirigia, Joses M

    2011-11-25

    roadmaps for accelerating the attainment of health MDGs relating to maternal and child health, reducing disease burden, and promoting social determinants of health.In order for governments to further explore the potential benefits of the private sector towards improved performance of health systems, there is need for accurate evidence on the private sector capacity in areas of prevention, promotion, treatment and rehabilitation; dialogue and negotiation; clear definition of roles and responsibilities; and regulatory frameworks.

  18. Private Sector Contracting and Democratic Accountability

    ERIC Educational Resources Information Center

    DiMartino, Catherine; Scott, Janelle

    2013-01-01

    Public officials are increasingly contracting with the private sector for a range of educational services. With much of the focus on private sector accountability on cost-effectiveness and student performance, less attention has been given to shifts in democratic accountability. Drawing on data from the state of New York, one of the most active…

  19. Comparison of Navy and Private-Sector Construction Costs

    DTIC Science & Technology

    1997-09-01

    contracts are comparable to private - sector construction costs. This report compares those costs. The report includes a description of the methodology...costs of complying with federal contracting requirements as compared with the costs of similar projects completed under typical private - sector contracts...The study found that the costs of facilities constructed under Navy contracts compare favorably to private - sector construction costs for similar

  20. [Mechanism and implication of regulation of the pricing of essential medicines in the private pharmaceutical sector in Mali].

    PubMed

    Maïga, D; Maïga, S; Maïga, M D

    2010-04-01

    The healthcare and pharmaceutical professions in Mali were privatized in 1985. Privatization led to swift expansion of the private sector and upset the balance that had existed between the public and private sectors. A national pharmaceutical policy did not emerge until a decade later. Its purpose was to promote a system ensuring fair access to essential generic medicines for all. It was hoped that synergy between the two sectors would promote that objective. However, the policy calling for distribution of essential generic medicine through the private sector was not accompanied by an adequate system for pricing. This problem led the government to adopt a price regulation policy to realign market dynamics with public health goals. This experience shows that a sustained effort from public policy makers is necessary to prevail against the professional and business interests that can conflict with the public interest. Analysis of this experience also demonstrates the need to improve, restructure, and control the pharmaceutical industry. The government must continue to play its crucial role in the context of limited resources and inequality between consumers and pharmaceutical companies.

  1. 7 CFR 652.23 - Certification process for private-sector entities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Certification process for private-sector entities. 652... ASSISTANCE Certification § 652.23 Certification process for private-sector entities. (a) A private sector... individual basis as part of the private-sector entity's certification and ensures that the requirements set...

  2. 22 CFR 201.23 - Procurement under private sector procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procurement under private sector procedures... § 201.23 Procurement under private sector procedures. (a) General requirements. Procurements under private sector procedures will normally be carried out by importers using negotiated procurement...

  3. The crucial role of the private sector.

    PubMed

    Barberis, M; Paxman, J M

    1986-12-01

    Private support for the development of family planning programs continues to grow and now includes industries that provide family planning services, commercial outlets that distribute contraceptives, community groups that help to build demand, private medical practitioners who include contraception as a part of health care, organizations that provide technical and financial assistance to developing country programs, pharmaceutical firms, and foundations that underwrite contraceptive research. Although the mix of private and public programs differs from country to country, these 2 family planning programs complement each other and often work in close partnership. The private sector has the advantages of being able to pioneer innovative programs the public sector is unwilling or unable to pursue, to bring foreign financial and technical assistance to developing countries without political implications, and to achieve financially self-sustaining family planning efforts that are linked to other development efforts. In many countries, the private sector has been instrumental in developing a national family planning program and in eliminating barriers to family planning in countries with restrictive laws and policies. The private sector has been especially important in pioneering grassroots programs that improve the status of women through education, health care, training, and economic opportunity.

  4. Public-Private Partnerships in China’s Urban Water Sector

    PubMed Central

    Mol, Arthur P. J.; Fu, Tao

    2008-01-01

    During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China’s water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China. PMID:18256780

  5. Review of Private Sector Personnel Screening Practices

    DTIC Science & Technology

    2000-10-01

    private sector investigative sources or methods would be useful to the DoD for conducting national security background investigations. The federal government by and large examines more sources and conducts more thorough investigations than industry. In general, private employers (1) have less access to information about applicants...outsource many elements of background checks. It is recommended that the DoD periodically evaluate private sector screening programs and data sources in order to monitor

  6. Private-Sector Financing of Child Development Centers.

    DTIC Science & Technology

    1987-01-01

    Military Departments to determine the feasibility of private - sector or so-called ’third-day’ financing of the centers. In this arrangement, land is...that private - sector financing was not feasible. Our review and analysis of a broader test by the Department of the Navy under a concession arrangement

  7. Performance of private sector health care: implications for universal health coverage.

    PubMed

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-06

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. How Do Private Sector Schools Serve the Public Good by Fostering Inclusive Service Delivery Models?

    ERIC Educational Resources Information Center

    Scanlan, Martin; Tichy, Karen

    2014-01-01

    Conversations about promoting educational reforms that redress educational inequities often ignore private schools as irrelevant. Yet pursuits of inclusivity in private sector schools serve the public interest. This article focuses on how the system of Catholic schools in the Archdiocese of St. Louis has been purposefully striving for 2 decades to…

  9. Private sector health reform in South Africa.

    PubMed

    Van Den Heever, A M

    1998-06-01

    This paper discusses some of the trends, debates and policy proposals in relation to the financing of the private health sector in South Africa. The public and private sectors in South Africa are of equivalent size in terms of overall expenditure, but cover substantially different population sizes. Within this context the government has reached the unavoidable conclusion that the private sector has to play some role in ensuring that equity, access and efficiency objectives are achieved for the health system as a whole. However, the private sector is some way off from taking on this responsibility. Substantial increases in per capita costs over the past 15 years, coupled with a degree of deregulation by the former government, have resulted in increasing instability and volatility. The development of a very competitive medical scheme (health insurance) market reinforced by intermediaries with commercial interests has accelerated trends toward excluding high health risks from cover. The approach taken by the government has been to define a new environment which leaves the market open for extensive competition, but removes from schemes the ability to compete by discriminating against high health risks. The only alternatives left to the private market, policy makers hope, will be to go out of business, or to survive through productivity improvements.

  10. [Collaboration between public health nurses and the private sector].

    PubMed

    Marutani, Miki; Okada, Yumiko; Hasegawa, Takashi

    2016-01-01

    We clarified collaborations between public health nurses (PHNs) and the private sector, such as nonprofit organizations. Semi-structured interviews were conducted with 11 private sector organizations and 13 PHNs who collaborate with them between December 2012 to October 2013. Interview guides were: overall suicide preventive measurements, details of collaboration between private sector organizations and PHNs, and suicide prevention outcomes/issues. Data from private sector organizations and PHNs were separately analyzed and categories created using qualitative and inductive design. Private sector organizations' and PHNs' categories were compared and separated into core categories by similarities. Six categories were created: 1. establishing a base of mutual understanding; 2. raising public awareness of each aim/characteristic; 3. competently helping high suicidal risk persons detected during each activity; 4. guarding lives and rehabilitating livelihoods after intervention; 5. restoring suicide attempters/bereaved met in each activity; and 6. continuing/expanding activities with reciprocal cohesion/evaluation. PHNs are required to have the following suicide prevention tasks when collaborating with private sector organizations: understanding the private sector civilization, sharing PHN experiences, improving social determinants of health, meeting basic needs, supporting foundation/difficulties each other (Dear editor. Thank you for kind comments. I was going to explain that PHNs and NPOs support each other their foundation of activity and difficulties in their activities. The foundations include knowledge, information, budgets, manpower etc. The difficulties mean like suffering faced with suicide during activities.), and enhancing local governments' flexibilities/ promptness.

  11. 48 CFR 37.112 - Government use of private sector temporaries.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... use of private sector temporaries. Contracting officers may enter into contracts with temporary help service firms for the brief or intermittent use of the skills of private sector temporaries. Services... part 300, subpart E, Use of Private Sector Temporaries, and agency procedures. [56 FR 55380, Oct. 25...

  12. Private sector data for performance management.

    DOT National Transportation Integrated Search

    2011-07-01

    This report examines and analyzes technical and institutional issues associated with the use of private sector travel time and speed data for public sector performance management. The primary data needs for congestion performance measures are outline...

  13. The first private sector health insurance company in Ghana.

    PubMed

    Huff-Rousselle, M; Akuamoah-Boateng, J

    1998-01-01

    This article analyses the development of Ghana's first private sector health insurance company, the Nationwide Medical Insurance Company. Taking both policy and practical considerations into account (stakeholders' perspectives, economic viability, equity and efficiency), it is structured around key questions which help to define the position and roles of stakeholders--the insurance agency itself, contributors, beneficiaries, and providers--and how they relate to one another and the insurance scheme. These relationships will to a large extent determine Nationwide's long-term success or failure. By creating a unique alliance between physician providers and private sector companies, Nationwide has used employers' interest in cost containment and physicians' interest in expanding their client base as an entrée into the virgin territory of health insurance, and created a hybrid variety of private sector insurance with some of the attributes of a health maintenance organization or managed care. The case study is unusual in that, while public sector programs are often open to academic scrutiny, researchers have rarely had access to detailed data on the establishment of a single private sector insurance company in a developing country. Given that Ghana is planning to launch a national health insurance plan, the article concludes by considering what the experience of this private sector initiative might have to offer public sector planners.

  14. University-Private Sector Research Partnerships in the Innovation Ecosystem

    DTIC Science & Technology

    2008-11-01

    private sector . There are several trends that PCAST considers to fall specifically within context of university- private sector research partnerships. The first is the growing imbalance between the academic research capacity and the Federal research budget. The second development is the reduction in basic research performed by the industrial sector. Private foundations are expanding their capacity to fund research, a trend expected to be important in the future. Lastly, the accelerating speed of technological development requires new methods of

  15. Private sector participation and health system performance in sub-saharan Africa.

    PubMed

    Yoong, Joanne; Burger, Nicholas; Spreng, Connor; Sood, Neeraj

    2010-10-07

    The role of the private health sector in developing countries remains a much-debated and contentious issue. Critics argue that the high prices charged in the private sector limits the use of health care among the poorest, consequently reducing access and equity in the use of health care. Supporters argue that increased private sector participation might improve access and equity by bringing in much needed resources for health care and by allowing governments to increase focus on underserved populations. However, little empirical exists for or against either side of this debate. We examine the association between private sector participation and self-reported measures of utilization and equity in deliveries and treatment of childhood respiratory disease using regression analysis, across a sample of nationally-representative Demographic and Health Surveys from 34 SSA economies. We also examine the correlation between private sector participation and key background factors (socioeconomic development, business environment and governance) and use multivariate regression to control for potential confounders. Private sector participation is positively associated with greater overall access and reduced disparities between rich and poor as well as urban and rural populations. The positive association between private sector participation and improved health system performance is robust to controlling for confounders including per capita income and maternal education. Private sector participation is positively correlated with measures of socio-economic development and favorable business environment. Greater participation is associated with favorable intermediate outcomes in terms of access and equity. While these results do not establish a causal link between private sector participation and health system performance, they suggest that there is no deleterious link between private sector participation and health system performance in SSA.

  16. 75 FR 34148 - Voluntary Private Sector Accreditation and Certification Preparedness Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency...) announces its adoption of three standards for the Voluntary Private Sector Accreditation and Certification... DHS to develop and implement a Voluntary Private Sector Preparedness Accreditation and Certification...

  17. Partnership for a Healthier America: Creating Change Through Private Sector Partnerships.

    PubMed

    Simon, Caitlin; Kocot, S Lawrence; Dietz, William H

    2017-06-01

    This review provides background on the formation of the Partnership for a Healthier America (PHA), that was created in conjunction with the Let's Move! initiative, and an overview of its work to date. To encourage industry to offer and promote healthier options, PHA partners with the private sector. Principles that guide PHA partnerships include ensuring that partnerships represent meaningful change, partners sign a legally binding contract and progress is monitored and publicly reported. Since 2010, PHA has established private sector partnerships in an effort to transform the marketplace to ensure that every child has the chance to grow up at a healthy weight. Many agreements between PHA and its industry partners align with the White House Task Force Report on Childhood Obesity. The reach and impact of over 200 partnerships attest to the success of this initiative.

  18. 75 FR 60773 - Voluntary Private Sector Accreditation and Certification Preparedness Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... concerns in the Voluntary Private Sector Accreditation and Certification Preparedness Program (PS-Prep...-53 (the 9/11 Act) mandated DHS to establish a voluntary private sector preparedness accreditation and...

  19. Labor Market Uncertainty and Private Sector Labor Supply in Russia

    DTIC Science & Technology

    2000-09-01

    The development of a vibrant private sector has been one of the key failures of the transitional period in Russia. This paper develops a theoretical...Monitoring Survey for the years 1994 - 1996 & 1998. As hypothesized, a decrease in private sector earnings variability is estimated to increase the likelihood...of private sector employment for individuals with constrained consumption smoothing ability. Evidence of ex-ante intra-household risk sharing is also

  20. Privatizing responsibility: public sector reform under neoliberal government.

    PubMed

    Ilcan, Suzan

    2009-08-01

    In light of public sector reforms in Canada and elsewhere, this paper focuses on the shift of emphasis from social to private responsibilities and raises new questions about the forces of private enterprise and market-based partnerships. Under neoliberal governmental agendas, privatizing responsibility links to three main developments: the reconsideration of the relations of public and private; the mobilization of responsible citizenship; and the formation of a cultural mentality of rule that works alongside these developments. The research for this article is based on extensive analysis of policy documents and public sector reform initiatives, as well as interviews with Canadian federal public service employees.

  1. Utilization of skilled birth attendants in public and private sectors in Vietnam.

    PubMed

    Do, Mai

    2009-05-01

    The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

  2. Career Education: Collaboration with the Private Sector. Information Series No. 246.

    ERIC Educational Resources Information Center

    Bhaerman, Robert D.

    This paper reviews three aspects of career education-private sector collaboration: (1) the general and specific approaches that have been utilized during the past 10 years by the career education movement and the private sector in developing career education collaboration in the private sector; (2) the major results of these activities, focusing…

  3. Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

    PubMed

    Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

    2012-07-01

    The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise

  4. Medical student teaching in the private sector - An overlooked opportunity?

    PubMed

    Galletly, Cherrie A; Turnbull, Carol; Goldney, Robert

    2016-04-01

    One in four psychiatric beds in Australia are located in the private sector, and more than half of Australian psychiatrists undertake private work. However, nearly all medical student teaching in psychiatry takes place in public hospitals. This paper explores the learning opportunities in the private sector. We report the South Australian experience; medical students have been taught in Ramsay Health Care (SA) Mental Health facilities for more than 23 years. Our experience demonstrates that clinical teaching in private hospitals is sustainable and well accepted by students, patients and clinicians. The private sector has the capacity to make a much greater contribution to medical student training in psychiatry. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  5. A proposed approach to monitor private-sector policies and practices related to food environments, obesity and non-communicable disease prevention.

    PubMed

    Sacks, G; Swinburn, B; Kraak, V; Downs, S; Walker, C; Barquera, S; Friel, S; Hawkes, C; Kelly, B; Kumanyika, S; L'Abbé, M; Lee, A; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Rayner, M; Sanders, D; Snowdon, W; Vandevijvere, S

    2013-10-01

    Private-sector organizations play a critical role in shaping the food environments of individuals and populations. However, there is currently very limited independent monitoring of private-sector actions related to food environments. This paper reviews previous efforts to monitor the private sector in this area, and outlines a proposed approach to monitor private-sector policies and practices related to food environments, and their influence on obesity and non-communicable disease (NCD) prevention. A step-wise approach to data collection is recommended, in which the first ('minimal') step is the collation of publicly available food and nutrition-related policies of selected private-sector organizations. The second ('expanded') step assesses the nutritional composition of each organization's products, their promotions to children, their labelling practices, and the accessibility, availability and affordability of their products. The third ('optimal') step includes data on other commercial activities that may influence food environments, such as political lobbying and corporate philanthropy. The proposed approach will be further developed and piloted in countries of varying size and income levels. There is potential for this approach to enable national and international benchmarking of private-sector policies and practices, and to inform efforts to hold the private sector to account for their role in obesity and NCD prevention. © 2013 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

  6. What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries.

    PubMed

    Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Cavagnero, Eleonora; Zhao, Hongwen

    2016-08-06

    Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners-both unlicensed and licensed-to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Collaborating with the Private Sector

    DTIC Science & Technology

    2009-08-01

    private sector, laws, Patriot Act, FISA, FAR, Intellectual Property, Antitrust Law, Title 10, Title 50, FOIA, FACA, data classification, culture...33 Intellectual Property...Patriot Act) Foreign Intelligence Surveillance Act (FISA) Federal Acquisition Regulation (FAR) Intellectual Property Antitrust Law Title 10

  8. Private Sector Investment in Pakistani Agriculture: The Role of Infrastructural Investment

    DTIC Science & Technology

    1999-01-01

    private sector will be expected to play the major role in providing capital to the agricultural sector, with the government’s remaining involvement being largely one of furnishing basic infrastructure. The critical question of course is how willing is the private sector to commit capital to agricultural activities in this new policy environment? Has the private sector responded in the past to the increases in profitability provided by an expansion in infrastructure? If so, what types of infrastructure are most conducive in

  9. Evaluation of Immunization Knowledge, Practices, and Service-delivery in the Private Sector in Cambodia

    PubMed Central

    Soeung, Sann Chan; Grundy, John; Morn, Cheng; Samnang, Chham

    2008-01-01

    A study of private-sector immunization services was undertaken to assess scope of practice and quality of care and to identify opportunities for the development of models of collaboration between the public and the private health sector. A questionnaire survey was conducted with health providers at 127 private facilities; clinical practices were directly observed; and a policy forum was held for government representatives, private healthcare providers, and international partners. In terms of prevalence of private-sector provision of immunization services, 93% of the private inpatient clinics surveyed provided immunization services. The private sector demonstrated a lack of quality of care and management in terms of health workers’ knowledge of immunization schedules, waste and vaccine management practices, and exchange of health information with the public sector. Policy and operational guidelines are required for private-sector immunization practices that address critical subject areas, such as setting of standards, capacity-building, public-sector monitoring, and exchange of health information between the public and the private sector. Such public/private collaborations will keep pace with the trends towards the development of private-sector provision of health services in developing countries. PMID:18637533

  10. Motivating the Private vs. Public Sector Managers.

    ERIC Educational Resources Information Center

    Khojasteh, Mak

    1993-01-01

    A questionnaire on intrinsic/extrinsic rewards received 362 responses from 380 managers. Pay and security were greater motivators for private than for public sector managers. Recognition had higher motivating potential in the public sector. Both groups were motivated by achievement and advancement. (SK)

  11. Analysis of Survivor Benefit Plan - Acceptance and Comparison with Private Sector

    DTIC Science & Technology

    1989-01-01

    I COPY AIU WAR COLLEGE ,.SEARCH REPORT ,YSIS OF SURVIVOR BENEFIT PLAN-__CCEPTANCE ’-U AND COMPARISON WITH PRIVATE SECTOR LIEUENNT COLONEL JOHN R...AAA AIR WAR COLLEGE AIR UNIVERSITY ANALYSIS OF SURVIVOR BENEFIT PLAN--ACCEPTANCE AND COMPARISON WITH PRIVATE SECTOR by John R. Adams Lieutenant...Survivor Benefit Plan (SBP)--Acceptance and Comparison With Private Sector . AUTHORS: John R. Adams, Lieutenant Colonel, USAF; Daniel 3. Kohn

  12. Public Sector/Private Sector Interaction in Providing Information Services. Report to the NCLIS from the Public Sector/Private Sector Task Force.

    ERIC Educational Resources Information Center

    National Commission on Libraries and Information Science, Washington, DC.

    The results of a 2-year study on the interactions between government and private sector information activities are presented in terms of principles and guidelines for federal policy to support the development and use of information resources, products, and services, and to implement the principles. Discussions address sources of conflict between…

  13. The Determinants of Private and Government Sector Earnings in Russia

    DTIC Science & Technology

    2000-11-01

    private sector earnings in Russia compare to those in the still strong government sector. This paper estimates sectoral earnings equations for rural and urban men and women which control for: (1) Self-selection into the workforce; and (2) Self-selection into either the private or government sector, while allowing for simultaneity in the selection decisions. The selection controls are found to have a considerable effect on the estimated sectoral earnings differentials for all four sample groups. Earnings differentials are examined by age, education, and unobserved skill.

  14. Private sector response to improving oral health care access.

    PubMed

    Robinson, Lindsey A

    2009-07-01

    Despite vast improvements in the oral health status of the United States population over the past 50 years, disparities in oral health status continue, with certain segments of the population carrying a disproportionate disease burden. This article attempts to describe the problem, discuss various frameworks for action, illustrate some solutions developed by the private sector, and present a vision for collaborative action to improve the health of the nation. No one sector of the health care system can resolve the problem. The private sector, the public sector, and the not-for-profit community must collaborate to improve the oral health of the nation.

  15. Accelerating TB notification from the private health sector in Delhi, India.

    PubMed

    Kundu, Debashish; Chopra, Kamal; Khanna, Ashwani; Babbar, Neeti; Padmini, T J

    2016-01-01

    In India, almost half of all patients with tuberculosis (TB) seek care in the private sector as the first point of care. The national programme is unable to support such TB patients and facilitate effective treatment, as there is no information on TB and Multi or Extensively Drug Resistant TB (M/XDR-TB) diagnosis and treatment in private sector. To improve this situation, Government of India declared TB a notifiable disease for establishing TB surveillance system, to extend supportive mechanism for TB treatment adherence and standardised practices in the private sector. But TB notification from the private sector is a challenge and still a lot needs to be done to accelerate TB notification. Delhi State TB Control Programme had taken initiatives for improving notification of TB cases from the private sector in 2014. Key steps taken were to constitute a state level TB notification committee to oversee the progress of TB notification efforts in the state and direct 'one to one' sensitisation of private practitioners (PPs) (in single PP's clinic, corporate hospitals and laboratories) by the state notification teams with the help of available tools for sensitising the PP on TB notification - TB Notification Government Order, Guidance Tool for TB Notification and Standards of TB Care in India. As a result of focussed state level interventions, without much external support, there was an accelerated notification of TB cases from the private sector. TB notification cases from the private sector rose from 341 (in 2013) to 4049 (by the end of March 2015). Active state level initiatives have led to increase in TB case notification. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

  16. Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC.

    PubMed

    Riley, Christina; Garfinkel, Danielle; Thanel, Katherine; Esch, Keith; Workalemahu, Endale; Anyanti, Jennifer; Mpanya, Godéfroid; Binanga, Arsène; Pope, Jen; Longfield, Kim; Bertrand, Jane; Shaw, Bryan

    2018-01-01

    An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector's role in increasing contraceptive coverage and choice. In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price. Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 41% of modern contraceptive stocking outlets were in the private sector compared with approximately 80% in Nigeria and DRC where drug shops were dominant. Ninety-five percent of private sector outlets in Ethiopia had modern contraceptive methods available; 37% had three or more methods. In Nigeria and DRC, only 54% and 42% of private sector outlets stocked modern contraceptives with 5% and 4% stocking three or more methods, respectively. High prices in Nigeria and DRC create barriers to consumer access and choice. There is a missed opportunity to provide modern contraception through the private sector, particularly drug shops. Subsidies and interventions, like social marketing and social franchising, could leverage the private sector's role in increasing access to a range of contraceptives. Achieving global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private sector and improvement of decisions around

  17. Women Using Physics: Alternate Career Paths, The Private Sector

    NASA Astrophysics Data System (ADS)

    Tams, Jessica

    2006-12-01

    For those who have spent their careers inside the safe walls of academia, the word is a little scary. Can I compete? Will I fit in? What do I need to know? Am I prepared? Will I succeed? While many would say: Yes! You are ready to excel! This isn’t actually the case. The private sector comes with many unanticipated shocks to many of us, especially women. This isn’t a group project. This session will discuss entering a quickly growing and competitive technical field and what one can do to prepare for continued success. Preparing and Entering the Private Sector * Women with technical skills are a desired part of the private workforcein general women posses stronger people skills, are more reliable and often more well rounded than their male counterparts. Key factors we will discuss to landing that first job: · Expand your knowledge base with current applications of technology · Preparing a solid employment pitch to highlight strengths: Overcoming stereotypes · Don’t show them your bad side: Why some student projects may hurt you · The private sector attitude toward performance and entry level expectations Excelling in the Private Sector * Now that we have landed a job * for better or worse we are now all about making money and exerting control. What to keep in mind while working in the private sector: · The formative first years: focus on your weaknesses and practice, practice, practice · Men & Women in the workplace: what women subconsciously do to hurt their careers · Politics: Working in a team environment · Polish & Detail & Reliabilit

  18. Is Satisfaction with the Acute-Care Experience Higher amongst Consumers Treated in the Private Sector? A Survey of Public and Private Sector Arthroplasty Recipients.

    PubMed

    Naylor, Justine M; Descallar, Joseph; Grootemaat, Mechteld; Badge, Helen; Harris, Ian A; Simpson, Grahame; Jenkin, Deanne

    2016-01-01

    Consumer satisfaction with the acute-care experience could reasonably be expected to be higher amongst those treated in the private sector compared to those treated in the public sector given the former relies on high-level satisfaction of its consumers and their subsequent recommendations to thrive. The primary aims of this study were to determine, in a knee or hip arthroplasty cohort, if surgery in the private sector predicts greater overall satisfaction with the acute-care experience and greater likelihood to recommend the same hospital. A secondary aim was to determine whether satisfaction across a range of service domains is also higher in the private sector. A telephone survey was conducted 35 days post-surgery. The hospital cohort comprised eight public and seven private high-volume arthroplasty providers. Consumers rated overall satisfaction with care out of 100 and likeliness to recommend their hospital on a 5-point Likert scale. Additional Likert-style questions were asked covering specific service domains. Generalized estimating equation models were used to analyse overall satisfaction (dichotomised as ≥ 90 or < 90) and future recommendations for care (dichotomised as 'definitely recommend' or 'other'), whilst controlling for covariates. The proportions of consumers in each sector reporting the best Likert response for each individual domain were compared using non-parametric tests. 457 survey respondents (n = 210 private) were included. Less patient-reported joint impairment pre-surgery [OR 1.03 (95% CI 1.01-1.05)] and absence of an acute complication (OR 2.13 95% CI 1.41-3.23) significantly predicted higher overall satisfaction. Hip arthroplasty [OR 1.84 (1.1-2.96)] and an absence of an acute complication [OR 2.31 (1.28-4.17] significantly predicted greater likelihood for recommending the hospital. The only care domains where the private out-performed the public sector were hospitality (46.7 vs 35.6%, p <0.01) and frequency of surgeon visitation (76

  19. Brazilian healthcare in the context of austerity: private sector dominant, government sector failing.

    PubMed

    Costa, Nilson do Rosário

    2017-04-01

    This paper presents the arguments in favor of government intervention in financing and regulation of health in Brazil. It describes the organizational arrangement of the Brazilian health system, for the purpose of reflection on the austerity agenda proposed for the country. Based on the literature in health economics, it discusses the hypothesis that the health sector in Brazil functions under the dominance of the private sector. The categories employed for analysis are those of the national health spending figures. An international comparison of indicators of health expenses shows that Brazilian public spending is a low proportion of total spending on Brazilian health. Expenditure on individuals' health by out-of-pocket payments is high, and this works against equitability. The private health services sector plays a crucial role in provision, and financing. Contrary to the belief put forward by the austerity agenda, public expenditure cannot be constrained because the government has failed in adequate provision of services to the poor. This paper argues that, since the Constitution did not veto activity by the private sector segment of the market, those interests that have the greatest capacity to vocalize have been successful in imposing their preferences in the configuration of the sector.

  20. Private Sector Initiative Between the U.S. and Japan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    1998-09-30

    OAK-A258 Private Sector Initiative Between the U.S. and Japan. This report for calendar years 1993 through September 1998 describes efforts performed under the Private Sector Initiatives contract. The report also describes those efforts that have continued with private funding after being initiated under this contract. The development of a pyrochemical process, called TRUMP-S, for partitioning actinides from PUREX waste, is described in this report. This effort is funded by the Central Research Institute of Electric Power Industry (CRIEPI), KHI, the United States Department of Energy, and Boeing.

  1. Homeland Security and the Private Sector : a CBO Paper

    DTIC Science & Technology

    2004-12-01

    private sector and the nation as a whole that would underlie the expected costs of terrorist attacks and, hence, the broader benefits of security. This paper focuses on those industries for which the expected human and economic losses from a terrorist attack would be highest -- the country’s critical infrastructure. The analysis more narrowly focuses on those industries that reside largely in the private sector and for which an attack could lead to a direct loss of life. The paper also reviews the incentives for private actions to limit

  2. Private sector cautious on Pemex reorganization

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sissell, K.

    1997-03-19

    Private sector interest in the privatization of the petrochemical subsidiaries of Mexico`s state oil company Petroleos Mexicanos (Pemex) will hinge on the government`s decisions on minority ownership, says Raul Millares, president of Aniq, the Mexican chemical industry association. The murkiest issues are how the subsidiaries will be operated and what rights minority owners will have. {open_quotes}The question is who is going to manage the subsidiaries on a day-to-day basis,{close_quotes} says Millares. {open_quotes}There is a lot of doubt as to whether private companies will be able to get the flexibility they need.{close_quotes}

  3. Private sector role, readiness and performance for malaria case management in Uganda, 2015.

    PubMed

    Kaula, Henry; Buyungo, Peter; Opigo, Jimmy

    2017-05-25

    Several interventions have been put in place to promote access to quality malaria case management services in Uganda's private sector, where most people seek treatment. This paper describes evidence using a mixed-method approach to examine the role, readiness and performance of private providers at a national level in Uganda. These data will be useful to inform strategies and policies for improving malaria case management in the private sector. The ACTwatch national anti-malarial outlet survey was conducted concurrently with a fever case management study. The ACTwatch nationally representative anti-malarial outlet survey was conducted in Uganda between May 18th 2015 and July 2nd 2015. A representative sample of sub-counties was selected in 14 urban and 13 rural clusters with probability proportional to size and a census approach was used to identify outlets. Outlets eligible for the survey met at least one of three criteria: (1) one or more anti-malarials were in stock on the day of the survey; (2) one or more anti-malarials were in stock in the 3 months preceding the survey; and/or (3) malaria blood testing (microscopy or RDT) was available. The fever case management study included observations of provider-patient interactions and patient exit interviews. Data were collected between May 20th and August 3rd, 2015. The fever case management study was implemented in the private sector. Potential outlets were identified during the main outlet survey and included in this sub-sample if they had both artemisinin-based combination therapy (ACT) [artemether-lumefantrine (AL)], in stock on the day of survey as well as diagnostic testing available. A total of 9438 outlets were screened for eligibility in the ACTwatch outlet survey and 4328 outlets were found to be stocking anti-malarials and were interviewed. A total of 9330 patients were screened for the fever case management study and 1273 had a complete patient observation and exit interview. Results from the outlet

  4. 28 CFR 302.1 - Public and private sector comment procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Public and private sector comment procedures. 302.1 Section 302.1 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE COMMENTS ON UNICOR BUSINESS OPERATIONS § 302.1 Public and private sector comment procedures. (a...

  5. 28 CFR 302.1 - Public and private sector comment procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Public and private sector comment procedures. 302.1 Section 302.1 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE COMMENTS ON UNICOR BUSINESS OPERATIONS § 302.1 Public and private sector comment procedures. (a...

  6. 28 CFR 302.1 - Public and private sector comment procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Public and private sector comment procedures. 302.1 Section 302.1 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE COMMENTS ON UNICOR BUSINESS OPERATIONS § 302.1 Public and private sector comment procedures. (a...

  7. 28 CFR 302.1 - Public and private sector comment procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Public and private sector comment procedures. 302.1 Section 302.1 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE COMMENTS ON UNICOR BUSINESS OPERATIONS § 302.1 Public and private sector comment procedures. (a...

  8. 28 CFR 302.1 - Public and private sector comment procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Public and private sector comment procedures. 302.1 Section 302.1 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE COMMENTS ON UNICOR BUSINESS OPERATIONS § 302.1 Public and private sector comment procedures. (a...

  9. Leveraging the private health sector to enhance HIV service delivery in lower-income countries.

    PubMed

    Rao, Pamela; Gabre-Kidan, Tesfai; Mubangizi, Deus Bazira; Sulzbach, Sara

    2011-08-01

    Evidence that the private health sector is a key player in delivering health services and impacting health outcomes, including those related to HIV/AIDS, underscores the need to optimize the role of the private health sector to scale up national HIV responses in lower-income countries. This article reviews findings on the types of HIV/AIDS services provided by the private health sector in developing countries and elaborates on the role of private providers of HIV services in Ethiopia. Drawing on data from the nation's innovative Private Health Sector Project, a pilot project that has demonstrated the feasibility of public-private partnerships in this area, the article highlights the potential for national governments to scale up HIV/AIDS services by leveraging private health sector resources, innovations, and expertise while working to regulate quality and cost of services. Although concerns about uneven quality and affordability of private sector health services must be addressed through regulation, policy, or other innovative approaches, we argue that the benefits of leveraging the private sector outweigh these challenges, particularly in light of finite donor and public domestic resources.

  10. Enhancing private sector engagement: Louisiana's business emergency operations centre.

    PubMed

    Day, Jamison M; Strother, Shannon; Kolluru, Ramesh; Booth, Joseph; Rawls, Jason; Calderon, Andres

    2010-07-01

    Public sector emergency management is more effective when it coordinates its efforts with private sector companies that can provide useful capabilities faster, cheaper and better than government agencies. A business emergency operations centre (EOC) provides a space for private sector and non-governmental organisations to gather together in support of government efforts. This paper reviews business-related EOC practices in multiple US states and details the development of a new business EOC by the State of Louisiana, including lessons learned in response to the May 2010 oil spill.

  11. Sharing the Knowledge: Government-Private Sector Partnerships to Enhance Information Security

    DTIC Science & Technology

    2000-05-01

    private sector . However, substantial barriers threaten to block information exchanges between the government and private sector . These barriers include concerns over release of sensitive material under Freedom of Information Act requests, antitrust actions, protection of business confidential and other private material, possible liability due to shared information, disclosure of classified information, and burdens entailed with cooperating with law enforcement agencies. There is good cause to believe that the government and private

  12. Private sector accountable care organization development: a qualitative study.

    PubMed

    Scheck McAlearney, Ann; Hilligoss, Brian; Song, Paula H

    2017-03-01

    To explore accountable care organizations (ACOs) as they develop in the private sector, including their motivation for development, perspectives from consumers regarding these emerging ACOs, and the critical success factors associated with ACO development. Comprehensive organizational case studies of 4 full-risk private sector ACOs that included in-person interviews with providers and administrators and focus groups with local consumers. Sixty-eight key informant interviews conducted during site visits, supplemented by document collection and telephone interviews, and 5 focus groups were held with 52 consumers associated with the study ACOs. We found 3 main motivators for private sector ACO development: 1) opportunity to improve quality and efficiency, 2) potential to improve population health, and 3) belief that payment reform is inevitable. With respect to consumer perspectives, consumers were unaware they received care from an ACO. From the perspectives of ACO stakeholders, these ACOs noted that they prefer to focus on patients' relationships with providers and typically do not emphasize the ACO name or entity. Critical success factors for private sector ACO development included provider engagement, strategic buy-in, prior experience managing risk, IT infrastructure, and leadership, all meant to shift the culture to a focus on value instead of volume. These organizations perceived that pursuing an accountable care strategy allowed them to respond to policy changes anticipated to impact the way healthcare is delivered and reimbursed. Increased understanding of factors that have been important for more mature private sector ACOs may help other healthcare organizations as they strive to enhance value and advance in their ACO journeys.

  13. Private-Sector Coalitions and State-Level Education Reform. Policy Bulletin.

    ERIC Educational Resources Information Center

    Hamrick, Flo

    The influence of the private sector on education has been and continues to be significant. The use of scientific management in education, which led to standardized testing, accountability, and educational administration, came from the private sector. In recent times, many businesses have formed charitable and professional support partnerships with…

  14. Health care of female outpatients in south-central India: comparing public and private sector provision.

    PubMed

    Bhatia, Jagdish; Cleland, John

    2004-11-01

    The object of this study was to compare components of quality of care provided to female outpatients by practitioners working in the private and public sectors in Karnataka State, India. Consultations conducted by 18 private practitioners and 25 public-sector practitioners were observed for 5 days using a structured protocol. Private practitioners were selected from members of the Indian Medical Association in a predominantly rural sub-district of Kolar District. Government doctors were selected from a random sample of hospitals and health centres in three sub-districts of Mysore District. A total of 451 private-sector and 650 public-sector consultations were observed; in each sector about half involved a female practitioner. The mean length of consultation was 2.81 minutes in the public sector and 6.68 minutes in the private sector. Compared with public-sector practitioners, private practitioners were significantly more likely to undertake a physical examination and to explain their diagnosis and prognosis to the patient. Privacy was much better in the private sector. One-third of public-sector patients received an injection compared with two-thirds of private patients. The mean cost of drugs dispensed or prescribed were Rupees 37 and 74 in public and private sectors, respectively. Both in terms of thoroughness of diagnosis and doctor-patient communication, the quality of care appears to be much higher in the private than in the public sector. However, over-prescription of drugs by private practitioners may be occurring.

  15. Private participation in infrastructure: A risk analysis of long-term contracts in power sector

    NASA Astrophysics Data System (ADS)

    Ceran, Nisangul

    The objective of this dissertation is to assess whether the private participation in energy sector through long term contracting, such as Build-Operate-Transfer (BOT) type investments, is an efficient way of promoting efficiency in the economy. To this end; the theoretical literature on the issue is discussed, the experience of several developing countries are examined, and a BOT project, which is undertaken by the Enron company in Turkey, has been studied in depth as a case study. Different risk analysis techniques, including sensitivity and probabilistic risk analysis with the Monte Carlo Simulation (MCS) method have been applied to assess the financial feasibility and risks of the case study project, and to shed light on the level of rent-seeking in the BOT agreements. Although data on rent seeking and corruption is difficult to obtain, the analysis of case study investment using the sensitivity and MCS method provided some information that can be used in assessing the level of rent-seeking in BOT projects. The risk analysis enabled to test the sustainability of the long-term BOT contracts through the analysis of projects financial feasibility with and without the government guarantees in the project. The approach of testing the sustainability of the project under different scenarios is helpful to understand the potential costs and contingent liabilities for the government and project's impact on a country's overall economy. The results of the risk analysis made by the MCS method for the BOT project used as the case study strongly suggest that, the BOT projects does not serve to the interest of the society and transfers substantial amount of public money to the private companies, implying severe governance problems. It is found that not only government but also private sector may be reluctant about full privatization of infrastructure due to several factors such as involvement of large sunk costs, very long time period for returns to be received, political and

  16. Roundtable discussion: what is the future role of the private sector in health?

    PubMed

    Stallworthy, Guy; Boahene, Kwasi; Ohiri, Kelechi; Pamba, Allan; Knezovich, Jeffrey

    2014-06-24

    The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage.This roundtable discussion offers diverse perspectives from a range of stakeholders--a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company--on what the future may hold for the private sector in health. The first perspective comes from a health funder, who argues that the discussion about the future role of the private sector has been bogged down in language. He argues for a 'both/and' approach rather than an 'either/or' when it comes to talking about health service provision in low- and middle-income countries.The second perspective is offered by an implementer of health insurance in sub-Saharan Africa. The piece examines the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term.Thirdly, a special advisor working in the federal government of Nigeria considers the situation in that country. He notes that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or forever be left behind.Finally, a representative from a multi-national pharmaceutical corporation gives an overview of global shifts that are creating opportunities for the private sector in health markets. Overall, the roundtable discussants agree that the private sector will play an important role in future health systems. But we must agree a common language, work together, and identify key issues and gaps that might be more effectively filled by the private sector.

  17. Is Satisfaction with the Acute-Care Experience Higher amongst Consumers Treated in the Private Sector? A Survey of Public and Private Sector Arthroplasty Recipients

    PubMed Central

    Naylor, Justine M.; Descallar, Joseph; Grootemaat, Mechteld; Badge, Helen; Harris, Ian A.; Simpson, Grahame; Jenkin, Deanne

    2016-01-01

    Background Consumer satisfaction with the acute-care experience could reasonably be expected to be higher amongst those treated in the private sector compared to those treated in the public sector given the former relies on high-level satisfaction of its consumers and their subsequent recommendations to thrive. The primary aims of this study were to determine, in a knee or hip arthroplasty cohort, if surgery in the private sector predicts greater overall satisfaction with the acute-care experience and greater likelihood to recommend the same hospital. A secondary aim was to determine whether satisfaction across a range of service domains is also higher in the private sector. Methods A telephone survey was conducted 35 days post-surgery. The hospital cohort comprised eight public and seven private high-volume arthroplasty providers. Consumers rated overall satisfaction with care out of 100 and likeliness to recommend their hospital on a 5-point Likert scale. Additional Likert-style questions were asked covering specific service domains. Generalized estimating equation models were used to analyse overall satisfaction (dichotomised as ≥ 90 or < 90) and future recommendations for care (dichotomised as ‘definitely recommend’ or ‘other’), whilst controlling for covariates. The proportions of consumers in each sector reporting the best Likert response for each individual domain were compared using non-parametric tests. Results 457 survey respondents (n = 210 private) were included. Less patient-reported joint impairment pre-surgery [OR 1.03 (95% CI 1.01–1.05)] and absence of an acute complication (OR 2.13 95% CI 1.41–3.23) significantly predicted higher overall satisfaction. Hip arthroplasty [OR 1.84 (1.1–2.96)] and an absence of an acute complication [OR 2.31 (1.28–4.17] significantly predicted greater likelihood for recommending the hospital. The only care domains where the private out-performed the public sector were hospitality (46.7 vs 35.6%, p <0

  18. Strategies for Involving the Private Sector in Job Training Programs.

    ERIC Educational Resources Information Center

    Greenwood, Katy; And Others

    This two-part report describes various strategies for involving the private sector in job training programs and summarizes a study conducted with prime sponsors of Comprehensive Employment and Training Act (CETA) programs in Texas. Included in a discussion of involving the private sector in job training programs are the following topics: the new…

  19. Is the public healthcare sector a more strenuous working environment than the private sector for a physician?

    PubMed

    Heponiemi, Tarja; Kouvonen, Anne; Sinervo, Timo; Elovainio, Marko

    2013-02-01

    The present study examined the differences between physicians working in public and private health care in strenuous working environments (presence of occupational hazards, physical violence, and presenteeism) and health behaviours (alcohol consumption, body mass index, and physical activity). In addition, we examined whether gender or age moderated these potential differences. Cross-sectional survey data were compiled on 1422 female and 948 male randomly selected physicians aged 25-65 years from The Finnish Health Care Professionals Study. Logistic regression and linear regression analyses were used with adjustment for gender, age, specialisation status, working time, managerial position, and on-call duty. Occupational hazards, physical violence, and presenteeism were more commonly reported by physicians working in the public sector than by their counterparts in the private sector. Among physicians aged 50 years or younger, those who worked in the public sector consumed more alcohol than those who worked in the private sector, whereas in those aged 50 or more the reverse was true. In addition, working in the private sector was most strongly associated with lower levels of physical violence in those who were older than 50 years, and with lower levels of presenteeism among those aged 40-50 years. The present study found evidence for the public sector being a more strenuous work environment for physicians than the private sector. Our results suggest that public healthcare organisations should pay more attention to the working conditions of their employees.

  20. Age of diagnosis of congenital hearing loss: Private v. public healthcare sector.

    PubMed

    Butler, I R T; Ceronio, D; Swart, T; Joubert, G

    2015-11-01

    The age of diagnosis of congenital hearing loss is one of the most important determinants of communication outcome. A previous study by the lead author had evaluated the performance of the public health services in Bloemfontein, South Africa (SA), in this regard. This study aimed to examine whether the private health services in the same city were any better. To determine whether the age of diagnosis of congenital hearing loss (CHL) in children seen in the private healthcare sector in Bloemfontein, Free State Province, SA, was lower than that in the public healthcare system in the same city. A comparative study design was utilised and a retrospective database review conducted. Data obtained from this study in the private healthcare sector were compared with data from a previous study in the public healthcare sector using the same study design. Forty-eight children aged <6 years with disabling hearing impairment (DHI) were identified in the private healthcare sector during the study period; 33/47 (70.2%) did not undergo hearing screening at birth. The median age of diagnosis of DHI in the private healthcare sector was 2.24 years, and this was statistically significantly lower than the median age of diagnosis of 3.71 years in the public healthcare sector (p<0.0001; 95% confidence interval (CI) 0.99-2.0). The median age of diagnosis of congenital hearing loss (CHL) in the private healthcare sector was 3.01 years in children who were not screened at birth, and 1.25 years in those who were screened at birth. This difference was statistically significant (p<0.01; 95% CI 0.72-2.47). We also compared the median age of diagnosis of CHL in children from the private healthcare sector who were not screened at birth (median 3.01 years) with that in children in the public healthcare sector (median 3.71 years). This difference was statistically significant (p<0.01; 95% CI 0.41-1.56). Children in the Free State are diagnosed with CHL at a younger age in the private healthcare

  1. 75 FR 67992 - Voluntary Private Sector Accreditation and Certification Preparedness Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2008-0017] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... on an initial small business plan to address small business concerns in the Voluntary Private Sector...

  2. 'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa.

    PubMed

    Ashmore, John

    2013-01-03

    There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the public sector. Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist 'dual practice', that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel 'needed' and 'relevant'. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the public sector. Policy recommendations center around boosting public sector resources and building trust of the public sector through including health workers more in decision-making, inter alia. These interventions may be more cost

  3. Exploring Ohio's Private Education Sector. School Survey Series

    ERIC Educational Resources Information Center

    Catt, Andrew D.

    2014-01-01

    Exploring Ohio's Private Education Sector is the second entry in the Friedman Foundation for Educational Choice's "School Survey Series." This report synthesizes information on Ohio's private schools collected by the U.S. Department of Education and the Ohio Department of Education (ODE). Two appendices provide supplementary tables and…

  4. 75 FR 80082 - State, Local, Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ..., Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: Information Security Oversight... State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC). The SLTPS-PAC will..., Tribal, and Private Sector Entities, as specified in Executive Order 13549 and its implementing directive...

  5. 78 FR 65218 - Defense Federal Acquisition Regulation Supplement: Private Sector Notification Requirements of In...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-31

    ... Federal Acquisition Regulation Supplement: Private Sector Notification Requirements of In-Sourcing Actions... Supplement (DFARS) to implement a section of the National Defense Authorization Act regarding private sector... section 938 of the National Defense Authorization Act (NDAA) for Fiscal Year 2012 regarding private sector...

  6. A Comparative Analysis of Financial Reporting Models for Private and Public Sector Organizations.

    DTIC Science & Technology

    1995-12-01

    The objective of this thesis was to describe and compare different existing and evolving financial reporting models used in both the public and...private sector. To accomplish the objective, this thesis identified the existing financial reporting models for private sector business organizations...private sector nonprofit organizations, and state and local governments, as well as the evolving financial reporting model for the federal government

  7. The Impact of Military Training on Veterans’ Earnings in the Private Sector: Is there Complimentarity Between Military and Private Training for Veterans

    DTIC Science & Technology

    1994-03-01

    thesis analyzed the complimentarity between military and post-military private sector training and the effect of military training on private sector wages...of data. The results of the thesis indicate that military training increases post-military private sector earnings of Veterans by 0.18 percent per...between military and post-service private sector training. When type of occupation is included in the models, the wage effect of military training fell to

  8. 78 FR 75376 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-11

    ...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC) AGENCY: National Archives... (NARA) announces a meeting of the State, Local, Tribal, and Private Sector Policy Advisory Committee... Information Program for State, Local, Tribal, and Private Sector Entities. The meeting will be open to the...

  9. Health promotion programme in the private workplaces in Singapore: a prevalence survey.

    PubMed

    Chew, L; Cheah, C; Koh, Y H

    2002-01-01

    A postal survey was conducted in 4,479 private companies with at least 50 employees in 1998 to determine the prevalence and the scope of workplace health promotion programme in these companies in Singapore. The self-administered questionnaire mailed to the study population covered five areas viz, organisational details, workplace health policies, health promotion and related activities, workplace health facilities and the source of assistance for the programme. The overall response was 49.5%. Parkinson's definition of workplace health promotion was used in the analysis to determine the prevalence of the programme. The data was collated on DBase IV and analysed using SPSS computer programmes. About one third of the respondents covering an estimated 26% of the private sector workforce had a comprehensive workplace health promotion programme as defined by Parkinson. This prevalence was a function of workforce size and industry type. Workplaces with larger workforce size (p<0.001) and those from the manufacturing and human/health service sectors (p<0.001) were more likely to have such programmes compared to their smaller counterparts and other industries respectively. The management remained the main driver behind these programmes. Many of the programmes were centred around health promoting policies and facilities with emphasis on occupational healthl safety and smoking issues. A significant proportion of workplaces surveyed had in place a comprehensive workplace health promotion programme. However, more could still be done to encourage its uptake such as training for facilitators, consultation, grant provision etc. Small workplaces remained an untapped market for such programmes.

  10. 2010 Staff Organization for Optimum C2: A Private Sector Analysis

    DTIC Science & Technology

    1998-02-13

    control over business operations. Warfighting CINCs can benefit from the lessons learned in the private sector by adapting those lessons to future military... private sector analysis. Through the use of a networked command and control system and a "matrix" staff structure, the model consolidates the JFC staff

  11. Dynamics of Private Sector Support for Education: Experiences in Latin America

    ERIC Educational Resources Information Center

    Brady, Kristin; Galisson, Kirsten

    2008-01-01

    Recognizing the diversity of models and strategies for private sector participation in education that have emerged in Latin America, the United States Agency for International Development (USAID) requested the Academy for Educational Development (AED) to conduct research with leaders in the public and private sectors in several countries. While…

  12. 76 FR 80971 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ..., Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records... made for the committee meeting of the State, Local, Tribal, and Private Sector Policy Advisory..., Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on January 18, 2012, 10 a.m...

  13. An Examination of Three Forms of Private Sector Financing of Military Facilities

    DTIC Science & Technology

    1988-09-01

    The purpose of this study was to introduce the concept of Private Sector Financing (PSF) of military facilities instead of acquiring facilities via... Private sector financing; Military construction; Leasing; Contracting out; Outleasing; Military family housing. Theses.

  14. Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

    PubMed

    Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur

    2007-01-01

    Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

  15. Trends in Private Sector Development in World Bank Education Projects. Policy Research Working Paper Series.

    ERIC Educational Resources Information Center

    Sosale, Shobhana

    The private sector is playing an increasingly important role in financing and providing educational services in many countries. (Often the term "private sector" encompasses households' out-of-pocket expenses rather than describing for-profit or not-for-profit sectors.) Private sector development has not arisen primarily through public…

  16. 77 FR 41204 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-12

    ..., Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: Information Security Oversight..., announcement is made for the committee meeting of the State, Local, Tribal, and Private Sector Policy Advisory..., Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on July 25, 2012, 10:00 a.m...

  17. Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings.

    PubMed

    Bennett, Adam; Avanceña, Anton L V; Wegbreit, Jennifer; Cotter, Chris; Roberts, Kathryn; Gosling, Roly

    2017-06-14

    In malaria elimination settings, all malaria cases must be identified, documented and investigated. To facilitate complete and timely reporting of all malaria cases and effective case management and follow-up, engagement with private providers is essential, particularly in settings where the private sector is a major source of healthcare. However, research on the role and performance of the private sector in malaria diagnosis, case management and reporting in malaria elimination settings is limited. Moreover, the most effective strategies for private sector engagement in malaria elimination settings remain unclear. Twenty-five experts in malaria elimination, disease surveillance and private sector engagement were purposively sampled and interviewed. An extensive review of grey and peer-reviewed literature on private sector testing, treatment, and reporting for malaria was performed. Additional in-depth literature review was conducted for six case studies on eliminating and neighbouring countries in Southeast Asia and Southern Africa. The private health sector can be categorized based on their commercial orientation or business model (for-profit versus nonprofit) and their regulation status within a country (formal vs informal). A number of potentially effective strategies exist for engaging the private sector. Conducting a baseline assessment of the private sector is critical to understanding its composition, size, geographical distribution and quality of services provided. Facilitating reporting, referral and training linkages between the public and private sectors and making malaria a notifiable disease are important strategies to improve private sector involvement in malaria surveillance. Financial incentives for uptake of rapid diagnostic tests and artemisinin-based combination therapy should be combined with training and community awareness campaigns for improving uptake. Private sector providers can also be organized and better engaged through social

  18. Private sector response against the cholera threat in Trinidad and Tobago.

    PubMed

    Hospedales, J; Holder, Y; Deyalsingh, I; Paul, R; Rosenbaum, J

    1993-01-01

    During the first half of 1992 the threat of cholera to Trinidad and Tobago prompted a strong health education effort by public authorities and the private sector. To help assess the private sector effort, the cost of cholera-related advertisements and private announcements placed in the country's two leading newspapers during January-June 1992 were reviewed. The review indicated that an estimated TT$ 540,660 was spent on these ads and announcements, that they contributed strongly to keeping cholera prevention continuously in the public eye, and that most of the messages published were accurate, specific, and safe. The strength and success of the private contribution to cholera prevention in this case suggests that similar approaches could be applied to other health problems and to the cholera problem outside Trinidad and Tobago. Overall, the lesson appears to be that if one can find congruence between private sector motives and public health interests, then the potential prospects for a successful partnership are great.

  19. Evaluation of Private Sector Roles in Space Resource Development

    NASA Astrophysics Data System (ADS)

    Lamassoure, Elisabeth S.; Blair, Brad R.; Diaz, Javier; Oderman, Mark; Duke, Michael B.; Vaucher, Marc; Manvi, Ramachandra; Easter, Robert W.

    2003-01-01

    An integrated engineering and financial modeling approach has been developed and used to evaluate the potential for private sector investment in space resource development, and to assess possible roles of the public sector in fostering private interest. This paper presents the modeling approach and its results for a transportation service using propellant extracted from lunar regolith. The analysis starts with careful case study definition, including an analysis of the customer base and market requirements, which are the basis for design of a modular, scalable space architecture. The derived non-recurring, recurring and operations costs become inputs for a `standard' financial model, as used in any commercial business plan. This model generates pro forma financial statements, calculates the amount of capitalization required, and generates return on equity calculations using two valuation metrics of direct interest to private investors: market enterprise value and multiples of key financial measures. Use of this model on an architecture to sell transportation services in Earth orbit based on lunar propellants shows how to rapidly test various assumptions and identify interesting architectural options, key areas for investment in exploration and technology, or innovative business approaches that could produce an economically viable industry. The same approach can be used to evaluate any other possible private ventures in space, and conclude on the respective roles of NASA and the private sector in space resource development and solar system exploration.

  20. Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC

    PubMed Central

    Garfinkel, Danielle; Thanel, Katherine; Esch, Keith; Workalemahu, Endale; Anyanti, Jennifer; Mpanya, Godéfroid; Binanga, Arsène; Pope, Jen; Longfield, Kim; Bertrand, Jane; Shaw, Bryan

    2018-01-01

    Background An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector’s role in increasing contraceptive coverage and choice. Methods In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price. Findings Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 41% of modern contraceptive stocking outlets were in the private sector compared with approximately 80% in Nigeria and DRC where drug shops were dominant. Ninety-five percent of private sector outlets in Ethiopia had modern contraceptive methods available; 37% had three or more methods. In Nigeria and DRC, only 54% and 42% of private sector outlets stocked modern contraceptives with 5% and 4% stocking three or more methods, respectively. High prices in Nigeria and DRC create barriers to consumer access and choice. Discussion There is a missed opportunity to provide modern contraception through the private sector, particularly drug shops. Subsidies and interventions, like social marketing and social franchising, could leverage the private sector’s role in increasing access to a range of contraceptives. Achieving global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private

  1. Enterprise Funds: Evolving Models for Private Sector Development in Central and Eastern Europe

    DTIC Science & Technology

    1994-03-01

    and Hungary to help private sector development in those countries. Enterprise funds for the former Czech and Slovak Federal Republic were created in...institutions are reluctant to invest. The enterprise funds are also to provide technical assistance for private sector development in the host country...Strategies of loan programs developed. Poland and Hungary had taken some steps toward the creation of a private sector before the collapse of communism

  2. United States private-sector physicians and pharmaceutical contract research: a qualitative study.

    PubMed

    Fisher, Jill A; Kalbaugh, Corey A

    2012-01-01

    There have been dramatic increases over the past 20 years in the number of nonacademic, private-sector physicians who serve as principal investigators on US clinical trials sponsored by the pharmaceutical industry. However, there has been little research on the implications of these investigators' role in clinical investigation. Our objective was to study private-sector clinics involved in US pharmaceutical clinical trials to understand the contract research arrangements supporting drug development, and specifically how private-sector physicians engaged in contract research describe their professional identities. We conducted a qualitative study in 2003-2004 combining observation at 25 private-sector research organizations in the southwestern United States and 63 semi-structured interviews with physicians, research staff, and research participants at those clinics. We used grounded theory to analyze and interpret our data. The 11 private-sector physicians who participated in our study reported becoming principal investigators on industry clinical trials primarily because contract research provides an additional revenue stream. The physicians reported that they saw themselves as trial practitioners and as businesspeople rather than as scientists or researchers. Our findings suggest that in addition to having financial motivation to participate in contract research, these US private-sector physicians have a professional identity aligned with an industry-based approach to research ethics. The generalizability of these findings and whether they have changed in the intervening years should be addressed in future studies. Please see later in the article for the Editors' Summary.

  3. Lost opportunity cost of surgical training in the Australian private sector.

    PubMed

    Aitken, R James

    2012-03-01

    To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  4. Public-Private Partnerships: The Private Sector and Innovation in Education. Policy Insight Number 142.

    ERIC Educational Resources Information Center

    David, Anna

    1992-01-01

    Partnerships between schools and the private sector as an alternative to increased taxes and service cuts are examined in this document. The introduction provides an overview of business involvement in U.S. education. The second section describes the private provision of infrastructure and types of school-business arrangements. Examples include…

  5. Willingness to pay for private primary care services in Hong Kong: are elderly ready to move from the public sector?

    PubMed

    Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M

    2013-10-01

    How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms.

  6. An Investigation of Conflict Management in Public and Private Sector Universities

    ERIC Educational Resources Information Center

    Din, Siraj ud; Khan, Bakhtiar; Rehman, Rashid; Bibi, Zainab

    2011-01-01

    The purpose of this paper is to gain an insight into the conflict management in public and private sector universities in Khyber Pakhtunkhwa, Pakistan. To achieve the earlier mentioned purpose, survey method was used with the help of questionnaire. In this research, impact of university type (public and private sector) was examined on the conflict…

  7. Does an expansion in private sector contraceptive supply increase inequality in modern contraceptive use?

    PubMed

    Agha, Sohail; Do, Mai

    2008-11-01

    To determine whether an expansion in private sector contraceptive supply is associated with increased socio-economic inequality in the modern contraceptive prevalence rate (MCPR inequality). Multiple rounds of Demographic and Health Surveys data were analysed for five countries that experienced an increase in the private sector supply of contraceptives: Morocco, Indonesia, Kenya, Ghana and Bangladesh. Information on household assets and amenities was used to construct wealth quintiles. A concentration index, which calculates the degree of inequality in contraceptive use by wealth, was calculated for each survey round. Socio-economic inequality in the MCPR (MCPR inequality) declined in Morocco and Indonesia, where substantial expansion in private sector contraceptive supply occurred. In both countries, poor women continued to rely heavily on contraceptives supplied by the public sector even as they increased use of contraceptives obtained from the private sector. A marginally significant decline in MCPR inequality occurred in Bangladesh, where the increase in private sector supply was modest. There was no significant overall change in MCPR inequality in Kenya or Ghana. In Kenya, this lack of significant overall change disguised trends moving in opposite directions in urban and rural areas. In urban Kenya, MCPR inequality declined as low-income urban women increased use of contraceptives obtained primarily from the public sector. In rural Kenya, MCPR inequality increased. This increase was associated with a decline in the supply of contraceptives by the public sector and non-governmental organizations to the poorest, rural, women. The study found no support for the hypothesis that an increase in private sector contraceptive supply leads to higher MCPR inequality. The findings suggest that continued public sector supply of contraceptives to the poorest women protects against increased MCPR inequality. The study highlights the role of the public sector in building

  8. Evaluating NASA Technology Programs in Terms of Private Sector Impacts

    NASA Technical Reports Server (NTRS)

    Greenberg, J. S.

    1984-01-01

    NASA is currently developing spacecraft technology for application to NASA scientific missions, military missions and commercial missions which are part of or form the basis of private sector business ventures. The justification of R&D programs that lead to spacecraft technology improvements encompasses the establishment of the benefits in terms of improved scientific knowledge that may result from new and/or improved NASA science missions, improved cost effectiveness of NASA and DOD missions and new or improved services that may be offered by the private sector (for example communications satellite services). It is with the latter of these areas that attention will be focused upon. In particular, it is of interest to establish the economic value of spacecraft technology improvements to private sector communications satellite business ventures. It is proposed to assess the value of spacecraft technology improvements in terms of the changes in cash flow and present value of cash flows, that may result from the use of new and/or improved spacecraft technology for specific types of private sector communications satellite missions (for example domestic point-to-point communication or direct broadcasting). To accomplish this it is necessary to place the new and/or improved technology within typical business scenarios and estimate the impacts of technical performance upon business and financial performance.

  9. Utilization of HIV-related services from the private health sector: A multi-country analysis.

    PubMed

    Wang, Wenjuan; Sulzbach, Sara; De, Susna

    2011-01-01

    Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. Sector Distinctions and the Privatization of Public Education Policymaking

    ERIC Educational Resources Information Center

    Lubienski, Christopher

    2016-01-01

    Current trends indicate declining distinctions between "public" and "private" sectors in education. Reformers see sector barriers as unnecessary impediments to innovation, distracting attention and effort from "what works". This analysis questions whether trends in education policy are simply a natural evolution away…

  11. Comparing VA and private sector healthcare costs for end-stage renal disease.

    PubMed

    Hynes, Denise M; Stroupe, Kevin T; Fischer, Michael J; Reda, Domenic J; Manning, Willard; Browning, Margaret M; Huo, Zhiping; Saban, Karen; Kaufman, James S

    2012-02-01

    Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; P<0.001), although levels were consistent with guidelines (Kt/V≥1.2). In adjusted analysis, the VA dialysis group had $36,431 higher costs than those in the private sector dialysis group (P<0.001). Continued research addressing costs and effectiveness of care across public and private sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD.

  12. United States Private-Sector Physicians and Pharmaceutical Contract Research: A Qualitative Study

    PubMed Central

    Fisher, Jill A.; Kalbaugh, Corey A.

    2012-01-01

    Background There have been dramatic increases over the past 20 years in the number of nonacademic, private-sector physicians who serve as principal investigators on US clinical trials sponsored by the pharmaceutical industry. However, there has been little research on the implications of these investigators' role in clinical investigation. Our objective was to study private-sector clinics involved in US pharmaceutical clinical trials to understand the contract research arrangements supporting drug development, and specifically how private-sector physicians engaged in contract research describe their professional identities. Methods and Findings We conducted a qualitative study in 2003–2004 combining observation at 25 private-sector research organizations in the southwestern United States and 63 semi-structured interviews with physicians, research staff, and research participants at those clinics. We used grounded theory to analyze and interpret our data. The 11 private-sector physicians who participated in our study reported becoming principal investigators on industry clinical trials primarily because contract research provides an additional revenue stream. The physicians reported that they saw themselves as trial practitioners and as businesspeople rather than as scientists or researchers. Conclusions Our findings suggest that in addition to having financial motivation to participate in contract research, these US private-sector physicians have a professional identity aligned with an industry-based approach to research ethics. The generalizability of these findings and whether they have changed in the intervening years should be addressed in future studies. Please see later in the article for the Editors' Summary. PMID:22911055

  13. PRIVATE SECTOR IN HEALTH CARE DELIVERY: A REALITY AND A CHALLENGE IN PAKISTAN.

    PubMed

    Shaikh, Babar Tasneem

    2015-01-01

    Under performance of the public sector health care system in Pakistan has created a room for private sector to grow and become popular in health service delivery, despite its questionable quality, high cost and dubious ethics of medical practice. Private sector is no doubt a reality; and is functioning to plug many weaknesses and gaps in health care delivery to the poor people of Pakistan. Yet, it is largely unregulated and unchecked due to the absence of writ of the state. In spite of its inherent trait of profit making, the private sector has played a significant and innovative role both in preventive and curative service provision. Private sector has demonstrated great deal of responsiveness, hence creating a relation of trust with the consumers of health in Pakistan, majority of who spend out of their pocket to buy 'health'. There is definitely a potential to engage and involve private and non-state entities in the health care system building their capacities and instituting regulatory frameworks, to protect the poor's access to health care system.

  14. Evaluating the benefits of government funded R & D aimed at the private sector

    NASA Technical Reports Server (NTRS)

    Greenberg, J. S.

    1977-01-01

    Federal funding of technological research and development is discussed with regard to the procedures for an economic analysis with the goals of (1) determining when the public sector should invest in a research and development program, (2) evaluating the likelihood of private sector participation in terms of public sector participation, and (3) considering the major factors in the formulation of a research and development program in terms of defining initiatives. Public sector investments are evaluated, noting procedures for determining whether benefits exceed costs. The role of the public sector research and development planning is described, considering the procedure for private sector implementation decisions and a methodology for evaluating the possibility of private sector commercialization. The economic value of the public sector research and development program is presented with attention given to a specific case of NASA-sponsored research and development aimed toward the commercialization of new public communications services.

  15. Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

    PubMed

    Bustreo, Flavia; Harding, April; Axelsson, Henrik

    2003-01-01

    The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations.

  16. Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

    PubMed Central

    Bustreo, Flavia; Harding, April; Axelsson, Henrik

    2003-01-01

    The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

  17. Government Investment in Manufacturing: Stimulus or Hindrance to Pakistan’s Private Sector?

    DTIC Science & Technology

    1999-01-01

    private sector , but it also has diverted funds away from productive activities that would most likely have encouraged a follow-on expansion in private investment. Has the expansion of private investment in manufacturing increased the profitability of investment in other key sectors of the economy? And, if so, in which areas? Has government investment in manufacturing produced similar effects? Would a diversion of public investment funds from manufacturing to areas supporting private investment (energy, infrastructure) stimulate greater amounts of private investment, and if

  18. Reducing Avoidable Deaths Among Veterans: Directing Private-Sector Surgical Care to High-Performance Hospitals

    PubMed Central

    Weeks, William B.; West, Alan N.; Wallace, Amy E.; Lee, Richard E.; Goodman, David C.; Dimick, Justin B.; Bagian, James P.

    2007-01-01

    Objectives. We quantified older (65 years and older) Veterans Health Administration (VHA) patients’ use of the private sector to obtain 14 surgical procedures and assessed the potential impact of directing that care to high-performance hospitals. Methods. Using a merged VHA–Medicare inpatient database for 2000 and 2001, we determined where older VHA enrollees obtained 6 cardiovascular surgeries and 8 cancer resections and whether private-sector care was obtained in high- or low-performance hospitals (based on historical performance and determined 2 years in advance of the service year). We then modeled the mortality and travel burden effect of directing private-sector care to high-performance hospitals. Results. Older veterans obtained most of their procedures in the private sector, but that care was equally distributed across high- and low-performance hospitals. Directing private-sector care to high-performance hospitals could have led to the avoidance of 376 to 584 deaths, most through improved cardiovascular care outcomes. Using historical mortality to define performance would produce better outcomes with lower travel time. Conclusions. Policy that directs older VHA enrollees’ private-sector care to high-performance hospitals promises to reduce mortality for VHA’s service population and warrants further exploration. PMID:17971543

  19. Job Values in Today's Workforce: A Comparison of Public and Private Sector Employees.

    ERIC Educational Resources Information Center

    Karl, Katherine A.; Sutton, Cynthia L.

    1998-01-01

    A comparison of 47 public- and 170 private-sector workers revealed private-sector workers value good wages most and public-sector workers value interesting work. Results suggest that employers must keep in touch with employee values to design jobs, reward systems, and human-resource policies that will result in maximum job satisfaction. (JOW)

  20. Contractor Past Performance Information (PPI) in Source Selection: A Comparison Study of Public and Private Sector

    DTIC Science & Technology

    2005-05-01

    efficiencies similar to those in the private sector . However, along the way, Government and private sector industry have begun to disagree about how PPI is...double that of the private sector due to an evaluation process that is cumbersome, time-consuming, and lacking the efficiencies enjoyed by private

  1. Private sector surgical training: feasibility through the lens of appendicectomy.

    PubMed

    Yap, Raymond; Cullinan, Mark

    2017-12-01

    Training in medicine and surgery has been a public hospital responsibility in Australia. Increasing specialist training needs has led to pressure on speciality societies to find additional training posts, with one utilized solution being the establishment of private hospital training. This growing use has been despite no previously published evaluations of private hospital training in Australia. This article seeks to evaluate the feasibility of surgical training in private hospitals in appendicectomy. Data were prospectively collected on registrar involvement in appendicectomy cases at a single private tertiary institution over 1 year. These data were divided into groups according to registrar involvement and analysed, looking at training caseload, operating theatre time and complications. A total of 122 cases were analysed over the study period. Registrars were more likely to have increased primary operator responsibility if they were an accredited versus unaccredited registrar (P = 0.04) and if the case was open versus laparoscopic (P < 0.001). There was an increase of 15% in total procedure time when the registrar was involved (P = 0.04). There was no significant difference in complications whether the registrar was involved or not. Training in the private sector in Australia appears feasible, with a small loss of efficiency and no increase in complications. This article hopes to further encourage implementation and evaluation of private sector training programs to expand current training positions. Further studies, in different specialty and procedural domains, are needed to assess and evaluate the ongoing feasibility of private sector training. © 2016 Royal Australasian College of Surgeons.

  2. Health reform and cesarean sections in the private sector: The experience of Peru.

    PubMed

    Arrieta, Alejandro

    2011-02-01

    To test the hypothesis that the health reform enacted in Peru in 1997 increased the rate of cesarean sections in the private sector due to non-clinical factors. Different rounds of the Demographic and Health Survey are used to estimate determinants of c-section rates in private and public facilities before and after the healthcare reform. Estimations are based on a pooled linear regression controlling by obstetric and socioeconomic characteristics. C-section rates in the private sector grew from 28 to 53% after the health reform. Compared to the Ministry of Health (MOH), giving birth in a private hospital in the post-reform period adds 19% to the probability of c-section. The health reform implemented in the private sector increased physician incentives to over-utilize c-sections. The reform consolidated and raised the market power of private health insurers, but at the same time did not provide mechanisms to enlarge, regulate and disclose information of private providers. All these factors created the conditions for fee-for-service paid providers to perform more c-sections. Comparable trends in c-section rates have been observed in Latin American countries who implemented similar reforms in their private sector, suggesting a need to rethink the role of private health providers in developing countries. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Combining DRGs and per diem payments in the private sector: the Equitable Payment Model.

    PubMed

    Hanning, Brian W T

    2005-02-01

    The many types of payment models used in the Australian private sector are reviewed. Their features are compared and contrasted to those desirable in an optimal private sector payment model. The EPM(TM) (Equitable Payment Model) is discussed and its consistency with the desirable features of an optimal private sector payment model outlined. These include being based on a robust classification system, nationally benchmarked length of stay (LOS) results, nationally benchmarked relative cost and encouraging continual improvement in efficiency to the benefit of both health funds and private hospitals. The advantages in the context of the private sector of EPM(TM) being a per diem model, albeit very different to current per diem models, are discussed. The advantages of EPM(TM) for hospitals and health funds are outlined.

  4. Caring for veterans in the private sector.

    PubMed

    Rivera, Maggie Leonard; Coplan, Bettie

    2015-11-01

    Veterans have several significant healthcare needs that can be addressed in the primary care setting. Within the private sector, clinicians can use military and nonmilitary resources to provide care to this unique population. Recommendations for several veteran healthcare needs also are addressed.

  5. Engagement of the private pharmaceutical sector for TB control: rhetoric or reality?

    PubMed

    Konduri, Niranjan; Delmotte, Emily; Rutta, Edmund

    2017-01-01

    Private-sector retail drug outlets are often the first point of contact for common health ailments, including tuberculosis (TB). Systematic reviews on public-private mix (PPM) interventions for TB did not perform in-depth reviews specifically on engaging retail drug outlets and related stakeholders in the pharmaceutical sector. Our objective was to better understand the extent to which the World Health Organization's (WHO) recommendation on engaging retail drug outlets has been translated into programmatic policy, strategy, and intervention in low- and middle-income countries. The study included a content analysis of global-level documents from WHO and the Stop TB Partnership in five phases. A country-level content analysis from four data sources was performed. Global-level findings were tabulated based on key messages related to engaging retail drug outlets. Country-level findings were analyzed based on four factors and tabulated. National strategic plans for TB control from 14 countries with varying TB burdens and a strong private sector were reviewed. 33 global-level documents and 77 full-text articles and Union World Lung Health conference abstracts were included for review. Based on experience of engaging retail drug outlets that has emerged since the mid-2000s, in 2011 WHO and the International Pharmaceutical Federation released a joint statement on promoting the engagement of national pharmacy associations in partnership with national TB programs. Only two of 14 countries' national strategic plans had explicit statements on the need to engage their national pharmacy professional association. The success rate of referrals from retail drug outlets who visited an approved health facility for TB screening ranged from 48% in Vietnam to 86% in Myanmar. Coverage of retail drug outlets ranged from less than 5 to 9% of the universe of retail drug outlets. For WHO's End TB Strategy to be successful, scaling up retail drug outlets to increase national coverage, at

  6. Using Internet-Based Language Testing Capacity to the Private Sector

    ERIC Educational Resources Information Center

    Garcia Laborda, Jesus

    2009-01-01

    Language testing has a large number of commercial applications in both the institutional and the private sectors. Some jobs in the health services sector or the public services sector require foreign language skills and these skills require continuous and efficient language assessments. Based on an experience developed through the cooperation of…

  7. The Generalizability of Private Sector Research on Software Project Management in Two USAF Organizations: An Exploratory Study

    DTIC Science & Technology

    2003-03-01

    private sector . Researchers have also identified software acquisitions as one of the major differences between the private sector and public sector MIS. This indicates that the elements for a successful software project in the public sector may be different from the private sector . Private sector project success depends on many elements. Three of them are user interaction with the project’s development, critical success factors, and how the project manager prioritizes the traditional success criteria.

  8. System Expertise Training Courses in Private Sector: Can They Be Given Online?

    ERIC Educational Resources Information Center

    Balci Demirci, Birim

    2014-01-01

    It is widely known that there are many schools in the private sector offering courses in Computer Technology, Computer Engineering, Information Systems and similar disciplines in addition to Universities presenting such courses. The private sector programs are extremely popular with students already studying at university as well as being of great…

  9. Advanced Traveler Information Service (ATIS) : private sector perceptions and public sector activities

    DOT National Transportation Integrated Search

    2000-01-01

    This paper presents the results of a study by the United States Department of Transportation Volpe Center to determine the nature and extent of the data gap between the needs of private sector Advanced Traveler Information Service (ATIS) provid...

  10. Role of the private sector in the provision of immunization services in low- and middle-income countries.

    PubMed

    Levin, Ann; Kaddar, Miloud

    2011-07-01

    The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization

  11. Acute appendicitis in the public and private sectors in Cape Town, South Africa.

    PubMed

    Yang, Estin; Cook, Colin; Kahn, Delawir

    2015-07-01

    South Africa has a low incidence of acute appendicitis, but poor outcomes. However, South African studies on appendicitis focus solely on public hospitals, neglecting those who utilize private facilities. This study aims to compare appendicitis characteristics and outcomes in public and private hospitals in South Africa. A prospective cohort study was conducted among two public and three private hospitals in the Cape Town metropole, from September 2013 to March 2014. Hospital records, operative notes, and histology results were reviewed for patients undergoing appendectomy for acute appendicitis. Patients were interviewed during their hospitalization and followed up at monthly intervals until normal function was attained. A total of 134 patients were enrolled, with 73 in the public and 61 in the private sector. Education and employment were higher among private sector patients. Public sector patients had a higher rupture rate (30.6 vs 13.2 %, p = 0.023). Times to presentation were not statistically different between the two cohorts. Public sector patients had longer hospital stays (5.3 vs 2.9 days, p = 0.036) and longer return to work times (23.0 vs 12.1 days, p < 0.0001). Although complication rates were similar, complications in public hospitals were more severe. Public sector patients in South Africa with appendicitis have higher rupture rates, worse complications, longer hospital stays, and longer recoveries than private sector patients. Patients with perforation had longer delays in presentation than patients without perforation.

  12. The USWRP Workshop on the Weather Research Needs of the Private Sector.

    NASA Astrophysics Data System (ADS)

    Pielke, Roger A., Jr.; Abraham, Jim; Abrams, Elliot; Block, Jim; Carbone, Richard; Chang, David; Droegemeier, Kelvin; Emanuel, Kerry; Friday, Elbert W. Joe, Jr.; Gall, Robert; Gaynor, John; Getz, Rodger R.; Glickman, Todd; Hoggatt, Bradley; Hooke, William H.; Johnson, Edward R.; Kalnay, Eugenia; Kimpel, James Jeff; Kocin, Paul; Marler, Byron; Morss, Rebecca; Nathan, Ravi; Nelson, Steve; Pielke, Roger, Sr.; Pirone, Maria; Prater, Erwin; Qualley, Warren; Simmons, Kevin; Smith, Michael; Thomson, John; Wilson, Greg

    2003-07-01

    Private sector meteorology is a rapidly growing enterprise. It has been estimated that the provision of weather information has, by some estimates, a global market totaling in the billions of dollars. Further, the decisions based on such information could easily total trillions of dollars in the U.S. economy alone. The private sector clearly plays an important, and growing, role at the interface of weather research and the weather information needs of society. To date, little information has been paid to the connections of the meteorological research community and the scientific needs of the private sector. Thus, the time is ripe to stimulate a more active dialogue between what is generally considered the "basic" research community of physical and social scientists and those individuals and businesses that provide weather information to myriad customers across the U.S. economy. In December 2000, the U.S. Weather Research Program (supported by NSF, NOAA, NASA, and the U.S. Navy) sponsored a workshop in Palm Springs, California, to bring together weather researchers and representatives of private sector meteorology to discuss needs, wants, opportunities, and challenges and how to enhance the linkages between the two relatively detached communities. The workshop focused on developing a better understanding of the relations of research and private sector meteorology, which ultimately means a better understanding of one of the important connections of research and societal needs.

  13. Harnessing the private health sector by using prices as a policy instrument: Lessons learned from South Africa.

    PubMed

    Barber, Sarah L; Kumar, Ankit; Roubal, Tomas; Colombo, Francesca; Lorenzoni, Luca

    2018-05-01

    Governments frequently draw upon the private health care sector to promote sustainability, optimal use of resources, and increased choice. In doing so, policy-makers face the challenge of harnessing resources while grappling with the market failures and equity concerns associated with private financing of health care. The growth of the private health sector in South Africa has fundamentally changed the structure of health care delivery. A mutually reinforcing ecosystem of private health insurers, private hospitals and specialists has grown to account for almost half of the country's spending on health care, despite only serving 16% of the population with the capacity to pay. Following years of consolidation among private hospital groups and insurance schemes, and after successive failures at establishing credible price benchmarks, South Africa's private hospitals charge prices comparable with countries that are considerably richer. This compromises the affordability of a broad-based expansion in health care for the population. The South African example demonstrates that prices can be part of a structure that perpetuates inequalities in access to health care resources. The lesson for other countries is the importance of norms and institutions that uphold price schedules in high-income countries. Efforts to compromise or liberalize price setting should be undertaken with a healthy degree of caution. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Government stewardship of the for-profit private health sector in Afghanistan

    PubMed Central

    Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C.; Sears, Kathleen; Sharma, Suneeta

    2017-01-01

    Abstract Background: Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. Aim: We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. Methods: We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. Results: The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. Conclusions: The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that

  15. Government stewardship of the for-profit private health sector in Afghanistan.

    PubMed

    Cross, Harry E; Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C; Sears, Kathleen; Sharma, Suneeta

    2017-04-01

    Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a

  16. Technical quality of delivery care in private- and public-sector health facilities in Enugu and Lagos States, Nigeria.

    PubMed

    Hirose, Atsumi; Yisa, Ibrahim O; Aminu, Amina; Afolabi, Nathanael; Olasunmbo, Makinde; Oluka, George; Muhammad, Khalilu; Hussein, Julia

    2018-06-01

    Private-sector providers are increasingly being recognized as important contributors to the delivery of healthcare. Countries with high disease burdens and limited public-sector resources are considering using the private sector to achieve universal health coverage. However, evidence for the technical quality of private-sector care is lacking. This study assesses the technical quality of maternal healthcare during delivery in public- and private-sector facilities in resource-limited settings, from a systems and programmatic perspective. A summary index (the skilled attendance index, SAI), was used. Two-staged cluster sampling with stratification was used to select representative samples of case records in public- and private-sector facilities in Enugu and Lagos States, Nigeria. Information to assess criteria was extracted, and the SAI calculated. Linear regression models examined the relationship between SAI and the private and public sectors, controlling for confounders. The median SAI was 54.8% in Enugu and 85.7% in Lagos. The private for-profit sector's SAI was lower than and the private not-for-profit sector's SAI was higher than the public sector in Enugu [coefficient = -3.6 (P = 0.018) and 12.6 (P < 0.001), respectively]. In Lagos, the private for-profit sector's SAI was higher and the private not-for-profit sector's SAI was lower than the public sector [3.71 (P = 0.005) and -3.92 (P < 0.001)]. Results indicate that the technical quality of private for-profit providers' care was poorer than public providers where the public provision of care was weak, while private for-profit facilities provided better technical quality care than public facilities where the public sector was strong and there was a relatively strong regulatory body. Our findings raise important considerations relating to the quality of maternity care, the public-private mix and needs for regulation in global efforts to achieve universal healthcare.

  17. The Social Security Program and the Private Sector Alternative: Lessons from History.

    ERIC Educational Resources Information Center

    Quadagno, Jill

    1987-01-01

    Used historical evidence to analyze how private sector benefits worked in the past in light of the debate surrounding the Social Security benefits and the federal deficit. Among conclusions reached are that the private sector failed to provide adequate protection for older citizens, and that benefits were inequitably distributed on basis of gender…

  18. How Old Is Old? Employing Elderly Teachers in the Private Sector Schools in Sri Lanka

    ERIC Educational Resources Information Center

    Madhuwanthi, L. A. P.

    2016-01-01

    The purpose of this paper is to explore why private sector schools in Sri Lanka employ elderly teachers (ETs). This paper used semi-structured in-depth interviews with 9 employers/principals in the private sector schools in Sri Lanka. The study found that the reasons for employing ETs in the private sector schools were shortfall of English medium…

  19. Cross-sector partnerships and public health: challenges and opportunities for addressing obesity and noncommunicable diseases through engagement with the private sector.

    PubMed

    Johnston, Lee M; Finegood, Diane T

    2015-03-18

    Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these.

  20. Profiles of Regional Efficiency in Pakistan: Comparison of Public and Private Sector Manufacturing Firms

    DTIC Science & Technology

    1994-01-01

    Public and Private Sector Manufacturing Firms 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...REGIONAL EFFICIENCY IN PAKISTAN: COMPARISON OF PUBLIC AND PRIVATE SECTOR MANUFACTURING FIRMS by Robert E. Looney In an examination of the relative...efficiency in public and private sector enter- prises should be explored in more detail. In this vein the purpose of the analysis below is to examine the

  1. Private Sector Engagement: An Approach

    NASA Astrophysics Data System (ADS)

    Benjamin, G.

    2016-12-01

    Public health organizations serve as scientific societies as a major part of their core mission. In addition, mobilizing partners to identify health threats and to work collaboratively to improve community health involves engagement of a variety of partners including those in the private sector. Increased concerns about conflicts of interest, transparency and undue influence are emerging as a major concern. This presentation will explore one framework for decision making to minimize risks and enhancing independence in scientific inquiry and public health programming.

  2. Lessons from the other side: what can we learn from the private sector?

    PubMed

    Clarke, D

    1999-01-01

    Business has reacted in an impressive manner to increasing globalisation, short-term stock market pressure for performance, emerging industries and new technologies. While the private sector has become increasingly competitive, the public sector has not adopted this commercial rigour. Funding pressures on health services will continue, as will increasing consumer and staff demands and the blurring of public and private health care provision. As a result, there are lessons and techniques the public and private health sectors should learn from each other. I have drawn the issues that follow from my experience in the steel and food industries.

  3. Development of Private Higher Education in Macau: Exploring the Relationship between Government and Private Sector

    ERIC Educational Resources Information Center

    Lau, Cheng Man Diana; Yuen, Pong Kau

    2010-01-01

    The development of private higher education in Macau has experienced rapid growth in the past two decades. The purpose of this paper is to understand this trend by investigating the facts and figures supplied by official sources and to analyze the role between the Government and the private sector. This paper shows that the attitude of the Macau…

  4. Who pays when VA users are hospitalized in the private sector? Evidence from three data sources.

    PubMed

    West, Alan N; Weeks, William B

    2007-10-01

    Older veterans enrolled in VA healthcare receive much of their medical care in the private sector, through Medicare. Less is known about younger VA enrollees' use of the private sector, or its funding. We compare payers for younger and older enrollees' private sector use in 3 hospitalization datasets. From 1998 to 2000, using private sector discharge data for VA enrollees in New York State, we categorized hospitalizations according to payer (self/family, private insurance, Medicare, Medicaid, other sources). We compared this payer distribution to population-weighted national Medical Expenditure Panel Survey (MEPS) data from 1996-2003 for veterans in VA healthcare. We also compared Medicare utilization in either dataset to hospitalizations for New York veterans from 1998-2000 in the VA-Medicare dataset. Analyses separated patients younger than age 65 from those age 65 or older. VA enrollees under age 65 obtain roughly half their hospitalizations in the private sector; older enrollees use the private sector at least twice as often as the VA. Datasets generally agree on payer distributions. Although older enrollees rely heavily on Medicare, they also use commercial insurance and self/family payments substantially. Half of younger enrollees' non-VA hospitalizations are paid by private insurance, but Medicare, Medicaid, and self/family each pay for one-quarter to one-third of admissions. VA enrollees use the private sector for most of their inpatient care, which is funded by multiple sources. Developing a national UB-92/VA dataset would be critical to understanding veterans' use of the private sector for specific diagnoses and procedures, particularly for the fast growing population of younger veterans.

  5. Implications of private sector Hib vaccine coverage for the introduction of public sector Hib-containing pentavalent vaccine in India: evidence from retrospective time series data

    PubMed Central

    Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Hasan Farooqui, Habib; Zodpey, Sanjay P

    2015-01-01

    Objective Haemophilus influenzae type b (Hib) vaccine has been available in India's private sector market since 1997. It was not until 14 December 2011 that the Government of India initiated the phased public sector introduction of a Hib (and DPT, diphtheria, pertussis, tetanus)-containing pentavalent vaccine. Our objective was to investigate the state-specific coverage and behaviour of Hib vaccine in India when it was available only in the private sector market but not in the public sector. This baseline information can act as a guide to determine how much coverage the public sector rollout of pentavalent vaccine (scheduled April 2015) will need to bear in order to achieve complete coverage. Setting 16 of 29 states in India, 2009–2012. Design Retrospective descriptive secondary data analysis. Data (1) Annual sales of Hib vaccines, by volume, from private sector hospitals and retail pharmacies collected by IMS Health and (2) national household surveys. Outcome measures State-specific Hib vaccine coverage (%) and its associations with state-specific socioeconomic status. Results The overall private sector Hib vaccine coverage among the 2009–2012 birth cohort was low (4%) and varied widely among the studied Indian states (minimum 0.3%; maximum 4.6%). We found that private sector Hib vaccine coverage depends on urban areas with good access to the private sector, parent's purchasing capacity and private paediatricians’ prescribing practices. Per capita gross domestic product is a key explanatory variable. The annual Hib vaccine uptake and the 2009–2012 coverage levels were several times higher in the capital/metropolitan cities than the rest of the state, suggesting inequity in access to Hib vaccine delivered by the private sector. Conclusions If India has to achieve high and equitable Hib vaccine coverage levels, nationwide public sector introduction of the pentavalent vaccine is needed. However, the role of private sector in universal Hib vaccine coverage is

  6. Public-private sector interactions and the demand for supplementary health insurance in the United Kingdom.

    PubMed

    Bíró, Anikó; Hellowell, Mark

    2016-07-01

    We examine the demand for private health insurance (PHI) in the United Kingdom and relate this to changes in the supply of public and private healthcare. Using a novel collection of administrative, private sector and survey data, we re-assess the relationships between the quality and availability of public and private sector inpatient care, and the demand for PHI. We find that PHI coverage in the United Kingdom is positively related to the median of the region- and year-specific public sector waiting times. We find that PHI prevalence ceteris paribus increases with being self-employed and employed, while it decreases with having financial difficulties. In addition, we highlight the complexities of inter-sectoral relations and their impact on PHI demand. Within a region, we find that an increase in private healthcare supply is associated with a decrease in public sector waiting times, implying lower PHI demand. This may be explained by the usage of private facilities by NHS commissioners. These results have important implications for policymakers interested in the role of private healthcare supply in enhancing the availability of and equitable access to acute inpatient care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. 48 CFR 37.112 - Government use of private sector temporaries.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... REGULATION SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.112 Government... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Government use of private... service firms for the brief or intermittent use of the skills of private sector temporaries. Services...

  8. Addressing cargo security with strategies involving private sector.

    DOT National Transportation Integrated Search

    2008-12-01

    The public and private sectors contributing to goods movement agree that cargo security has : not been addressed nearly as much as physical and vessel security. Addressing cargo security : will require additional operational data that is not currentl...

  9. Gender Differences in Pay among Recent Graduates: Private Sector Employees in Ireland

    ERIC Educational Resources Information Center

    Russell, Helen; Smyth, Emer; O'Connell, Philip J.

    2010-01-01

    In this paper we seek to investigate the role of different factors in accounting for the differences in earnings among recent graduates working in the private sector in Ireland. Three years after graduation there is a pay gap of 8 per cent in hourly wages between male and female graduates in the private sector and a 4 per cent non-significant gap…

  10. A study on moral hazard in dentistry: costs of care in the private and the public sector.

    PubMed

    Tuominen, Risto; Eriksson, Anna-Leena

    2011-10-01

    The aim of this study was to evaluate the costs of subsidized care for an adult population provided by private and public sector dentists. A sample of 210 patients was drawn systematically from the waiting list for nonemergency dental treatment in the city of Turku. Questionnaire data covering sociodemographic background, dental care utilization and marginal time cost estimates were combined with data from patient registers on treatment given. Information was available on 104 patients (52 from each of the public and the private sectors). The overall time taken to provide treatment was 181 days in the public sector and 80 days in the private sector (P<0.002). On average, public sector patients had significantly (P < 0.01) more dental visits (5.33) than private sector patients (3.47), which caused higher visiting fees. In addition, patients in the public sector also had higher other out-of-pocket costs than in the private sector. Those who needed emergency dental treatment during the waiting time for comprehensive care had significantly more costly treatment and higher total costs than the other patients. Overall time required for dental visits significantly increased total costs. The total cost of dental care in the public sector was slightly higher (P<0.05) than in the private sector. There is no direct evidence of moral hazard on the provider side from this study. The observed cost differences between the two sectors may indicate that private practitioners could manage their publicly funded patients more quickly than their private paying patients. On the other hand, private dentists providing more treatment per visit could be explained by private dentists providing more than is needed by increasing the content per visit. © 2011 John Wiley & Sons A/S.

  11. Accelerated reforms in healthcare financing: the need to scale up private sector participation in Nigeria.

    PubMed

    Ejughemre, Ufuoma John

    2014-01-01

    The health sector, a foremost service sector in Nigeria, faces a number of challenges; primarily, the persistent under-funding of the health sector by the Nigerian government as evidence reveals low allocations to the health sector and poor health system performance which are reflected in key health indices of the country.Notwithstanding, there is evidence that the private sector could be a key player in delivering health services and impacting health outcomes, including those related to healthcare financing. This underscores the need to optimize the role of private sector in complementing the government's commitment to financing healthcare delivery and strengthening the health system in Nigeria. There are also concerns about uneven quality and affordability of private-driven health systems, which necessitates reforms aimed at regulation. Accordingly, the argument is that the benefits of leveraging the private sector in complementing the national government in healthcare financing outweigh the challenges, particularly in light of lean public resources and finite donor supports. This article, therefore, highlights the potential for the Nigerian government to scale up healthcare financing by leveraging private resources, innovations and expertise, while working to achieve the universal health coverage.

  12. The quality of family planning services and client satisfaction in the public and private sectors in Kenya.

    PubMed

    Agha, Sohail; Do, Mai

    2009-04-01

    To compare the quality of family planning services delivered at public and private facilities in Kenya. Data from the 2004 Kenya Service Provision Assessment were analysed. The Kenya Service Provision Assessment is a representative sample of health facilities in the public and private sectors, and comprises data obtained from a facility inventory, service provider interviews, observations of client-provider interactions and exit interviews. Quality-of-care indicators are compared between the public and private sectors along three dimensions: structure, process and outcome. Private facilities were superior to public sector facilities in terms of physical infrastructure and the availability of services. Public sector facilities were more likely to have management systems in place. There was no difference between public and private providers in the technical quality of care provided. Private providers were better at managing interpersonal aspects of care. The higher level of client satisfaction at private facilities could not be explained by differences between public and private facilities in structural and process aspects of care. Formal private sector facilities providing family planning services exhibit greater readiness to provide services and greater attention to client needs than public sector facilities in Kenya. Consistent with this, client satisfaction is much higher at private facilities. Technical quality of care provided is similar in public and private facilities.

  13. Comparing the Costs of Military Treatment Facilities with Private Sector Care

    DTIC Science & Technology

    2016-02-01

    Log: H 15-000527 Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie INSTITUTE FOR DEFENSE ANALYSES 4850 Mark...other national challenges. Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie I N S T I T U T E F O R D...members. The latter benefit, known as TRICARE, serves 9.5 million beneficiaries worldwide, and consists of care in Military Treatment Facilities (MTFs

  14. Region IV Transit Workshop: Harnessing the Private Sector

    DOT National Transportation Integrated Search

    1988-09-01

    This Report constitutes the Proceedings of the Region IV Transit Workshop: : Harnessing the Private Sector. Included in this document is a general report of : the activities of the Workshop. : The purpose ot the Region IV Transit Workshop: Harnessing...

  15. 31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the...' Compensation Funds § 50.33 Entities that do not share profits and losses with private sector insurers. (a... share profits and losses with a private sector insurer is deemed to be a separate insurer under the...

  16. Analyzing Differences Between Public and Private Sector Information Resource Management: Chief Information Officer Challenges and Critical Technologies

    DTIC Science & Technology

    2002-01-01

    Private sector organizations have a valuable knowledge base from their CIO office implementation efforts and subsequent operations. This private sector knowledge could offer public sector CIOs invaluable insight into successful information resource management practices. However, public and private managers must take great care in deciphering which IRM prescriptions are relevant to their organizational situation. The goal of this research is to discover if public and private sector CIOs are faced with the same challenges and view

  17. Educating the future public health workforce: do schools of public health teach students about the private sector?

    PubMed

    Rutkow, Lainie; Traub, Arielle; Howard, Rachel; Frattaroli, Shannon

    2013-01-01

    Recent surveys indicate that approximately 40% of graduates from schools of public health are employed within the private sector or have an employer charged with regulating the private sector. These data suggest that schools of public health should provide curricular opportunities for their students--the future public health workforce--to learn about the relationship between the private sector and the public's health. To identify opportunities for graduate students in schools of public health to select course work that educates them about the relationship between the private sector and public health. We systematically identified and analyzed data gathered from publicly available course titles and descriptions on the Web sites of accredited schools of public health. Data were collected in the United States. The sample consisted of accredited schools of public health. Descriptions of the number and types of courses that schools of public health offer about the private sector and identification of how course descriptions frame the private sector relative to public health. We identified 104 unique courses with content about the private sector's relationship to public health. More than 75% of accredited schools of public health offered at least 1 such course. Nearly 25% of identified courses focused exclusively on the health insurance industry. Qualitative analysis of the data revealed 5 frames used to describe the private sector, including its role as a stakeholder in the policy process. Schools of public health face a curricular gap, with relatively few course offerings that teach students about the relationship between the private sector and the public's health. By developing new courses or revising existing ones, schools of public health can expose the future public health workforce to the varied ways public health professionals interact with the private sector, and potentially influence students' career paths.

  18. Public and private sector contributions to the discovery and development of "impact" drugs.

    PubMed

    Reichert, Janice M; Milne, Christopher-Paul

    2002-01-01

    Recently, well-publicized reports by Public Citizen and the Joint Economic Committee (JEC) of the US Congress questioned the role of the drug industry in the discovery and development of therapeutically important drugs. To gain a better understanding of the relative roles of the public and private sectors in pharmaceutic innovation, the Tufts Center for the Study of Drug Development evaluated the underlying National Institutes of Health (NIH) and academic research cited in the Public Citizen and JEC reports and performed its own assessment of the relationship between the private and public sectors in drug discovery and development of 21 "impact" drugs. We found that, ultimately, any attempt to measure the relative contribution of the public and private sectors to the research and development (R&D) of therapeutically important drugs by output alone, such as counting publications or even product approvals, is flawed. Several key factors (eg, degree of uncertainty, expected market value, potential social benefit) affect investment decisions and determine whether public or private sector funds, or both, are most appropriate. Because of the competitiveness and complexity of today's R&D environment, both sectors are increasingly challenged to show returns on their investment and the traditional boundaries separating the roles of the private and public research spheres have become increasingly blurred. What remains clear, however, is that the process still starts with good science and ends with good medicine.

  19. Petroleum Based Development and the Private Sector: A Critique of the Saudi Arabian Industrialization Strategy

    DTIC Science & Technology

    1985-01-01

    1985 2. REPORT TYPE 3. DATES COVERED 00-00-1985 to 00-00-1985 4. TITLE AND SUBTITLE Petroleum Based Development and the Private Sector : A...PETROLEUM BASED DEVELOPMENT AND THE PRIVATE SECTOR : A CRITIQUE OF THE SAUDI ARABIAN INDUSTRIALIZATION STRATEGY By Robert E. Looney In almost every country...providing incentives and external economies to the private sector to establish a number of industries supplying the basic consumer and development needs of

  20. Inviting In the Private Sector

    DTIC Science & Technology

    2002-10-01

    private sector . After all, corruption does not just involve government. Business people and lawyers and citizens pay the bribes, even as they condemn bribery. They should be invited to become part of the solution. But how? The first point to note is that business people and citizens know where corruption exists and how corrupt systems work. Citizens understand how bribery shapes the services they receive or don’t receive. Accountants know the illicit games played with audits and taxes. Lawyers understand corrupt legal practices. Business people know all about corrupt

  1. [Public-private partnerships (PPPs) in the health sector: global processes and national dynamics].

    PubMed

    Almeida, Celia

    2017-10-02

    This essay addresses several dimensions that promote and consolidate the growing participation by private stakeholders in the decision-making process in health, emphasizing international and domestic factors that have facilitated and sustained the persistence of the neoliberal political and ideological perspective over the course of nearly thirty years (since the 1990s). The article emphasizes the role of intergovernmental organizations in this process, highlighting public-private interactions at the global and domestic levels, with a specific focus on so-called public-private partnerships (PPPs). The working premise is that such linkages alter the power relations in policy formulation and implementation, with a predominance of private stakeholders. The article presents an overview of the development of PPPs in Europe, Latin America, and Brazil, identifying their specific origins and the simultaneity of triggering events. The text reiterates the importance of not overlooking the power of these actors in dislodging them from this political position, whether in multilateral organizations or national health systems. The aim is to emphasize the importance of more in-depth reflection on the subject, backing debates within the sector. This entire dynamic requires rethinking strategies of resistance to preserve the rights won through centuries of struggle.

  2. Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

    PubMed

    Grépin, Karen A

    2016-07-01

    There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

    PubMed

    Peters, David H; Mirchandani, Gita G; Hansen, Peter M

    2004-10-01

    The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research

  4. The private sector, international development and NCDs

    PubMed Central

    2011-01-01

    This article addresses an area that has been largely underserved by the development community, and one in which there is a particularly good opportunity for the private sector to take a lead in making a difference to employees, customers and local communities: chronic, non-communicable diseases (NCDs). It highlights the extent of the epidemic of NCDs in developing countries, sets out the 'business case' for the private sector to act on NCDs, and gives examples of initiatives by business to ensure that the healthy choice really is an easier choice for employees, consumers and local communities. It makes the case that, to be genuinely sustainable, businesses should be addressing health as a core part of what they do and, by working in partnership - as called for by the Millennium Development Goals - they can make a real difference and become part of the solution. Identifying ways in which this can be done should form a key part both of planning for, and action after, the UN High-level Meeting on NCDs, to be held in September 2011. PMID:21798001

  5. Direct and indirect economic costs among private-sector employees with osteoarthritis.

    PubMed

    Berger, Ariel; Hartrick, Craig; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

    2011-11-01

    To estimate direct and indirect economic costs among private-sector employees with osteoarthritis (OA). Using a large US employer benefits database, we identified all employees with evidence of OA during calendar year 2007, and compared their costs of health care and work loss to age-and-sex-matched employees without evidence of OA in that year. Private-sector employees with OA (n = 2399) averaged 62.9 days of absenteeism versus 36.7 days among matched comparators (n = 2399) (P < 0.01). Mean total direct costs among these persons were $17,751 and $5057, respectively (P < 0.01); 34% of health care costs among persons with OA arose from medical encounters with listed diagnoses of OA. Mean total indirect costs were two-fold higher among persons with OA ($5002 versus $2120 for those without OA; P < 0.01). Private-sector employees with OA have higher direct and indirect costs than those without this condition.

  6. Implications of private sector Hib vaccine coverage for the introduction of public sector Hib-containing pentavalent vaccine in India: evidence from retrospective time series data.

    PubMed

    Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Hasan Farooqui, Habib; Zodpey, Sanjay P

    2015-02-23

    Haemophilus influenzae type b (Hib) vaccine has been available in India's private sector market since 1997. It was not until 14 December 2011 that the Government of India initiated the phased public sector introduction of a Hib (and DPT, diphtheria, pertussis, tetanus)-containing pentavalent vaccine. Our objective was to investigate the state-specific coverage and behaviour of Hib vaccine in India when it was available only in the private sector market but not in the public sector. This baseline information can act as a guide to determine how much coverage the public sector rollout of pentavalent vaccine (scheduled April 2015) will need to bear in order to achieve complete coverage. 16 of 29 states in India, 2009-2012. Retrospective descriptive secondary data analysis. (1) Annual sales of Hib vaccines, by volume, from private sector hospitals and retail pharmacies collected by IMS Health and (2) national household surveys. State-specific Hib vaccine coverage (%) and its associations with state-specific socioeconomic status. The overall private sector Hib vaccine coverage among the 2009-2012 birth cohort was low (4%) and varied widely among the studied Indian states (minimum 0.3%; maximum 4.6%). We found that private sector Hib vaccine coverage depends on urban areas with good access to the private sector, parent's purchasing capacity and private paediatricians' prescribing practices. Per capita gross domestic product is a key explanatory variable. The annual Hib vaccine uptake and the 2009-2012 coverage levels were several times higher in the capital/metropolitan cities than the rest of the state, suggesting inequity in access to Hib vaccine delivered by the private sector. If India has to achieve high and equitable Hib vaccine coverage levels, nationwide public sector introduction of the pentavalent vaccine is needed. However, the role of private sector in universal Hib vaccine coverage is undefined as yet but it should not be neglected as a useful complement to

  7. AN ANALYSIS OF THE INEQUALITIES BETWEEN THE PUBLIC AND PRIVATE SECTOR IN SOUTH AFRICA.

    PubMed

    Dell, A; Kahn, D; Klopper, J

    2017-09-01

    The full extent of the global burden of surgical disease is largely unknown, however, the scope of the problem is thought to be large. Despite the substantial burden of surgical disease, surgical services are inaccessible to many of those who need them most. There are disparities between public and private sectors in South Africa, which compounds inequitable access to surgical care. This study involved a descriptive analysis of surgical resources and included the total number of hospitals, of hospital beds, the number of surgical beds, the number of general surgeons (specialist and non-specialist), and the number of functional operating theatres in South Africa. A comparison was performed between the public and private sectors. Hospitals were contacted during the period from the 1st October 2014 until the 31st of December 2014. Surgical resources were concentrated in metropolitan areas of urban provinces. There were striking differences between the public and private sectors, where private resources were comparable to those available in high income countries (HICs). Improving access to surgical services in lower middle income countries (LMICs) requires addressing gaps between the public and private sector regarding infrastructure, personnel, as well as equipment. South Africa is unique in that although it is classified as an upper middle income country (UMIC), is comprises of two sectors; a public sector which has resources similar to other LMICs, and a private sector which has resources similar to HICs. These data identified disparities between geographic regions which may be contributing to ongoing inequity in South Africa, and by doing so allows for evidence-based planning towards improving surgical infrastructure and workforce.

  8. Barriers of mistrust: public and private health sectors' perceptions of each other in Madhya Pradesh, India.

    PubMed

    De Costa, Ayesha; Johansson, Eva; Diwan, Vinod K

    2008-06-01

    India has one of the most highly privatized health care systems in the world. The dominant private health sector functions alongside a traditional tiered public health sector. There has been an overall lack of collaboration between the two sectors despite international policy recommendations and local initiatives. It has been postulated that "conflicting perceptions" might contribute to the uncooperative attitude between the two sectors. But there has been little empirical exploration of the existing perceptions that the private and public health sectors have of each other. We explored these perceptions among key stakeholders (who influence the direction of health policy) in the public and private health sectors in the province of Madhya Pradesh, India. The barriers of mistrust, which hinder true dialogue, are complex, and have social, moral, and economic bases. They can be best addressed by necessary structural change before any significant long-term partnership between the two sectors is possible.

  9. The willingness of private-sector doctors to manage public-sector HIV/AIDS patients in the eThekwini metropolitan region of KwaZulu-Natal

    PubMed Central

    Jinabhai, Champaklal C.; Taylor, Myra

    2010-01-01

    ABSTRACT Background South Africa is severely affected by the AIDS pandemic and this has resulted in an already under-resourced public sector being placed under further stress, while there remains a vibrant private sector. To address some of the resource and personnel shortages facing the public sector in South Africa, partnerships between the public and private sectors are slowly being forged. However, little is known about the willingness of private-sector doctors in the eThekwini Metropolitan (Metro) region of KwaZulu-Natal, South Africa to manage public-sector HIV and AIDS patients. Objectives To gauge the willingness of private-sector doctor to manage public-sector HIV and AIDS patients and to describe factors that may influence their responses. Method A descriptive cross-sectional study was undertaken among private-sector doctors, both general practitioners (GPs) and specialists, working in the eThekwini Metro, using an anonymous, structured questionnaire to investigate their willingness to manage public-sector HIV and AIDS patients and the factors associated with their responses. Chi-square and independent t-tests were used to evaluate associations. Odds ratios were determined using a binary logistic regression model. A p value < 0.05 was considered statistically significant. Results Most of the doctors were male GPs aged 30–50 years who had been in practice for more than 10 years. Of these, 133 (77.8%) were willing to manage public-sector HIV and AIDS patients, with 105 (78.9%) reporting adequate knowledge, 99 (74.4%) adequate time, and 83 (62.4%) adequate infrastructure. Of the 38 (22.2%) that were unwilling to manage these patients, more than 80% cited a lack of time, knowledge and infrastructure to manage them. Another reason cited by five doctors (3.8%) who were unwilling, was the distance from public-sector facilities. Of the 33 specialist doctors, 14 (42.4%) indicated that they would not be willing to manage public-sector HIV and AIDS patients

  10. 76 FR 41826 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Information Security Oversight Office State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records... Information Program for State, Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on...

  11. Public and private sector interactions: an economic perspective.

    PubMed

    Maynard, A

    1986-01-01

    The debate about the public-private mix for health care has been dominated by rhetoric and the failure to evaluate the characteristics of the outcomes of public and private health care systems and to relate these to policy targets. After a brief analysis of the competing, liberal (conservative) and collectivist (socialist), objectives, the nature of the private health care sector in Britain is described and it is shown that growth has faltered due to cost containment problems. This outcome is the product of characteristics of the private health care system, paralleled precisely in the NHS: asymmetry information, monopoly power, moral hazard and third party pays. The final section discusses briefly some remedies for the inefficient and inequitable outcomes which are seen in all health care markets and it is argued that competition within public and private health care systems may enable each system type to achieve its own particular objectives more efficiently.

  12. 20 CFR 641.660 - Who is eligible to participate in section 502(e) private sector training activities?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...(e) private sector training activities? 641.660 Section 641.660 Employees' Benefits EMPLOYMENT AND... PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.660 Who is eligible to participate in section 502(e) private sector training activities? The same eligibility criteria used in the...

  13. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

    PubMed

    Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

    2016-05-09

    Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

  14. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges

    PubMed Central

    Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S.; Mattke, Soeren

    2016-01-01

    Abstract Overhauling the individual health insurance market—including through the creation of health insurance exchanges—was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges—privately facilitated exchanges—which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment. PMID:28083414

  15. Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK.

    PubMed

    Bishop, Felicity L; Barlow, Fiona; Coghlan, Beverly; Lee, Philippa; Lewith, George T

    2011-05-27

    The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the

  16. Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK

    PubMed Central

    2011-01-01

    Background The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Methods Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Conclusions Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had

  17. Private sector contributions and their effect on physician emigration in the developing world.

    PubMed

    Loh, Lawrence C; Ugarte-Gil, Cesar; Darko, Kwame

    2013-03-01

    The contribution made by the private sector to health care in a low- or middle-income country may affect levels of physician emigration from that country. The increasing importance of the private sector in health care in the developing world has resulted in newfound academic interest in that sector's influences on many aspects of national health systems. The growth in physician emigration from the developing world has led to several attempts to identify both the factors that cause physicians to emigrate and the effects of physician emigration on primary care and population health in the countries that the physicians leave. When the relevant data on the emerging economies of Ghana, India and Peru were investigated, it appeared that the proportion of physicians participating in private health-care delivery, the percentage of health-care costs financed publicly and the amount of private health-care financing per capita were each inversely related to the level of physician expatriation. It therefore appears that private health-care delivery and financing may decrease physician emigration. There is clearly a need for similar research in other low- and middle-income countries, and for studies to see if, at the country level, temporal trends in the contribution made to health care by the private sector can be related to the corresponding trends in physician emigration. The ways in which private health care may be associated with access problems for the poor and therefore reduced equity also merit further investigation. The results should be of interest to policy-makers who aim to improve health systems worldwide.

  18. AN ANALYSIS OF THE INEQUALITIES BETWEEN THE PUBLIC AND PRIVATE SECTOR IN SOUTH AFRICA.

    PubMed

    Dell, A J; Kahn, D; Klopper, J

    2017-06-01

    The full extent of the global burden of surgical disease is largely unknown; however, the scope of the problem is thought to be large. Despite the substantial burden of surgical disease, surgical services are inaccessible to many of those who need them most. There are disparities between public and private sectors in South Africa, which compounds inequitable access to surgical care. This study involved a descriptive analysis of surgical resources and included the total number of hospitals, hospital beds, surgical beds, general surgeons (specialist and nonspecialist), and the number of functional operating theatres in South Africa. A comparison was performed between the public sector resources per uninsured population and private sector resources per insured population. Hospitals were contacted during the period 01 October 2014 to 31 December 2014. Surgical resources were concentrated in metropolitan areas of urban provinces. There were striking differences between sectors when a comparison was made between patients with and without health insurance. Private resources were comparable to those available in high income countries (HICs) and were accessible to only 16% of South Africans. Improving access to surgical services in lower middle income countries (LMICs) requires addressing gaps between the public and private sector regarding infrastructure, personnel, as well as equipment. South Africa is unique in that although it is classified as an upper middle income country (UMIC), it comprises of two sectors; a public sector which has resources similar to other LMICs, and a private sector which has resources similar to HICs. These data identified disparities between geographic regions which may be contributing to ongoing inequity in South Africa, and by doing so allows for evidence-based planning towards improving surgical infrastructure and workforce.

  19. The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.

    PubMed

    Reta, Alemayehu; Simachew, Addis

    2018-01-01

    Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.

  20. Preparing Rehabilitation Counselors for Private Sector Practice within a CORE Accredited Generalist Educational Model

    ERIC Educational Resources Information Center

    Zanskas, Stephen; Leahy, Michael

    2007-01-01

    As private sector rehabilitation has matured as a field of practice, the issue of how rehabilitation counselor educators can effectively prepare rehabilitation counselors for practice in this setting remains. This article reviews the literature regarding the training needs of rehabilitation counselors entering private sector practice, and proposes…

  1. Development of health biotechnology in developing countries: can private-sector players be the prime movers?

    PubMed

    Abuduxike, Gulifeiya; Aljunid, Syed Mohamed

    2012-01-01

    Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Length of stay benchmarking in the Australian private hospital sector.

    PubMed

    Hanning, Brian W T

    2007-02-01

    Length of stay (LOS) benchmarking is a means of comparing hospital efficiency. Analysis of private cases in private facilities using Australian Institute of Health and Welfare (AIHW) data shows interstate variation in same-day (SD) cases and overnight average LOS (ONALOS) on an Australian Refined Diagnosis Related Groups version 4 (ARDRGv4) standardised basis. ARDRGv4 standardised analysis from 1998-99 to 2003-04 shows a steady increase in private sector SD cases (approximately 1.4% per annum) and a decrease in ONALOS (approximately 4.3% per annum). Overall, the data show significant variation in LOS parameters between private hospitals.

  3. Do elections matter for private-sector healthcare management in Brazil? An analysis of municipal health policy.

    PubMed

    McGregor, Alecia J; Siqueira, Carlos Eduardo; Zaslavsky, Alan M; Blendon, Robert J

    2017-07-12

    This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested. Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed. Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery. Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

  4. Stereosat: A proposed private sector/government joint venture in remote sensing from space

    NASA Technical Reports Server (NTRS)

    Anglin, R. L.

    1980-01-01

    Stereosat, a free flying Sun synchronous satellite whose purpose is to obtain worldwide cloud-free stereoscopic images of the Earth's land masses, is proposed as a joint private sector/government venture. A number of potential organization models are identified. The legal, economic, and institutional issues which could impact the continuum of potential joint private sector/government institutional structures are examined.

  5. Harnessing private sector expertise to improve complementary feeding within a regulatory framework: Where is the evidence?

    PubMed

    van Liere, Marti J; Tarlton, Dessie; Menon, Ravi; Yellamanda, M; Reerink, Ietje

    2017-10-01

    Global recognition that the complex and multicausal problems of malnutrition require all players to collaborate and to invest towards the same objective has led to increased private sector engagement as exemplified through the Scaling Up Nutrition Business Network and mechanisms for blended financing and matched funding, such as the Global Nutrition for Growth Compact. The careful steps made over the past 5 to 10 years have however not taken away or reduced the hesitation and scepticism of the public sector actors towards commercial or even social businesses. Evidence of impact or even a positive contribution of a private sector approach to intermediate nutrition outcomes is still lacking. This commentary aims to discuss the multiple ways in which private sector can leverage its expertise to improve nutrition in general, and complementary feeding in particular. It draws on specific lessons learned in Bangladesh, Côte d'Ivoire, India, Indonesia, and Madagascar on how private sector expertise has contributed, within the boundaries of a regulatory framework, to improve availability, accessibility, affordability, and adequate use of nutritious foods. It concludes that a solid evidence base regarding the contribution of private sector to complementary feeding is still lacking and that the development of a systematic learning agenda is essential to make progress in the area of private sector engagement in nutrition. © 2017 John Wiley & Sons Ltd.

  6. 75 FR 42766 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies... private insurance companies participating under the current FY2010 Arrangement. Any private insurance...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of...

  7. The dominance of the private sector in the provision of emergency obstetric care: studies from Gujarat, India.

    PubMed

    Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

    2016-07-07

    India has experienced a steep rise in institutional childbirth. The relative contributions of public and private sector facilities to emergency obstetric care (EmOC) has not been studied in this setting. This paper aims to study in three districts of Gujarat state, India:(a) the availability of EmOC facilities in the public and private sectors; (b) the availability and distribution of human resources for birth attendance in the two sectors; and (c) to benchmark the above against 2005 World Health Report benchmarks (WHR2005). A cross-sectional survey of obstetric care facilities reporting 30 or more births in the last three months was conducted (n = 159). Performance of EmOC signal functions and availability of human resources were assessed. EmOC provision was dominated by private facilities (112/159) which were located mainly in district headquarters or small urban towns. The number of basic and comprehensive EmOC facilities was below WHR2005 benchmarks. A high number of private facilities performed C-sections but not all basic signal functions (72/159). Public facilities were the main EmOC providers in rural areas and 40/47 functioned at less than basic EmOC level. The rate of obstetricians per 1000 births was higher in the private sector. The private sector is the dominant EmOC provider in the state. Given the highly skewed distribution of facilities and resources in the private sector, state led partnerships with the private sector so that all women in the state receive care is important alongside strengthening the public sector.

  8. Coverage of private sector community midwife services in rural Punjab, Pakistan: development and demand.

    PubMed

    Mumtaz, Zubia; Levay, Adrienne V; Jhangri, Gian S; Bhatti, Afshan

    2015-11-25

    In 2007, the Government of Pakistan introduced a new cadre of community midwives (CMWs) to address low skilled birth attendance rates in rural areas; this workforce is located in the private-sector. There are concerns about the effectiveness of the programme for increasing skilled birth attendance as previous experience from private-sector programmes has been sub-optimal. Indonesia first promoted private sector midwifery care, but the initiative failed to provide universal coverage and reduce maternal mortality rates. A clustered, stratified survey was conducted in the districts of Jhelum and Layyah, Punjab. A total of 1,457 women who gave birth in the 2 years prior to the survey were interviewed. χ(2) analyses were performed to assess variation in coverage of maternal health services between the two districts. Logistic regression models were developed to explore whether differentials in coverage between the two districts could be explained by differential levels of development and demand for skilled birth attendance. Mean cost of childbirth care by type of provider was also calculated. Overall, 7.9% of women surveyed reported a CMW-attended birth. Women in Jhelum were six times more likely to report a CMW-attended birth than women in Layyah. The mean cost of a CMW-attended birth compared favourably with a dai-attended birth. The CMWs were, however, having difficulty garnering community trust. The majority of women, when asked why they had not sought care from their neighbourhood CMW, cited a lack of trust in CMWs' competency and that they wanted a different provider. The CMWs have yet to emerge as a significant maternity care provider in rural Punjab. Levels of overall community development determined uptake and hence coverage of CMW care. The CMWs were able to insert themselves into the maternal health marketplace in Jhelum because of an existing demand. A lower demand in Layyah meant there was less 'space' for the CMWs to enter the market. To ensure universal

  9. Injuries among solid waste collectors in the private versus public sectors.

    PubMed

    Bunn, Terry L; Slavova, Svetla; Tang, Minao

    2011-10-01

    Solid waste collection is among the occupations with the highest risk for injuries and illnesses. Solid waste collector injuries were characterized in terms of injury risk and employment industry sector (public versus private) using Kentucky workers' compensation first reports of injury and claims data. When compared to 35-44-year-old workers, solid waste collectors who were under 35 years of age were less likely to have a workers' compensation first report of injury or claim that resulted in awarded benefits. The probability that a workers' compensation first report of injury or claim would result in an awarded benefit was higher if the worker was employed as a solid waste collector in the private sector compared to the public sector, or was injured due to a motor vehicle-related injury or a push-or-pull type of injury. A better understanding of the differences in the contributing factors for an injury that results in a first report of injury or claim with awarded benefits (e.g., job activities, new and refresher worker safety training, type of equipment used, differences in collection vehicle automation, and differential reporting of injuries on the job) between the public and private sectors is necessary to target injury prevention strategies in this high-risk occupation.

  10. Public Disorder, Private Boons? Inter-Sectoral Dynamics Illustrated by the Kenyan Case. PROPHE Working Paper Series. WP No. 9

    ERIC Educational Resources Information Center

    Otieno, Wycliffe; Levy, Daniel

    2007-01-01

    Within and beyond Africa, it is the public sector much more than the private sector that is the scene of strikes and other forms of disorder, conflict and difficulty. Yet the private sector can be much affected by the public problems. Effects may be simultaneously positive for the private sector and deleterious for the public sector. Although a…

  11. Who are more responsive? Mixed-methods comparison of public and private sector physicians in rural Bangladesh.

    PubMed

    Joarder, Taufique; George, Asha; Sarker, Malabika; Ahmed, Saifuddin; Peters, David H

    2017-11-01

    Responsiveness of physicians (ROPs) reflects the social actions by physicians to meet the legitimate expectations of health care users. Responsiveness is important since it improves understanding and care seeking by users, as well as fostering trust in health systems rather than replicating discrimination and entrenching inequality. Given widespread public and private sector health care provision in Bangladesh, we undertook a mixed-methods study comparing responsiveness of public and private physicians in rural Bangladesh. The study included in-depth interviews with physicians (n = 12, seven public, five private) and patients (n = 7, three male, four female); focus group discussions with users (four sessions, two male and two female); and observations in consultation rooms of public and private sector physicians (1 week in each setting). This was followed by structured observation of patient consultations with 195 public and 198 private physicians using the ROPs Scale, consisting of five domains (Friendliness; Respecting; Informing and guiding; Gaining trust; and Financial sensitivity). Qualitative data were analysed by framework analysis and quantitative data were analyzed using two-sample t-test, multiple linear regression, multivariate analysis of variance, and descriptive discriminant analyses. The mean responsiveness score of public sector physicians was statistically different from private sector physicians: -0.29 vs 0.29, i.e. a difference of - 0.58 (P-value < 0.01; 95% CI - 0.77, -0.39) on a normalized scale. Despite relatively higher level of responsiveness of private sector, according to qualitative findings, neither of the sectors performed optimally. Private physicians scored higher in Friendliness, Respecting and Informing and guiding; while public sector physicians scored higher in other domains. 'Respecting' domain was found as the most important. Unlike findings from other studies in Bangladesh, instead of seeing one sector as better than

  12. Intra-Sectoral Diversity: A Political Economy of Thai Private Higher Education

    ERIC Educational Resources Information Center

    Praphamontripong, Prachayani

    2010-01-01

    Private higher education (PHE) worldwide has been a rapid development in the last several decades. The private sector will continue to grow, diversify and undoubtedly play a significant role in the political economy of higher education. Nevertheless, systematically empirical studies on the trio relationships among PHE, institutional diversity and…

  13. 31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

  14. 31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

  15. 31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

  16. 31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

  17. 31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

  18. Private and Public Sector Enterprise Resource Planning System Post-Implementation Practices: A Comparative Mixed Method Investigation

    ERIC Educational Resources Information Center

    Bachman, Charles A.

    2010-01-01

    While private sector organizations have implemented enterprise resource planning (ERP) systems since the mid 1990s, ERP implementations within the public sector lagged by several years. This research conducted a mixed method, comparative assessment of post "go-live" ERP implementations between public and private sector organization. Based on a…

  19. A Literature Survey of Private Sector Methods of Determining Personal Financial Responsibility

    DTIC Science & Technology

    1988-09-01

    private sector methods to the public sector is also discussed. The judgmental and empirical methods are each effective. Their utilization is based upon their respective abilities to minimize cost while achieving the organization’s

  20. Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps.

    PubMed

    Awor, Phyllis; Miller, Jane; Peterson, Stefan

    2014-12-01

    Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community-acquired malaria, pneumonia or diarrhoea. We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were "malaria", "pneumonia", "diarrhoea", "private sector" and "community case management". A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM-related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM-related studies in the public sector directly reported on community case management of 2 or more of the illnesses. While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non-malaria-associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in conjunction with private sector intervention programs.

  1. Regulating the for-profit private health sector: lessons from East and Southern Africa.

    PubMed

    Doherty, Jane E

    2015-03-01

    International evidence shows that, if poorly regulated, the private health sector may lead to distortions in the type, quantity, distribution, quality and price of health services, as well as anti-competitive behaviour. This article provides an overview of legislation governing the for-profit private health sector in East and Southern Africa. It identifies major implementation problems and suggests strategies Ministries of Health could adopt to regulate the private sector more effectively and in line with key public health objectives. This qualitative study was based on a document review of existing legislation in the region, and seven semi-structured interviews with individuals selected purposively on the basis of their experience in policymaking and legislation. Legislation was categorized according to its objectives and the level at which it operates. A thematic content analysis was conducted on interview transcripts. Most legislation focuses on controlling the entry of health professionals and organizations into the market. Most countries have not developed adequate legislation around behaviour following entry. Generally the type and quality of services provided by private practitioners and facilities are not well-regulated or monitored. Even where there is specific health insurance regulation, provisions seldom address open enrolment, community rating and comprehensive benefit packages (except in South Africa). There is minimal control of prices. Several countries are updating and improving legislation although, in most cases, this is without the benefit of an overarching policy on the private sector, or reference to wider public health objectives. Policymakers in the East and Southern African region need to embark on a programme of action to strengthen regulatory frameworks and instruments in relation to private health care provision and insurance. They should not underestimate the power of the private health sector to undermine efforts for increased

  2. 20 CFR 641.670 - May an eligible individual be enrolled simultaneously in section 502(e) private sector training...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... simultaneously in section 502(e) private sector training activities operated by one grantee and a community... EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.670 May an eligible individual be enrolled simultaneously in section 502(e) private sector training activities operated by one...

  3. Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors.

    PubMed

    Ashton, Toni; Brown, Paul; Sopina, Elizaveta; Cameron, Linda; Tenbensel, Timothy; Windsor, John

    2013-09-27

    As in many countries, medical and surgical specialists in New Zealand have the opportunity of working in the public sector, the private sector or both. This study aimed to explore the level and sources of satisfaction and dissatisfaction of specialists in New Zealand with working in the two sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated. Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education and professional development, key sources of dissatisfaction are workload pressures, mentally demanding work and managerial interference. In the private sector specialists value the opportunity to work independently and apply their own ideas in the workplace. Sources of job satisfaction and dissatisfaction amongst specialists are different for the public and private sectors. Allowing specialists more freedom to work independently and to apply their own ideas in the workplace may enhance recruitment and retention of specialists in the public health system.

  4. How do patients access the private sector in Chennai, India? An evaluation of delays in tuberculosis diagnosis.

    PubMed

    Bronner Murrison, L; Ananthakrishnan, R; Swaminathan, A; Auguesteen, S; Krishnan, N; Pai, M; Dowdy, D W

    2016-04-01

    The diagnosis and treatment of tuberculosis (TB) in India are characterized by heavy private-sector involvement. Delays in treatment remain poorly characterized among patients seeking care in the Indian private sector. To assess delays in TB diagnosis and treatment initiation among patients diagnosed in the private sector, and pathways to care in an urban setting. Cross-sectional survey of 289 consecutive patients diagnosed with TB in the private sector and referred for anti-tuberculosis treatment through a public-private mix program in Chennai from January 2014 to February 2015. Among 212 patients with pulmonary TB, 90% first contacted a formal private provider, and 78% were diagnosed by the first or second provider seen after a median of three visits per provider. Median total delay was 51 days (mean 68). Consulting an informal (rather than formally trained) provider first was associated with significant increases in total delay (absolute increase 22.8 days, 95%CI 6.2-39.5) and in the risk of prolonged delay >90 days (aRR 2.4, 95%CI 1.3-4.4). Even among patients seeking care in the formal (vs. informal) private sector in Chennai, diagnostic delays are substantial. Novel strategies are required to engage private providers, who often serve as the first point of contact.

  5. Private Cultural Promotion in the Federal Republic of Germany.

    ERIC Educational Resources Information Center

    Fohrbeck, Karla; Wiesand, Andreas Johannes

    Private cultural promotion has become a major topic of interest in cultural policy in recent years. Ranging from personal patronage, to salons, to lifestyle promotion, this document is concerned with presenting the great variety of possible fields of activity in private cultural promotion. Divided into eight chapters the topics covered include:…

  6. Going private: clinicians' experience of working in UK independent sector treatment centres.

    PubMed

    Waring, Justin; Bishop, Simon

    2012-02-01

    With increased possibility that public healthcare services in the UK will be outsourced to the private sector, this study investigates how clinicians working in Independent Sector Treatment Centres perceive the differences between public and private sectors. Qualitative interviews with 35 clinicians recruited from two ISTCs. All participants were transferred to the independent sector from the public National Health Service. Interview data were analysed to identify shared experience about the variable organisation and delivery of services. Clinicians perceived differences between public and independent sectors in the areas of 'environment and facilities', 'management', 'work organisation and care delivery', and 'patient experience'. The independent sector was described as offering a positive alternative to public services in regard to service environment and patient experience, but there were concerns about management priorities and the reconfiguration of work. Clinicians' experience of moving between sectors reveals mixed experiences. Although some improvements might legitimise the growing role of the independent sector, there remain doubts about the commercialisation of services, the motives of managers and the impact of clinical roles and capabilities. With policies looking to expand the mixed economy of public healthcare services, the study suggests clinicians will not automatically embrace a move between sectors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  7. BKKBN and the expanding role of private sector FP services and commercial contraceptive sales in Indonesia.

    PubMed

    Suyono, H

    1989-07-01

    The Indonesian family planning program is an internationally recognized success. Launched in 1970, the program, coordinated by the National Family Planning Coordinating Board (BKKBN), now enrolls an average of 20,000 new acceptors each day. About 60% of eligible couples participate in the program. The key factors in the BKKBN's strategy are 1) a firm commitment from all government leaders, 2) a positive relationship with religious and other leaders, 3) decentralization and flexibility, 4) a shift from a traditional clinic-based to a community-based program, and 5) the integration of the program with health, family welfare, and other development activities. The next phase of the program emphasizes self-support or self-reliance in family planning. This means taking responsibility for one's own family planning, but it also means that those who are financially able to do so should pay for services and supplies. New projects have begun with the private sector. BKKBN has been working with professional doctors' and midwives' associations to promote private initiatives for family planning. The Kondom Dua Lima, a social marketing project with a private company, distributes and sells condoms in the commercial retail sales market. The Blue Circle Contraceptive Social Marketing Project provides low-cost but high-quality contraceptive supplies to fill the gap between free BKKBN supplies and the expensive contraceptives available through commercial pharmacies. BKKBN is working with the private sector to encourage its participation in the Indonesian goal of institutionalizing the small, happy, and prosperous family norm.

  8. 78 FR 41959 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC); Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC); Notice of Meeting AGENCY... Classified National Security Information Program for State, Local, Tribal, and Private Sector Entities. FOR..., announcement is made for the following committee meeting. Name of Committee: State, Local, Tribal, and Private...

  9. Job Satisfaction and Burnout among Greek Early Educators: A Comparison between Public and Private Sector Employees

    ERIC Educational Resources Information Center

    Tsigilis, Nikolaos; Zachopoulou, Evridiki; Grammatikopoulos, Vasilios

    2006-01-01

    The purpose of the present study was to examine perceived levels of burnout and job satisfaction of Greek early educators, across public and private sector. One hundred and seventy eight childhood educators participated in the study. 108 were working in the public sector, 67 in private sector, whereas three did not respond. Participants were…

  10. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?

    PubMed

    Montagu, Dominic; Goodman, Catherine

    2016-08-06

    The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Investigating nurse practitioners in the private sector: a theoretically informed research protocol.

    PubMed

    Adams, Margaret; Gardner, Glenn; Yates, Patsy

    2017-06-01

    To report a study protocol and the theoretical framework normalisation process theory that informs this protocol for a case study investigation of private sector nurse practitioners. Most research evaluating nurse practitioner service is focused on public, mainly acute care environments where nurse practitioner service is well established with strong structures for governance and sustainability. Conversely, there is lack of clarity in governance for emerging models in the private sector. In a climate of healthcare reform, nurse practitioner service is extending beyond the familiar public health sector. Further research is required to inform knowledge of the practice, operational framework and governance of new nurse practitioner models. The proposed research will use a multiple exploratory case study design to examine private sector nurse practitioner service. Data collection includes interviews, surveys and audits. A sequential mixed method approach to analysis of each case will be conducted. Findings from within-case analysis will lead to a meta-synthesis across all four cases to gain a holistic understanding of the cases under study, private sector nurse practitioner service. Normalisation process theory will be used to guide the research process, specifically coding and analysis of data using theory constructs and the relevant components associated with those constructs. This article provides a blueprint for the research and describes a theoretical framework, normalisation process theory in terms of its flexibility as an analytical framework. Consistent with the goals of best research practice, this study protocol will inform the research community in the field of primary health care about emerging research in this field. Publishing a study protocol ensures researcher fidelity to the analysis plan and supports research collaboration across teams. © 2016 John Wiley & Sons Ltd.

  12. Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense

    DTIC Science & Technology

    2006-04-30

    Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= REFORM OF BUDGETING FOR ACQUISITION: LESSONS FROM PRIVATE SECTOR CAPITAL BUDGETING FOR THE DEPARTMENT OF DEFENSE...TITLE AND SUBTITLE Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense 5a. CONTRACT...Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense Presenter: Jerry McCaffery, PhD, serves

  13. Leveraging the private sector for child health: a qualitative examination of caregiver and provider perspectives on private sector care for childhood pneumonia in Uttar Pradesh, India.

    PubMed

    Brunie, Aurélie; Lenzi, Rachel; Lahiri, Anamika; Izadnegahdar, Rasa

    2017-02-22

    The private health sector is a primary source of curative care for childhood illnesses in many low- and middle-income countries. Therefore ensuring appropriate private sector care is an important step towards improving outcomes from illnesses like pneumonia, which is the leading infectious cause of childhood mortality worldwide. This study aimed to provide evidence on private sector care for childhood pneumonia in Uttar Pradesh, India, by simultaneously exploring providers' knowledge and practices and caregivers' experiences. We conducted in-depth interviews with a purposive sample of 36 practitioners and 34 caregivers in two districts. Practitioners included allopathic doctors, AYUSH providers, and drug sellers. Caregivers were mothers of children under the age of five with symptoms consistent with pneumonia who had seen one of those practitioners. Interview transcripts were analyzed thematically. Caregivers were generally prompt in seeking care outside the home, but many initially favored local informal providers based on access and cost. Drug sellers were not commonly consulted for treatment. Formal providers had imperfect, but reasonable, knowledge of pneumonia and followed appropriate steps for diagnosis, though some gaps were noticed that were primarily related to lack of (or failure to use) diagnostic tools. Most practitioners prescribed antibiotics and supportive symptomatic treatment. Relational and structural factors encouraged overuse of antibiotics and treatment interruption. Caregivers often had a limited understanding of treatment but wanted rapid symptomatic improvements, frequently leading to sequentially consulting multiple providers and interrupting treatment when symptoms improved. Providers were confronted with these expectations and care-seeking patterns. This study contributes in-depth evidence on private sector care for childhood pneumonia in UP. Achieving appropriate care requires an enriched perspective that simultaneously considers the

  14. Government Investment and Follow-on Private Sector Investment in Pakistan, 1972-1995

    DTIC Science & Technology

    1997-06-01

    private sector investment has long been suggested. Until recently, an appropriate model to test for the relationship in developing countries has been absent. In 1984, Blejer and Khan developed and estimated a model for 24 developing countries between 1971 and 1979. They found that higher rates of investment took place when the private sector took a large role in capital formation. This paper estimates a similar model for one developing country, Pakistan, for the period 1972 to 1995. Our results are broadly similar to those obtained by Blejer and Khan

  15. To Profit or Not to Profit: The Private Higher Education Sector in Brazil

    ERIC Educational Resources Information Center

    Salto, Dante J.

    2018-01-01

    Brazil has by far the largest higher education system in Latin America, with a sizable share of students enrolled in private-sector institutions. Its recently established and fast-growing for-profit sector is one of the largest worldwide. The for-profit sector already surpasses the public sector in student enrollment, and its role is growing.…

  16. Psychosocial Work Hazards, Self-Rated Health and Burnout: A Comparison Study of Public and Private Sector Employees.

    PubMed

    Liu, Hsi-Chen; Cheng, Yawen

    2018-04-01

    To compare psychosocial work conditions and health status between public and private sector employees and to examine if psychosocial work conditions explained the health differences. Two thousand four hundred fourty one public and 15,589 private sector employees participated in a cross-sectional survey. Psychosocial work hazards, self-rated health (SRH), and burnout status were assessed by questionnaire. As compared with private sector employees, public sector employees reported better psychosocial work conditions and better SRH, but higher risk of workplace violence (WPV) and higher levels of client-related burnout. Regression analyses indicated that higher psychosocial job demands, lower workplace justice, and WPV experience were associated with poor SRH and higher burnout. The public-private difference in client-related burnout remained even with adjustment of psychosocial work factors. Greater risks of WPV and client-related burnout observed in public sector employees warrant further investigation.

  17. Valuing public sector risk exposure in transportation public-private partnerships.

    DOT National Transportation Integrated Search

    2010-10-01

    This report presents a methodological framework to evaluate public sector financial risk exposure when : delivering transportation infrastructure through public-private partnership (PPP) agreements in the United : States (U.S.). The framework is base...

  18. Information Technology Training: Practices of Leading Private Sector Companies.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    The General Accounting Office (GAO) examined private-sector workforce training practices for information technology (IT) and non-IT professionals. Data were collected from the following sources: a literature review; discussions with academic and professional authorities; interviews with executives and managers at leading companies regarding their…

  19. Public/Private Sector Interactions: The Implications for Networking. A Discussion Report Prepared by the Network Advisory Committee.

    ERIC Educational Resources Information Center

    Network Planning Paper, 1983

    1983-01-01

    At a 2-day meeting in October 1982, the Library of Congress Network Advisory Committee (NAC) members discussed the complex issues involved in public and private sector interactions and their relationship to networking activities. The report, "Public Sector/Private Sector Interaction in Providing Information Services," prepared by the…

  20. Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps

    PubMed Central

    Awor, Phyllis; Miller, Jane; Peterson, Stefan

    2014-01-01

    Background Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community–acquired malaria, pneumonia or diarrhoea. Methods We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were “malaria”, “pneumonia”, “diarrhoea”, “private sector” and “community case management”. Results A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM–related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM–related studies in the public sector directly reported on community case management of 2 or more of the illnesses. Conclusions While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non–malaria–associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in

  1. Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India.

    PubMed

    Akinyemi, Oluwaseun O; Martineau, Tim; Tharyan, Prathap

    2015-06-01

    The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use

  2. Trends in Health Care Spending by the Private Sector

    DTIC Science & Technology

    1997-04-01

    private - sector spending for health insurance increases each year has raised many questions about the meaning of the trend and its implications for the future. According to the federal government’s national health accounts (NHA), the annual growth rate of private health insurance expenditures tumbled from around 14 percent in 1990 to less than 3 percent in 1994 and 1995. Understanding the factors that contribute to that reduction is of particular concern to policymakers who are seeking ways to slow the growth of Medicare spending. At the same time that fundamental

  3. 20 CFR 641.640 - How do the private sector training activities authorized under section 502(e) differ from other...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How do the private sector training activities... COMMUNITY SERVICE EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.640 How do the private sector training activities authorized under section 502(e) differ from other...

  4. Are PhDs Winners or Losers? Wage Premiums for Doctoral Degrees in Private Sector Employment

    ERIC Educational Resources Information Center

    Pedersen, Heidi Skovgaard

    2016-01-01

    Policy makers expect increasing numbers of PhDs to find employment in the private sector. However, the incentive structure for completing a PhD and subsequently seeking private sector employment has not been adequately assessed in the literature. This paper investigates the financial incentives for this career choice of recent Danish PhD…

  5. Private sector contributions and their effect on physician emigration in the developing world

    PubMed Central

    Ugarte-Gil, Cesar; Darko, Kwame

    2013-01-01

    Abstract The contribution made by the private sector to health care in a low- or middle-income country may affect levels of physician emigration from that country. The increasing importance of the private sector in health care in the developing world has resulted in newfound academic interest in that sector’s influences on many aspects of national health systems. The growth in physician emigration from the developing world has led to several attempts to identify both the factors that cause physicians to emigrate and the effects of physician emigration on primary care and population health in the countries that the physicians leave. When the relevant data on the emerging economies of Ghana, India and Peru were investigated, it appeared that the proportion of physicians participating in private health-care delivery, the percentage of health-care costs financed publicly and the amount of private health-care financing per capita were each inversely related to the level of physician expatriation. It therefore appears that private health-care delivery and financing may decrease physician emigration. There is clearly a need for similar research in other low- and middle-income countries, and for studies to see if, at the country level, temporal trends in the contribution made to health care by the private sector can be related to the corresponding trends in physician emigration. The ways in which private health care may be associated with access problems for the poor and therefore reduced equity also merit further investigation. The results should be of interest to policy-makers who aim to improve health systems worldwide. PMID:23476095

  6. The impact of private-sector provision on equitable utilisation of coronary revascularisation in London.

    PubMed

    Mindell, J; Klodawski, E; Fitzpatrick, J; Malhotra, N; McKee, M; Sanderson, C

    2008-08-01

    To investigate the impact of including private-sector data on assessments of equity of coronary revascularisation provision using NHS data only. Analyses of hospital episodes statistics and private-sector data by age, sex and primary care trust (PCT) of residence. For each PCT, the share of London's total population and revascularisations (all admissions, NHS-funded, and privately-funded admissions) were calculated. Gini coefficients were derived to provide an index of inequality across subpopulations, with parametric bootstrapping to estimate confidence intervals. London. London residents undergoing coronary revascularisation April 2001-December 2003. Coronary artery bypass graft or angioplasty. Directly standardised revascularisation rates, Gini coefficients. NHS-funded age-standardised revascularisation rates varied from 95.2 to 193.9 per 100,000 and privately funded procedures from 7.6 to 57.6. Although the age distribution did not vary by funding, the proportion of revascularisations among women that were privately funded (11.0%) was lower than among men (17.0%). Privately funded rates were highest in PCTs with the lowest death rates (p = 0.053). NHS-funded admission rates were not related to deprivation nor age-standardised deaths rates from coronary heart disease. Privately funded admission rates were lower in more deprived PCTs. NHS provision was significantly more egalitarian (Gini coefficient 0.12) than the private sector (0.35). Including all procedures was significantly less equal (0.13) than NHS-funded care alone. Private provision exacerbates geographical inequalities. Those responsible for commissioning care for defined populations must have access to consistent data on provision of treatment wherever it takes place.

  7. Administration and Regulation of a Military Retirement System Funded by Private Sector Investments

    DTIC Science & Technology

    1990-03-01

    private sector , as opposed to the current method of investing the funds within the Government, between 1985 and 1989, under assumptions of administrative and regulatory constraints; the timeframe was selected because in 1985 the Government began setting aside funds for future military retirement costs versus the pay-as-you-go method in previous years. The study had three objectives: (1) identify administrative factors that result from modifying the current MRS to an MRS funded by private sector investments; (2) identify regulatory constraints that

  8. Policy implications of private sector involvement in correctional services and programs.

    PubMed

    Johnson, T A

    1987-01-01

    The movement toward private sector involvement in our correctional services and programs is growing. Before our focus is turned completely to privatization of these services, it would be prudent to analyze the "policy impact of such change. It is evident that the diverse and incompatible policies guiding the government approach to corrections and the absence of any rational planning to answer public interest goals is costly. Moreover, despite the increasing complexity of problems now confronting public authorities, little change has been made in their approach to resolving them. However, is it realistic to assume that the profit/loss barometer of the private sector can be applied in an area of social problems that are so pluralistic and ill defined? What of the many areas of potential legal concern, that is, vicarious litigation, First Amendment right of prisoners, and so forth? These are all areas that need to be researched so that any judgements or decisions made will be sound.

  9. Private or public? An empirical analysis of the importance of work values for work sector choice among Norwegian medical specialists.

    PubMed

    Midttun, Linda

    2007-03-01

    In the aftermath of the Norwegian hospital reform of 2002, the private supply of specialized healthcare has increased substantially. This article analyses the likelihood of medical specialists working in the private sector. Sector choice is operationalized in two ways: first, as the likelihood of medical specialists working in the private sector at all (at least 1% of the total work hours), and second, as the likelihood of working full-time (90-100%) privately. The theoretical framework is embedded in work values theory and the results suggest that work values are important predictors of sector choice. All analyses are based on a postal questionnaire survey of medical specialists working in private contract practices and for-profit hospitals and a control group of specialists selected from the Norwegian Medical Association's member register. The analyses revealed that while autonomy values impact positively on the propensity for allocating any time at all to the private sector, professional values have a negative effect. Given that the medical specialist already works in the private sector, a high valuation of professional values and payment and benefit values increases the likelihood of having a dual sector job rather than a full-time private position. However, due to the cross-sectional structure of the data and limitations in the dataset, causality questions cannot be fully settled on the basis of the analyses. The relationship between work values and sector choice should, therefore, be regarded as associations rather than causality links. Finally, the likelihood of working in the private sector varies significantly at the municipality level, suggesting that medical specialist's location is important for sector choice.

  10. Private dentists assess treatment required as more extensive, demanding and costly, than public sector dentists.

    PubMed

    Tuominen, Risto; Eriksson, Anna-Leena; Vahlberg, Tero

    2012-08-01

    The aim was to evaluate whether contracted private practitioners assess required treatment more extensive, demanding and economically more rewarding than mainly salaried public sector dentists and to estimate the cost consequences of using these alternative providers. All dental services included in comprehensive treatments funded by the city of Turku and provided to adult patients during the year 2009 were recorded. Patients were distributed randomly without any determination of treatment needs before appointing them to different dentists. Treatment courses for 7432 patients in public clinics included 63 906 procedures and for 2932 patients assigned to treatment by contracted private practitioners included 21 194 procedures. Public sector dentists were mainly salaried with production incentives, and private practitioners worked purely on a fee-for-service basis. The cost estimates were based on the distributions of competence classifications recorded by the providers, which also formed the basis for reimbursement. For each studied treatment category with more than one competence classification, private contractors were less likely than their public sector counterparts to give an assessment of simple or less demanding: 8% versus 29% of examinations, 46% versus 69% of periodontal treatments, 63% versus 85% of extractions, 31% versus 46% of fillings, 18% versus 35% of root canals. The excess cost to society varied from 7.0% for root canal treatments to 21.3% for extractions, causing on average 14.4% higher cost level from use of private practitioners compared with public sector dentists. Private practitioners systematically classified the treatment procedures they provided as more demanding, and therefore more economically rewarding, than their public sector counterparts. The findings indicate that the costs of publicly funded dental care may be increased by the use of private dental contractors. © 2012 John Wiley & Sons A/S.

  11. The needs of having a paradigm shift from public sector to private sector on funding digitizing management work of historical buildings in Malaysia

    NASA Astrophysics Data System (ADS)

    Kamarudin, M. K.; Yahya, Z.; Harun, R.; Jaapar, A.

    2014-02-01

    In Malaysia, the government agencies that handle the management of historical buildings are finding themselves facing a shortage of funds to provide the necessary work on digitalising management works. Due to the rising cost of management, which also covers maintenance and infrastructure works, there is a need for a paradigm shift from public sector to private sector provision on infrastructure and management works. Therefore the government agencies need to find the suitable mechanism to encourage private sector especially the private property and developers to take part in it. This scenario has encouraged the authorities to look new ways of entering into partnership and collaboration with the private sector to secure the continuity of provision and funding. The paper first reviews the different approach to facilitate off-site local management system of historical buildings and then examines options for both private and public funding in digitalising the historical buildings management works by interviewing government officer, conservator and member of nongovernment agencies. It then explores how the current system of management may adopt the shift to avoid any vulnerability and threat to the existing historical buildings. This paper concludes with a short summary of key issues in management works of historical buildings and recommendations.

  12. The Medicaid School Program: An Effective Public School and Private Sector Partnership

    ERIC Educational Resources Information Center

    Mallett, Christopher A.

    2013-01-01

    Privatized service delivery within Medicaid has greatly increased over the past two decades. This public program-private sector collaboration is quite common today, with a majority of Medicaid recipients receiving services in this fashion; yet controversy remains. This article focuses on just one program within Medicaid, school-based services for…

  13. Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study.

    PubMed

    Talisuna, Ambrose O; Daumerie, Penny Grewal; Balyeku, Andrew; Egan, Timothy; Piot, Bram; Coghlan, Renia; Lugand, Maud; Bwire, Godfrey; Rwakimari, John Bosco; Ndyomugyenyi, Richard; Kato, Fred; Byangire, Maria; Kagwa, Paul; Sebisubi, Fred; Nahamya, David; Bonabana, Angela; Mpanga-Mukasa, Susan; Buyungo, Peter; Lukwago, Julius; Batte, Allan; Nakanwagi, Grace; Tibenderana, James; Nayer, Kinny; Reddy, Kishore; Dokwal, Nilesh; Rugumambaju, Sylvester; Kidde, Saul; Banerji, Jaya; Jagoe, George

    2012-10-29

    Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Four intervention districts were purposefully selected to receive branded subsidized medicines - "ACT with a leaf", while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention's impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, "ACT with a leaf" accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had "ACT with a leaf" purchased for them more often than those aged above five years. There was no

  14. A comparison of private and public sector intensive care unit infrastructure in South Africa.

    PubMed

    Mahomed, S; Sturm, A W; Moodley, P

    2017-11-27

    Intensive care units (ICUs) are designed to care for patients who are often at increased risk of acquiring healthcare-associated infections. The structure of ICUs should be optimally designed to facilitate the care of these critically ill patients, and minimise their risk of infection. National regulations (R158) were developed to govern the building and registration of private hospitals, and until recently equivalent regulations were not available for public hospitals. To assess and compare the compliance of ICUs in the private and public sectors with the R158 regulations. A cross-sectional study design was used to assess the infrastructure of 25 private sector and 6 public sector ICUs in eThekwini Health District, KwaZulu-Natal Province, South Africa. We used the R158 checklist, which was developed by the KwaZulu-Natal Department of Health Private Licensing Unit and Infection Prevention and Control Unit. The aspects covered in the R158 checklist were categorised into the design, general safety and patient services of the ICUs. Most of the ICUs in both sectors met the general safety requirements. There were varying levels of compliance with the design criteria. Only 7 (28.0%) and 1 (16.7%) of the private and public ICUs, respectively, had sufficient space around the beds. Twenty-two private ICUs (88.0%) and 4 public ICUs (66.7%) had isolation rooms, but only some of these isolation rooms (15 private and 2 public) had appropriate mechanical ventilation. None of the ICUs had clinical hand-wash basins in the nurse stations and dirty utility rooms. The majority of the ICUs had the required number of oxygen and electric outlets at the bedside. None of the public ICUs met the light intensity requirement over the bed area. Adequate spacing in ICUs is an issue in many cases. Interventions need to be put in place to ensure that ICUs meet the relevant design standards. There is an urgent need to revise the R158 regulations to reflect current best practices, particularly

  15. The private partners of public health: public-private alliances for public good.

    PubMed

    McDonnell, Sharon; Bryant, Carol; Harris, Jeff; Campbell, Marci Kramish; Lobb, Ano; Hannon, Peggy A; Cross, Jeffrey L; Gray, Barbara

    2009-04-01

    We sought to convey lessons learned by the Centers for Disease Control and Prevention's (CDC's) Prevention Research Centers (PRCs) about the value and challenges of private-sector alliances resulting in innovative health promotion strategies. Several PRCs based in a variety of workplace and community settings contributed. We conducted interviews with principal investigators, a literature review, and a review of case studies of private-sector alliances in a microbusiness model, a macrobusiness model, and as multiparty partnerships supporting public health research, implementation, and human resource services. Private-sector alliances provide many advantages, particularly access to specialized skills generally beyond the expertise of public health entities. These skills include manufacturing, distribution, marketing, business planning, and development. Alliances also allow ready access to employee populations. Public health entities can offer private-sector partners funding opportunities through special grants, data gathering and analysis skills, and enhanced project credibility and trust. Challenges to successful partnerships include time and resource availability and negotiating the cultural divide between public health and the private sector. Critical to success are knowledge of organizational culture, values, mission, currency, and methods of operation; an understanding of and ability to articulate the benefits of the alliance for each partner; and the ability and time to respond to unexpected changes and opportunities. Private-public health alliances are challenging, and developing them takes time and resources, but aspects of these alliances can capitalize on partners' strengths, counteract weaknesses, and build collaborations that produce better outcomes than otherwise possible. Private partners may be necessary for program initiation or success. CDC guidelines and support materials may help nurture these alliances.

  16. Corporate Governance: Can Universities Learn from the Private Sector?

    ERIC Educational Resources Information Center

    Henze, Raphaela

    2010-01-01

    Corporate governance has several objectives: growth, transparency, leadership, social responsibility and trust, as well as the protection of shareholders and company assets. It also plays a key role in determining a company's control environment. In this article, the author takes a closer look at corporate governance in the private sector,…

  17. Assessment of the impact of market regulation in Mali on the price of essential medicines provided through the private sector.

    PubMed

    Maïga, Diadié; Williams-Jones, Bryn

    2010-10-01

    In 1998, the government of Mali adopted a national pharmaceutical policy aimed at promoting a supply system for generic essential medicines that would guarantee equal access for all citizens. Distribution and delivery is a shared responsibility of both public and private sectors (wholesalers and pharmacies). To influence private sector behaviour, the national policy uses a combination of government regulation and market forces. In 2006, the government issued a decree fixing maximum prices in the private sector for 107 prescription drugs from the national list of 426 essential medicines. The current study assessed the impact of this intervention on the evolution of market prices (wholesale and retail), and the subsequent availability and public access to essential medicines in Mali. A cross-sectional descriptive survey was conducted in February and May 2006, and January 2009, with 16 wholesalers and 30 private drugstores in Bamako, Mali. The overall availability of essential medicines at private wholesalers (p=1) and pharmacies (p=0.53) was identical before and after the enforcement of the 2006 decree fixing maximum drug prices. Contrary to concerns expressed by wholesalers and pharmacies, and the other stakeholders, the decree did not impact negatively on availability of essential medicines. In fact, median wholesale prices in 2009 were 25.6% less than those fixed by the decree. In private pharmacies, retail prices were only 3% more expensive than the recommended prices, compared with being 25.5% more expensive prior to enforcement of the decree. The study shows that prices of essential medicines in Mali have evolved favourably towards the prices recommended by the government decree. Further, the study contributes to mounting evidence that market regulation by governments does not necessarily negatively affect drug availability; in fact, given the reduction in prices, the study shows that Malians arguably have better access to more affordable essential medicines

  18. Effectively engaging the private sector through vouchers and contracting - A case for analysing health governance and context.

    PubMed

    Nachtnebel, Matthias; O'Mahony, Ashleigh; Pillai, Nandini; Hort, Kris

    2015-11-01

    Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more

  19. Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

    PubMed

    Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

    2016-10-18

    Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

  20. 29 CFR Appendix C to Part 4022 - Lump Sum Interest Rates for Private-Sector Payments

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Interest Rates for Private-Sector Payments C... Appendix C to Part 4022—Lump Sum Interest Rates for Private-Sector Payments [In using this table: (1) For... (where y is an integer and 0 n 1 + n 2), interest rate i 3 shall apply from the valuation date for a...

  1. Private sector participation in domestic waste management in informal settlements in Lagos, Nigeria.

    PubMed

    Opoko, Akunnaya P; Oluwatayo, Adedapo A

    2016-12-01

    Lagos is one of the fastest growing cities in Africa, which is grappling with the challenges of poorly managed urbanisation. With an estimated population of about 17.5 million, solid waste management is one of the most pressing environmental challenges currently faced in the city. It is estimated that more than 9071847.4kg of urban waste is generated every day in the city. The city lacks the capacity to deal with such magnitude of waste. Consequently, the city has involved the private sector (private sector participation) in its waste management drive. This article examines the effectiveness of this public-private sector collaboration model in waste management in informal settlements in Lagos using empirical data. Major findings of the article include the irregularity of waste collection owing to a poor road network, an inadequate transport infrastructure and the desire to maximise profit, as well as poor waste handling and disposal methods by the private sector participation operators who are not chosen based on competence and capacity to perform. Another major finding is the lack of cooperation from residents evidenced in non-payment of bills and poor packaging of wastes, resulting in wastes being littered. The article concludes on the need to restructure the scheme through proper sensitisation of residents, selection of operators with demonstrable delivery capacity and provision of a well-maintained road network to facilitate access of operators to settlements. © The Author(s) 2016.

  2. Online Learning Trends in Private-Sector Colleges and Universities

    ERIC Educational Resources Information Center

    Seaman, Jeff

    2011-01-01

    For the past eight years, the Babson Survey Research Group has conducted surveys of higher education institutions on their attitudes, beliefs, and practices concerning online education. This current report is a new analysis of this collection of data, focusing on the role of online education among private-sector colleges and universities. For the…

  3. Online Tutoring and Emotional Labour in the Private Sector

    ERIC Educational Resources Information Center

    Webb, Sue

    2012-01-01

    Purpose: What happens when computer software is designed to replace the teacher and the human role is to service the relationship between the software and the learner? Specifically, this paper aims to consider whether or not emotional labour is performed in contexts mediated by technology in the private sector. Design/methodology/approach: The…

  4. Real or Illusory Growth in an Oil-Based Economy: Government Expenditures and Private Sector Investment in Saudi Arabia

    DTIC Science & Technology

    1992-02-10

    private sector investment in Saudi Arabia. The main finding is that in Saudi Arabia at least infrastructure investment does not appear to have played a strong role in stimulating private sector investment. Instead, the private investors appear to be much more sensitive to shorter run current conditions created by government

  5. Panel 2.17: private commercial sector partnerships for health action in crises.

    PubMed

    Sundnes, Knut Ole; Sannerkvist, Milan; Hedger, Philip; Woodworth, Brent; Hyre, Anne; Cuddyre, Terrence; Waldman, Ronald

    2005-01-01

    This is a summary of the presentations and discussion of Panel 2.17, Private Commercial Sector Partnerships for Health Action in Crises of the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to private sector partnerships for health action in crises as pertain to the responses to the damage created by the Tsunami. It is presented in the following sections: (1) key questions; (2) issues and challenges; (3) lessons learned; (4) what was done well?; (5) what could have been done better?; and (6) conclusions and recommendations.

  6. [Limits of self regulation of the private food sector: the case of removing of vending machines from schools].

    PubMed

    Michaud, Claude; Baudier, François

    2007-01-01

    Conflicts of interest between the food industry and public decision makers have increasingly multiplied over the last few years, especially within the context of implementing the French National Nutrition Programme. This paper describes the rhetoric and the strategies developed by the private sector in order to counter the law's implementation and enforcement based on a concrete example, namely, the removal of vending machines from schools. After having evoked possibilities of developing new partnerships as suggested by national and international health authorities, it reaffirms the right and the duty of the State to regulate within the framework of a health promotion policy, an approach which integrates the necessary open democratic public debate between the different sectors.

  7. Public and private sector in the health care system of the Federation bosnia and herzegovina: policy and strategy.

    PubMed

    Slipicevic, Osman; Malicbegovic, Adisa

    2012-01-01

    In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other.

  8. Public and Private Sector in the Health Care System of the Federation Bosnia and Herzegovina: Policy and Strategy

    PubMed Central

    Slipicevic, Osman; Malicbegovic, Adisa

    2012-01-01

    In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the public sector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the public sector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as public sector, since actions directed toward one part of the system will inevitable influence the other. PMID:23678309

  9. Private sector involvement in civil space remote sensing. Volume 1: Report

    NASA Technical Reports Server (NTRS)

    1979-01-01

    A survey of private sector developers, users, and interpreters of Earth resources data was conducted in an effort to encourage private investment and participation in remote sensing systems. Results indicate positive interest in participation beyond the current hardware contracting level, however, there is a substantial gap between current market levels and system costs. Issues identified include the selection process for an operating entity, the public/private interface, data collection and access policies, price and profit regulation in a subsidized system, international participation, and the responsibility for research and development. It was agreed that the cost, complexity, and security implications of integrated systems need not be an absolute bar to their private operation.

  10. Staffing Practices in the Private Sector in Sri Lanka

    ERIC Educational Resources Information Center

    Wickramasinghe, Vathsala

    2007-01-01

    Purpose: This paper seeks to present and discuss the findings of a study of staffing practices in the Sri Lankan private sector with particular reference to junior level managerial jobs. The scope of staffing practices consisted of six major areas, namely the usage of information from job analysis in staffing, the sources of labour, selection…

  11. Does the Wage Gap between Private and Public Sectors Encourage Political Corruption?

    PubMed Central

    Podobnik, Boris; Vukovic, Vuk; Stanley, H. Eugene

    2015-01-01

    We present a dynamic network model of corrupt and noncorrupt employees representing two states in the public and private sector. Corrupt employees are more connected to one another and are less willing to change their attitudes regarding corruption than noncorrupt employees. This behavior enables them to prevail and become the majority in the workforce through a first-order phase transition even though they initially represented a minority. In the model, democracy—understood as the principle of majority rule—does not create corruption, but it serves as a mechanism that preserves corruption in the long run. The motivation for our network model is a paradox that exists on the labor market. Although economic theory indicates that higher risk investments should lead to larger rewards, in many developed and developing countries workers in lower-risk public sector jobs are paid more than workers in higher-risk private sector jobs. To determine the long-run sustainability of this economic paradox, we study data from 28 EU countries and find that the public sector wage premium increases with the level of corruption. PMID:26495847

  12. Does the Wage Gap between Private and Public Sectors Encourage Political Corruption?

    PubMed

    Podobnik, Boris; Vukovic, Vuk; Stanley, H Eugene

    2015-01-01

    We present a dynamic network model of corrupt and noncorrupt employees representing two states in the public and private sector. Corrupt employees are more connected to one another and are less willing to change their attitudes regarding corruption than noncorrupt employees. This behavior enables them to prevail and become the majority in the workforce through a first-order phase transition even though they initially represented a minority. In the model, democracy-understood as the principle of majority rule-does not create corruption, but it serves as a mechanism that preserves corruption in the long run. The motivation for our network model is a paradox that exists on the labor market. Although economic theory indicates that higher risk investments should lead to larger rewards, in many developed and developing countries workers in lower-risk public sector jobs are paid more than workers in higher-risk private sector jobs. To determine the long-run sustainability of this economic paradox, we study data from 28 EU countries and find that the public sector wage premium increases with the level of corruption.

  13. 20 CFR 641.600 - What is the purpose of the private sector training projects authorized under section 502(e) of...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the purpose of the private sector... EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.600 What is the purpose of the private sector training projects authorized under section 502(e) of the OAA? The purpose of...

  14. Private sector deployment of intelligent transportation systems : current status and trends

    DOT National Transportation Integrated Search

    2006-02-01

    This report summarizes the current state of deployment of Intelligent Transportation Systems and related technologies by the private sector in the United States. Coverage is focused primarily on in-vehicle entertainment, information and communication...

  15. Who, What, Where: an analysis of private sector family planning provision in 57 low- and middle-income countries.

    PubMed

    Campbell, Oona M R; Benova, Lenka; Macleod, David; Goodman, Catherine; Footman, Katharine; Pereira, Audrey L; Lynch, Caroline A

    2015-12-01

    Family planning service delivery has been neglected; rigorous analyses of the patterns of contraceptive provision are needed to inform strategies to address this neglect. We used 57 nationally representative Demographic and Health Surveys in low- and middle-income countries (2000-2013) in four geographic regions to estimate need for contraceptive services, and examined the sector of provision, by women's socio-economic position. We also assessed method mix and whether women were informed of side effects. Modern contraceptive use among women in need was lowest in sub-Saharan Africa (39%), with other regions ranging from 64% to 72%. The private sector share of the family planning market was 37-39% of users across the regions and 37% overall (median across countries: 41%). Private sector users accessed medical providers (range across regions: 30-60%, overall mean: 54% and median across countries 23%), specialised drug sellers (range across regions: 31-52%, overall mean: 36% and median across countries: 43%) and retailers (range across regions: 3-14%, overall mean: 6% and median across countries: 6%). Private retailers played a more important role in sub-Saharan Africa (14%) than in other regions (3-5%). NGOs and FBOs served a small percentage. Privileged women (richest wealth quintile, urban residents or secondary-/tertiary-level education) used private sector services more than the less privileged. Contraceptive method types with higher requirements (medical skills) for provision were less likely to be acquired from the private sector, while short-acting methods/injectables were more likely. The percentages of women informed of side effects varied by method and provider subtype, but within subtypes were higher among public than private medical providers for four of five methods assessed. Given the importance of private sector providers, we need to understand why women choose their services, what quality services the private sector provides, and how it can be improved

  16. Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study

    PubMed Central

    2012-01-01

    Background Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Methods Four intervention districts were purposefully selected to receive branded subsidized medicines - “ACT with a leaf”, while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention’s impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. Results At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, “ACT with a leaf” accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had “ACT with a leaf” purchased for them more often than those

  17. A comparison between antenatal care quality in public and private sector in rural Hebei, China.

    PubMed

    Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H M M T; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W

    2013-04-01

    To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. The quality of ANC in Hebei was poorer than required by China's national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities.

  18. The use of private-sector contracts for primary health care: theory, evidence and lessons for low-income and middle-income countries.

    PubMed Central

    Palmer, N.

    2000-01-01

    Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. PMID:10916919

  19. Terrorism: The Challenge to the Private Sector,

    DTIC Science & Technology

    private sector , security is a line management responsibility, particularly where goals and objectives, information protection, and protection of key assets are concerned. Each company in the corporate world has a different personality. The goals are pretty much the same, but once you get below that initial goal, then you go to beliefs. Some companies are very macho. Some companies won’t let a security man interview a suspect, some companies will. Companies are very hesitant to go th extremes. Companies are both image conscious and fundamentally ethical. They truly do

  20. Managerial competencies of hospital managers in South Africa: a survey of managers in the public and private sectors.

    PubMed

    Pillay, Rubin

    2008-02-08

    South Africa has large public and private sectors and there is a common perception that public sector hospitals are inefficient and ineffective while the privately owned and managed hospitals provide superior care and are more sustainable. The underlying assumption is that there is a potential gap in management capacity between the two sectors. This study aims to ascertain the skills and competency levels of hospital managers in South Africa and to determine whether there are any significant differences in competency levels between managers in the different sectors. A survey using a self administered questionnaire was conducted among hospital managers in South Africa. Respondents were asked to rate their proficiency with seven key functions that they perform. These included delivery of health care, planning, organizing, leading, controlling, legal and ethical, and self-management. Ratings were based on a five point Likert scale ranging from very low skill level to very high skill level. The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. The findings confirm our supposition that there is a lack of management capacity within the public sector in South Africa and that there is a significant gap between private and public sectors. It provides evidence that there is a great need for further development of managers, especially those in the public sector. The onus is therefore on administrators and those responsible for management education and training to identify managers in need of development and to make available training that is contextually relevant in terms of design and delivery.

  1. Managerial competencies of hospital managers in South Africa: a survey of managers in the public and private sectors

    PubMed Central

    Pillay, Rubin

    2008-01-01

    Background South Africa has large public and private sectors and there is a common perception that public sector hospitals are inefficient and ineffective while the privately owned and managed hospitals provide superior care and are more sustainable. The underlying assumption is that there is a potential gap in management capacity between the two sectors. This study aims to ascertain the skills and competency levels of hospital managers in South Africa and to determine whether there are any significant differences in competency levels between managers in the different sectors. Methods A survey using a self administered questionnaire was conducted among hospital managers in South Africa. Respondents were asked to rate their proficiency with seven key functions that they perform. These included delivery of health care, planning, organizing, leading, controlling, legal and ethical, and self-management. Ratings were based on a five point Likert scale ranging from very low skill level to very high skill level. Results The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. Conclusion The findings confirm our supposition that there is a lack of management capacity within the public sector in South Africa and that there is a significant gap between private and public sectors. It provides evidence that there is a great need for further development of managers, especially those in the public sector. The onus is therefore on administrators and those responsible for management education and training to identify managers in need of development and to make available training that is contextually relevant in terms of design and delivery. PMID:18257936

  2. The Public Good in English Private School Governance

    ERIC Educational Resources Information Center

    Boyask, Ruth

    2015-01-01

    There exist some rare private schools that attempt to mitigate the anti-democratic qualities of the private schooling sector in England. This article reports on a study of private schools that aim to promote equality and participation through some aspects of their operations. It considers to what extent the governance structures within the schools…

  3. [Health care plans: interfaces between the public and private system in the dental sector].

    PubMed

    Pietrobon, Louise; da Silva, Cíntia Magali; Batista, Luciana Rodrigues Vieira; Caetano, João Carlos

    2008-01-01

    The present work presents a brief history of health plans in Brazil examining the interface between the public and the private sector. The evolution and regulation of the supplementary care system is analyzed, the different care modalities are defined and the main differences between health plans and dental care insurance are pointed out. The coverage provided by the supplementary care system and its relationship with the public health system is shown on the basis of current data. On the other hand, the study focuses on the care services, health plans and the labor market in the sector correlating, also on the basis of current data, the challenges and new opportunities of the supplementary care market, mainly in the dental sector. Although the dental sector is living an extraordinary moment within the private health care system and given that ANS data are pointing to a growth of this sector of 210% over last the 7 years, the service coverage of the supplementary care sector mainly directed to medical and inpatient care does not meet the real demand for integrated health care.

  4. The problems and prospects of the public-private partnership in the Russian fuel and energy sector

    NASA Astrophysics Data System (ADS)

    Nikitenko, SM; Goosen, EV

    2017-02-01

    This article highlights some opportunities for shifting the paradigm for the development of natural resources in the Russian fuel and energy sector using public-private partnership instruments. It shows three main directions for developing public-private partnerships in the area of subsoil use and emphasizes the role of innovations in implementing the most promising projects in the fuel and energy sector of Russia.

  5. 5 CFR 300.503 - Conditions for using private sector temporaries.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... temporaries. 300.503 Section 300.503 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... help service firm for the brief or intermittent use of the skills of private sector temporaries, when... through the direct appointment of temporary employees within the time available by the date, and for the...

  6. Defense Expenditures in Pakistan: A Source of Stimulus for or Competition With the Private Sector

    DTIC Science & Technology

    1994-01-01

    private sector activity, particularly investment, is the only viable option open to the authorities. It follows that for policy purposes the most important issue involves restructuring government expenditures and their financing in a manner that would provide the maximum inducement to private sector capital formation, especially in manufacturing. Operationally, this means finding an optimal balance between the government’s three most important budgetary items: defense, public consumption and infrastructural development. More importantly because

  7. Large regional differences in incidence of arthroscopic meniscal procedures in the public and private sector in Denmark.

    PubMed

    Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch

    2015-02-24

    A recent study reported a large increase in the number of meniscal procedures from 2000 to 2011 in Denmark. We examined the nation-wide distribution of meniscal procedures performed in the private and public sector in Denmark since different incentives may be present and the use of these procedures may differ from region to region. We included data on all patients who underwent an arthroscopic meniscal procedure performed in the public or private sector in Denmark. Data were retrieved from the Danish National Patient Register on patients who underwent arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. Yearly incidence of meniscal procedures per 100,000 inhabitants was calculated with 95% CIs for public and private procedures for each region. Incidence of meniscal procedures increased at private and at public hospitals. The private sector accounted for the largest relative and absolute increase, rising from an incidence of 1 in 2000 to 98 in 2011. In 2011, the incidence of meniscal procedures was three times higher in the Capital Region than in Region Zealand. Our study identified a large increase in the use of meniscal procedures in the public and private sector in Denmark. The increase was particularly conspicuous in the private sector as its proportion of procedures performed increased from 1% to 32%. Substantial regional differences were present in the incidence and trend over time of meniscal procedures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. The economic rationale of public and private sector roles in the provision of animal health services.

    PubMed

    Ahuja, V

    2004-04-01

    In the changing market environment of livestock products, the delivery of animal health services is emerging as an important priority area for enhancing the competitiveness of poor livestock producers. At the same time, governments are continuing to face serious budgetary difficulties and are finding it difficult to expand the reach of these services or improve service quality. In this context of a changing environment and dwindling public resources, this paper revisits the economic framework that has thus far guided thinking about public and private sector roles in the provision of animal health services and examines the ongoing debate on livestock service delivery for the poor. The paper highlights the importance of strong institutions and appropriate legislation for regulating behaviour and enforcing contracts and re-emphasises the idea, which is supported by economic theory, that there is a need for task sharing between the public and private sectors. The paper further emphasizes the need for: a) integrating the debate on livestock service delivery with the larger debate on political economy and institutional development, and b) ensuring service access in poor marginal areas by working through membership organisations, self-help groups and civil society organisations, and by promoting the use of para-professionals and community-based animal health delivery systems.

  9. Firm-Level Perspectives on Public Sector Engagement with Private Healthcare Providers: Survey Evidence from Ghana and Kenya

    PubMed Central

    Sood, Neeraj; Burger, Nicholas; Yoong, Joanne; Kopf, Dan; Spreng, Connor

    2011-01-01

    Background Health systems in Sub-Saharan Africa (SSA) are in urgent need of improvement. The private health sector is a major provider of care in the region and it will remain a significant actor in the future. Any efforts by SSA governments to improve health systems performance therefore has to account for the private health sector. Regional and international actors increasingly recognize importance of effectively engaging with the private health sector, and initiatives to improve engagement are underway in several countries. However, there is little systematic analysis of private health providers' view and experience with engagement. Methodology/Principal Findings In this study we surveyed private health facilities in Kenya and Ghana to understand the extent to which and how governments interact and engage with these facilities. The results suggest that government engagement with private health facilities is quite limited. The primary focus of this engagement is “command-and-control” type regulations to improve the quality of care. There is little attention paid to building the capacity of health care businesses through either technical or financial assistance. The vast majority of these facilities also receive no government assistance in meeting public health and social goals. Finally, government engagement with private pharmacies is often neglected and clinics receive a disproportionate share of government assistance. Conclusions/Significance Overall, our findings suggest that there may be considerable untapped potential for greater engagement with private health facilities—particularly pharmacies. Improving engagement will likely help governments with limited resources to better take advantage of the private sector capacity to meet access and equity objectives and to accelerate the achievement of the Millennium Development Goals. PMID:22132092

  10. Why Privatization Signals a Sea Change in Schooling.

    ERIC Educational Resources Information Center

    Murphy, Joseph

    1996-01-01

    Reviews several privatization strategies and their applications to public education, including load-shedding, asset sales, volunteerism, self-help, user fees, contracting, franchises, vouchers, subsidies, and deregulation. The major forces promoting privatization in education are those stemming from growing discontent with the public sector and…

  11. Public-private sector partnership in household waste management as perceived by residents in south-west Nigeria.

    PubMed

    Ezebilo, Eugene E; Animasaun, Emmanuel D

    2012-08-01

    In most developing countries public-private sector partnership is becoming increasingly applied in household waste management service delivery especially in urban areas to reduce cost and improve effectiveness. This paper reports a study of householders' perceptions of public-private sector partnership in provision of household waste management services in Ilorin, south-west Nigeria. A multistage random sampling technique was used to select 224 households for the study. The data generated from the survey were analysed using a binary logit model. The results show that most of the respondents were of the opinion that the public-private partnership has not been able to improve household waste management services. Time taken to visit solid waste collection point, income and marital status negatively influenced their perceptions, while activities of sanitary inspectors, occupation and gender had positive influence. The public-private partnership will be more effective and sustainable if the public sector could pay more attention to performance monitoring and accountability.

  12. Private Sector Views of Vocational Education: A Statewide Employer Survey.

    ERIC Educational Resources Information Center

    Owens, Thomas R.; Monthey, Wanda

    A study examined the views of private sector employers in Oregon on vocational education. During the study, researchers mailed questionnaires to a stratified random sample of 1,500 employers throughout Oregon. In addition, they surveyed another 140 employers who were identified as hiring the largest numbers of vocational education completers in…

  13. A comparison between antenatal care quality in public and private sector in rural Hebei, China

    PubMed Central

    Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Saftić, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.

    2013-01-01

    Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142

  14. Innovative work behavior of managers: Implications regarding stressful challenges of modernized public- and private-sector organizations

    PubMed Central

    Mukherjee, Sudeshna Basu; Ray, Anjali

    2009-01-01

    Background: The present study was firstly aimed to find out the nature of stressful life events arising out of the innovative challenges in modernized organizations; and secondly, it tried to identify the relationship between innovative work behavior of managers and the levels of stress arising out of stressful events in modernized organizations (public and private) in West Bengal. Materials and Methods: Data was collected from a sample of 200 managers, by using 3 tools (General Information Schedule, Life Event Inventory and Innovative Work Behavior Scale) through a face-to-face interview. Responses were subjected to both quantitative and qualitative analyses. The data was statistically treated for ‘t’ and ANOVA. Results: Data highlighted the fact that the qualitative profile of stressful events in the lives of managers expressed specificity in terms of their organizational type (public- and private-sector modernized organizations), and levels of stress from stressful life events were significantly higher among the modernized private-sector managers than those among public-sector managers. The prevalence of innovative work behavior was moderately higher among managers of private-sector modernized organizations than their counterparts in public-sector organizations. The trends of innovative work behavior of the managers indicated much variability due to interaction of their level of perceived stressful challenges for innovation and the global forces of change that have unleashed dynamic, systematic and higher expectation level from them. PMID:21180486

  15. Innovative work behavior of managers: Implications regarding stressful challenges of modernized public- and private-sector organizations.

    PubMed

    Mukherjee, Sudeshna Basu; Ray, Anjali

    2009-07-01

    The present study was firstly aimed to find out the nature of stressful life events arising out of the innovative challenges in modernized organizations; and secondly, it tried to identify the relationship between innovative work behavior of managers and the levels of stress arising out of stressful events in modernized organizations (public and private) in West Bengal. Data was collected from a sample of 200 managers, by using 3 tools (General Information Schedule, Life Event Inventory and Innovative Work Behavior Scale) through a face-to-face interview. Responses were subjected to both quantitative and qualitative analyses. The data was statistically treated for 't' and ANOVA. Data highlighted the fact that the qualitative profile of stressful events in the lives of managers expressed specificity in terms of their organizational type (public- and private-sector modernized organizations), and levels of stress from stressful life events were significantly higher among the modernized private-sector managers than those among public-sector managers. The prevalence of innovative work behavior was moderately higher among managers of private-sector modernized organizations than their counterparts in public-sector organizations. The trends of innovative work behavior of the managers indicated much variability due to interaction of their level of perceived stressful challenges for innovation and the global forces of change that have unleashed dynamic, systematic and higher expectation level from them.

  16. Private sector participation in solid waste collection in Addis Ababa (Ethiopia) by involving micro-enterprises.

    PubMed

    Tilaye, Mesfin; van Dijk, Meine Pieter

    2014-01-01

    Privatization of urban services focuses often on the involvement of foreign enterprises. This contribution deals with micro-privatization, the partial transfer of government responsibility for solid waste collection to micro-enterprises. It tries to shed light on whether the current private sector participation (PSP) of micro-enterprises in solid waste collection service is the best way to capture the expected advantages of private sector involvement. The article examines the relations of the micro-enterprises with beneficiaries and the public sector by focusing on the contract procedure, the tariff-setting process, the cost recovery mechanism and institutionalizing of market principles for micro-enterprises. The research was carried out using secondary and primary data sources. Primary data were collected through the interviewing of public sector officials at different levels, focus group discussions with community groups and micro-enterprises, and observation. A survey was conducted among 160 micro-enterprises in the city of Addis Ababa, Ethiopia, using a standard questionnaire. What are some of the factors contributing to the results of PSP in Addis Ababa, the capital of Ethiopia? Policies at higher levels of government definitely produced an overall climate conducive to micro-privatization and recognized the need to develop micro-enterprises, but it is not clear what role the micro-enterprises are to play in solid waste management. New opportunities were created by formalization and taken up by communities and micro-enterprises. Coverage and waste collected both increased. The initiation and institutionalization of the formalization process was not without problems. The public sector over-stressed the autonomy of micro-enterprises. The fate of the micro-enterprises is largely determined by the reforms undertaken at local government level. The rapid changes in policies at the local level made waste-collecting micro-enterprises lose confidence and more dependent

  17. Disease surveillance and private sector in the metropolitans: a troublesome collaboration.

    PubMed

    Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

    2013-09-01

    An effective response to health problems is completely dependent upon the capacities of the health system in providing timely and valid information to take action. This study was designed to identify various reasons from various perspectives for underreporting disease by physicians in the private sector in big cities in developing countries setting. In this qualitative study, we used focus group discussions (16 manager), and in-depth semi-structured interviews. Themes were classified in 6 categories: Infrastructure and legal issues, the priority of disease reporting, workflow processes, motivation and attitude, human resources and knowledge and awareness. As the main reasons of under reporting, most physicians pointed out complicacy in reporting process and inadequate attention by the public sector. Managers emphasized instituting legal incentives and penalties. Experts focused on physicians' knowledge and expressed a need for continuing medical education programs. Independent interventions will have little chance of success and sustainability. Different intervention programs should consider legal issues, attitude and knowledge of physicians in the private sector, and building a simple reporting process for physicians. Intervention programs in which the reporting process offers incentives for all stakeholders can help improving and sustaining the disease reporting system.

  18. Disease Surveillance and Private Sector in the Metropolitans: A Troublesome Collaboration

    PubMed Central

    Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

    2013-01-01

    Background: An effective response to health problems is completely dependent upon the capacities of the health system in providing timely and valid information to take action. This study was designed to identify various reasons from various perspectives for underreporting disease by physicians in the private sector in big cities in developing countries setting. Methods: In this qualitative study, we used focus group discussions (16 manager), and in-depth semi-structured interviews Results: Themes were classified in 6 categories: Infrastructure and legal issues, the priority of disease reporting, workflow processes, motivation and attitude, human resources and knowledge and awareness. As the main reasons of under reporting, most physicians pointed out complicacy in reporting process and inadequate attention by the public sector. Managers emphasized instituting legal incentives and penalties. Experts focused on physicians’ knowledge and expressed a need for continuing medical education programs. Conclusions: Independent interventions will have little chance of success and sustainability. Different intervention programs should consider legal issues, attitude and knowledge of physicians in the private sector, and building a simple reporting process for physicians. Intervention programs in which the reporting process offers incentives for all stakeholders can help improving and sustaining the disease reporting system. PMID:24130945

  19. Case Studies of UMTA Private Sector Initiative Projects in Syracuse, Central New Jersey, and Atlanta

    DOT National Transportation Integrated Search

    1987-12-01

    This report documents the results of three grants awarded in 1983 by the Urban Mass Transportation Administration for Section 8 Private Sector Initiative projects. The grants were intended to encourage cooperative public and private planning for the ...

  20. Foreign Assistance: Enterprise Funds’ Contributions to Private Sector Development Vary.

    DTIC Science & Technology

    1999-09-01

    private sector development in selected countries of Central and Eastern Europe as they transition from centrally planned to market-oriented economies. The funds, which are private, nonprofit U.S. corporations, are supposed to make loans to, or investments in, small- and medium-sized businesses in which other financial institutions are reluctant to invest. With the breakup of the Soviet Union in 1991, enterprise funds were subsequently established in the newly independent states. Currently, 10 funds operate in Central Europe and the former Soviet Union, covering 19

  1. Capital Budgeting: Do Private Sector Methods of Budgeting for Capital Assets Have Applicability to the Department of Defense

    DTIC Science & Technology

    2005-12-01

    private sector and the Department of Defense. Additionally, the purpose is to evaluate the strengths and weaknesses of each capital budgeting method and conduct a comparison. The intent is to identify those capital budgeting practices that are used in the private sector , some of which have been implemented in other public sector organizations, which may have merit for implementation in the Federal sector and possibly the Department of Defense. Finally, a set of conclusions and recommendations on how to implement best practices of capital budgeting for

  2. ‘Going private’: a qualitative comparison of medical specialists’ job satisfaction in the public and private sectors of South Africa

    PubMed Central

    2013-01-01

    Background There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the public sector. Methods Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist ‘dual practice’, that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. Results Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel ‘needed’ and ‘relevant’. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. Conclusions The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the public sector. Policy recommendations center around boosting public sector resources and building trust of the public sector through including health workers more in decision

  3. Health Resources in a 200,000 Urban Indian Population Argues the Need for a Policy on Private Sector Health Services

    PubMed Central

    Furtado, Kheya Melo; Kar, Anita

    2014-01-01

    Background: There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Results: Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Conclusions: Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals. PMID:24963226

  4. Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

    PubMed

    Furtado, Kheya Melo; Kar, Anita

    2014-04-01

    There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

  5. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states.

    PubMed

    Peters, David H; Chakraborty, Subrata; Mahapatra, Prasanta; Steinhardt, Laura

    2010-11-25

    Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P < 0.01). Discordance between what motivational factors health workers considered important and their perceptions of actual presence of these factors were also highest in Uttar Pradesh in the public sector, where all 17 items had greater discordance for public sector workers than for workers in the private sector (P < 0.001). There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working

  6. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states

    PubMed Central

    2010-01-01

    Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P < 0.01). Discordance between what motivational factors health workers considered important and their perceptions of actual presence of these factors were also highest in Uttar Pradesh in the public sector, where all 17 items had greater discordance for public sector workers than for workers in the private sector (P < 0.001). Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non

  7. A protocol for developing an evaluation framework for an academic and private-sector partnership to assess the impact of major food and beverage companies' investments in community health in the United States.

    PubMed

    Huang, Terry T-K; Ferris, Emily; Crossley, Rachel; Guillermin, Michelle; Costa, Sergio; Cawley, John

    2015-01-01

    Public health leaders increasingly recognize the importance of multi-sector partnerships and systems approaches to address obesity. Public-private partnerships (PPP), which are joint ventures between government agencies and private sector entities, may help facilitate this process, but need to be delivered through comprehensive, transparent frameworks to maximize potential benefits and minimize potential risks for all partners. The City University of New York (CUNY) School of Public Health and the Healthy Weight Commitment Foundation (HWCF) propose to engage in a unique academic-private-sector research partnership to evaluate the impact and effectiveness of the food and beverage industry's investment in obesity and hunger prevention and reduction through community-level healthful eating and active living programs. The CUNY-HWCF academic-private partnership protocol described here incorporates best practices from the literature on PPP into the partnership's design. The CUNY-HWCF partnership design demonstrates how established guidelines for partnership components will actively incorporate and promote the principles of successful PPPs identified in various research papers. These identified principles of successful PPP, including mutuality (a reciprocal relationship between entities), and equality among partners, recognition of partners' unique strengths and roles, alignment of resources and expertise toward a common cause, and coordination and delegation of responsibilities, will be embedded throughout the design of governance, management, funding, intellectual property and accountability structures. The CUNY-HWCF partnership responds to the call for increased multi-sector work in obesity prevention and control. This framework aims to promote transparency and the shared benefits of complementary expertise while minimizing shared risks and conflicts of interest. This framework serves as a template for future academic-private research partnerships.

  8. Renewing the model employer. Changing employment relations and "partnership" in the health and private sectors.

    PubMed

    Stuart, M; Martinez Lucio, M

    2000-01-01

    Drawing from original empirical data this paper compares the changing nature of employment relations in the health and private sectors. A key concern is to assess the extent to which the emergence of partnership-type arrangements between employers and trade unions lays the basis for the "renewal" of the traditional public sector concept of the model employer. Empirically, the paper draws on a survey of trade union representatives from 238 workplaces and a case study of a hospital trust. The data reveal that employment relations in the NHS are more collectivist when compared with the private sector. However, the development of partnership in the NHS is hamstrung by ongoing training and involvement gaps and widespread work intensification.

  9. Evidence on Private Sector Training. Background Paper No. 7c.

    ERIC Educational Resources Information Center

    Ouweneel, William M.

    Private sector training is a primary force in education in the United States for a number of reasons: (1) the sheer amount of such training makes it a major factor; (2) this training has a significant impact on the nation's productivity and competitiveness; (3) it plays a major role in creating innovative and cost-effective solutions to training…

  10. Gonorrhea prevention and clinical care in the private sector: lessons learned and priorities for quality improvement.

    PubMed

    Tao, Guoyu; Irwin, Kathleen L

    2006-11-01

    We reviewed literature on gonorrhea prevention and clinical care in the private sector, the setting where most gonorrhea cases in the United States are now diagnosed. Although most private-sector health settings had a low prevalence of gonorrhea (0.1-2.5%), some private emergency departments and specialty clinics that serve a large number of high-risk or infected patients had prevalences ranged from 1.7% to 11.0%. Studies of diverse settings and populations suggest that, in general, diagnostic testing of symptomatic patients (69-83%), appropriate treatment (61-100%), and case reporting (64-94%) are delivered more commonly than risk assessment for asymptomatic patients (15-28%), routine screening of pregnant women (31-77%), risk-reduction counseling (35-78%), and sex partner management (0-82%). To sustain the recent declines in gonorrhea incidence in the United States, private-sector providers and health systems must continue to offer gonorrhea prevention and clinical services and consider implementing interventions to improve delivery of risk assessment, risk-reduction counseling, and partner management services.

  11. Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria.

    PubMed

    Bali, Sulzhan; Stewart, Kearsley A; Pate, Muhammad Ali

    2016-01-01

    The already significant impact of the Ebola epidemic on Guinea, Liberia and Sierra Leone, was worsened by a fear of contagion that aggravated the health crisis. However, in contrast to other Ebola-affected countries, Nigeria fared significantly better due to its swift containment of the disease. The objective of our study was to describe the impact of Ebola on the Nigerian private sector. This paper introduces and defines the term fearonomic effect as the direct and indirect economic effects of both misinformation as well as fear-induced aversion behaviour, exhibited by individuals, organisations or countries during an outbreak or an epidemic. This study was designed as a cross-sectional mixed-methods study that used semistructured in-depth interviews and a supporting survey to capture the impact of Ebola on the Nigerian private sector after the outbreak. Themes were generated from the interviews on the direct and indirect impact of Ebola on the private sector; the impact of misinformation and fear-based aversion behaviour in the private sector. Our findings reveal that the fearonomic effects of Ebola included health service outages and reduced healthcare usage as a result of misinformation and aversion behaviour by both patients and providers. Although certain sectors (eg, health sector, aviation sector, hospitality sector) in Nigeria were affected more than others, no business was immune to Ebola's fearonomic effects. We describe how sectors expected to prosper during the outbreak (eg, pharmaceuticals), actually suffered due to the changes in consumption patterns and demand shocks. In a high-stressor epidemic-like setting, altered consumption behaviour due to distorted disease perception, misinformation and fear can trigger short-term economic cascades that can disproportionately affect businesses and lead to financial insecurity of the poorest and the most vulnerable in a society.

  12. Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria

    PubMed Central

    Bali, Sulzhan; Stewart, Kearsley A

    2016-01-01

    Background The already significant impact of the Ebola epidemic on Guinea, Liberia and Sierra Leone, was worsened by a fear of contagion that aggravated the health crisis. However, in contrast to other Ebola-affected countries, Nigeria fared significantly better due to its swift containment of the disease. The objective of our study was to describe the impact of Ebola on the Nigerian private sector. This paper introduces and defines the term fearonomic effect as the direct and indirect economic effects of both misinformation as well as fear-induced aversion behaviour, exhibited by individuals, organisations or countries during an outbreak or an epidemic. Methods This study was designed as a cross-sectional mixed-methods study that used semistructured in-depth interviews and a supporting survey to capture the impact of Ebola on the Nigerian private sector after the outbreak. Themes were generated from the interviews on the direct and indirect impact of Ebola on the private sector; the impact of misinformation and fear-based aversion behaviour in the private sector. Results Our findings reveal that the fearonomic effects of Ebola included health service outages and reduced healthcare usage as a result of misinformation and aversion behaviour by both patients and providers. Although certain sectors (eg, health sector, aviation sector, hospitality sector) in Nigeria were affected more than others, no business was immune to Ebola's fearonomic effects. We describe how sectors expected to prosper during the outbreak (eg, pharmaceuticals), actually suffered due to the changes in consumption patterns and demand shocks. Conclusion In a high-stressor epidemic-like setting, altered consumption behaviour due to distorted disease perception, misinformation and fear can trigger short-term economic cascades that can disproportionately affect businesses and lead to financial insecurity of the poorest and the most vulnerable in a society. PMID:28588965

  13. Private sector tuberculosis prevention in the US: Characteristics associated with interferon-gamma release assay or tuberculin skin testing.

    PubMed

    Stockbridge, Erica L; Miller, Thaddeus L; Carlson, Erin K; Ho, Christine

    2018-01-01

    To determine whether latent tuberculosis infection risk factors are associated with an increased likelihood of latent tuberculosis infection testing in the US private healthcare sector. A national sample of medical and pharmacy claims representing services rendered January 2011 through December 2013 for 3,997,986 commercially insured individuals in the US who were 0 to 64 years of age. We used multivariable logistic regression models to determine whether TB/LTBI risk factors were associated with an increased likelihood of Interferon-Gamma Release Assay (IGRA) or Tuberculin Skin Test (TST) testing in the private sector. 4.31% (4.27-4.34%) received at least one TST/IGRA test between 2011 and 2013 while 1.69% (1.67-1.72%) received a TST/IGRA test in 2013. Clinical risk factors associated with a significantly increased likelihood of testing included HIV, immunosuppressive therapy, exposure to tuberculosis, a history of tuberculosis, diabetes, tobacco use, end stage renal disease, and alcohol use disorder. Other significant variables included gender, age, asthma, the state tuberculosis rate, population density, and percent of foreign-born persons in a county. Private sector TST/IGRA testing is not uncommon and testing varies with clinical risk indicators. Thus, the private sector can be a powerful resource in the fight against tuberculosis. Analyses of administrative data can inform how best to leverage private sector healthcare toward tuberculosis prevention activities.

  14. The School and the Private Sector: Romance or Marriage of Convenience.

    ERIC Educational Resources Information Center

    Mauch I, James W.

    1999-01-01

    Presents the alliance between Reading High School (Pennsylvania) and a local corporation as a case study of the potential for incentives and private-sector involvement to improve student attendance. The partnership, Reading's Excellence and Attendance Programs, used positive reinforcements, including lottery drawings and ice-cream socials, to…

  15. Institutional delivery in public and private sectors in South Asia: a comparative analysis of prospective data from four demographic surveillance sites.

    PubMed

    Das, Sushmita; Alcock, Glyn; Azad, Kishwar; Kuddus, Abdul; Manandhar, Dharma S; Shrestha, Bhim Prasad; Nair, Nirmala; Rath, Shibanand; More, Neena Shah; Saville, Naomi; Houweling, Tanja A J; Osrin, David

    2016-09-20

    Maternity care in South Asia is available in both public and private sectors. Using data from demographic surveillance sites in Bangladesh, Nepal and rural and urban India, we aimed to compare institutional delivery rates and public-private share. We used records of maternity care collected in socio-economically disadvantaged communities between 2005 and 2011. Institutional delivery was summarized by four potential determinants: household asset index, maternal schooling, maternal age, and parity. We developed logistic regression models for private sector institutional delivery with these as independent covariates. The data described 52 750 deliveries. Institutional delivery proportion varied and there were differences in public-private split. In Bangladesh and urban India, the proportion of deliveries in the private sector increased with wealth, maternal education, and age. The opposite was observed in rural India and Nepal. The proportion of institutional delivery increased with economic status and education. The choice of sector is more complex and provision and perceived quality of public sector services is likely to play a role. Choices for safe maternity are influenced by accessibility, quantity and perceived quality of care. Along with data linkage between private and public sectors, increased regulation should be part of the development of the pluralistic healthcare systems that characterize south Asia.

  16. Cost benefit for assessment of intermediate coronary stenosis with fractional flow reserve in public and private sectors in australia.

    PubMed

    Murphy, J C; Hansen, P S; Bhindi, R; Figtree, G A; Nelson, G I C; Ward, M R

    2014-09-01

    Fractional Flow Reserve (FFR) is a proven technology for guiding percutaneous coronary intervention (PCI), but is not reimbursed despite the fact that it is frequently used to defer PCI. Costs incurred with use of FFR were compared in both the public and private sectors with the costs that would have been incurred if the technology was not available using consecutive cases over a two year period in a public teaching hospital and its co-located private hospital. FFR was performed on 143 lesions in 120 patients. FFR was < 0.80 in 37 lesions in 34 patients and 25 underwent PCI while 11 had CABG. It was estimated that without FFR 78 lesions in 70 patients would have had PCI with 17 patients having CABG with 35 additional functional tests. Despite a cost of $A1200 per wire, FFR actually saved money. Mean savings in the public sector were $1200 per patient while in the private sector the savings were $5000 per patient. FFR use saves money for the Federal Government in the public sector and for the Private Health Funds in the private sector. These financial benefits are seen in addition to the improved outcomes seen with this technology. Copyright © 2014. Published by Elsevier B.V.

  17. An Evaluation of Public and Private Sector Housing Alternatives for Military Families

    DTIC Science & Technology

    2002-03-01

    private sector alternatives are less expensive than government provided housing. In addition, it appears that the MHPI is reaching its goals of providing housing faster and at a lower cost to the American taxpayer than traditional on base

  18. Involving the private sector in Georgia's conservation initiatives for neotropical birds

    Treesearch

    Terry W. Johnson

    1993-01-01

    Faced with major financial and manpower restrictions, the Georgia Department of Natural Resources (DNR) Nongame-Endangered Wildlife Program (NGEWP) is aggressively encouraging the private sector to participate in a broad spectrum of innovative neotropical bird-related research, survey, fund raising, management and educational activities. A key element in this...

  19. Comparative performance of public and private sector delivery of BCG vaccination: evidence from Sub-Saharan Africa.

    PubMed

    Wagner, Zachary; Szilagyi, Peter G; Sood, Neeraj

    2014-07-31

    The private sector is an important source of health care in the developing world. However, there is limited evidence on how private providers compare to public providers, particularly for preventive services such as immunizations. We used data from Sub-Saharan Africa (SSA) to assess public-private differences in Bacillus Calmette-Guérin (BCG) vaccine delivery. We used demographic and health surveys from 102,629 children aged 0-59 months from 29 countries across SSA to measure differences in BCG status for children born at private versus public health facilities (BCG is recommended at birth). We used a probit model to estimate public-private differences in BCG delivery, while controlling for key confounders. Next, we estimated how differences in BCG status evolved over time for children born at private versus public facilities. Finally, we estimated heterogeneity in public-private differences based on wealth and rural-urban residency. We found that children born at a private facility were 7.1 percentage points less likely to receive BCG vaccine in the same month as birth than children born at a public facility (95% CI 6.3-8.0; p<0.001). Most of this difference was driven by for-profit private providers (as opposed to NGOs) where the BCG provision rate was 10.0 percentage points less than public providers (95% CI 9.0-11.2; p<0.001) compared to only 2.4 percentage points for NGOs (95% CI 1.0-3. 8; p<0.01). Moreover, children born at private for-profit facilities remained less likely to be vaccinated up to 59 months after birth. Finally, public-private differences were more pronounced for poorer children and children in rural areas. The for-profit private sector performed substantially worse than the public sector in providing BCG vaccine to newborns, resulting in a longer duration of vulnerability to tuberculosis. This disparity was greater for poorer children and children in rural areas. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Quality of anti-malarials collected in the private and informal sectors in Guyana and Suriname

    PubMed Central

    2012-01-01

    Background Despite a significant reduction in the number of malaria cases in Guyana and Suriname, this disease remains a major problem in the interior of both countries, especially in areas with gold mining and logging operations, where malaria is endemic. National malaria control programmes in these countries provide treatment to patients with medicines that are procured and distributed through regulated processes in the public sector. However, availability to medicines in licensed facilities (private sector) and unlicensed facilities (informal sector) is common, posing the risk of access to and use of non-recommended treatments and/or poor quality products. Methods To assess the quality of circulating anti-malarial medicines, samples were purchased in the private and informal sectors of Guyana and Suriname in 2009. The sampling sites were selected based on epidemiological data and/or distance from health facilities. Samples were analysed for identity, content, dissolution or disintegration, impurities, and uniformity of dosage units or weight variation according to manufacturer, pharmacopeial, or other validated method. Results Quality issues were observed in 45 of 77 (58%) anti-malarial medicines sampled in Guyana of which 30 failed visual & physical inspection and 18 failed quality control tests. The proportion of monotherapy and ACT medicines failing quality control tests was 43% (13/30) and 11% (5/47) respectively. A higher proportion of medicines sampled from the private sector 34% (11/32) failed quality control tests versus 16% (7/45) in the informal sector. In Suriname, 58 medicines were sampled, of which 50 (86%) were Artecom®, the fixed-dose combination of piperaquine-dihydroartemisinin-trimethoprim co-blistered with a primaquine phosphate tablet. All Artecom samples were found to lack a label claim for primaquine, thus failing visual and physical inspection. Conclusions The findings of the studies in both countries point to significant problems with

  1. Private-Sector Provision of Schooling: An Economic Assessment

    ERIC Educational Resources Information Center

    Adnett, Nick

    2004-01-01

    In many countries the school choice agenda has promoted increased inter-school competition as a means of creating stronger incentives for state schools to raise measures of average pupil attainment. Privatization of the provision of schooling takes market-based reforms a stage further. We identify the factors that have increased governments'…

  2. Private-Sector Cleanup Expenditures and Transaction Costs at 18 Superfund Sites (1993)

    EPA Pesticide Factsheets

    Superfund allows the government either to clean up a site and recover its cost from the potentially responsible parties (PRPs) or to require the PRPs to undertake the cleanup themselves. This study examines private-sector expenditures and transaction-costs

  3. Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia

    PubMed Central

    Ron Levey, Ilana; Wang, Wenjuan

    2014-01-01

    Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre

  4. Private sector involvement in times of armed conflict: What are the constraints for trading medical equipment?

    PubMed

    Schmidt, Georg

    Today, healthcare facilities are highly dependent on the private sector to keep their medical equipment functioning. Moreover, private sector involvement becomes particularly important for the supply of spare parts and consumables. However, in times of armed conflict, the capacity of the corporate world appears to be seriously hindered. Subsequently, this study researches the influence of armed conflict on the private medical equipment sector. This study follows a qualitative approach by conducting 19 interviews with representatives of the corporate world in an active conflict zone. A semistructured interview guide, consisting of 10 questions, was used to examine the constraints of this sector. The results reveal that the lack of skilled personnel, complicated importation procedures, and a decrease in financial capacity are the major constraints faced by private companies dealing in medical equipment in conflict zones. Even when no official sanctions and embargoes for medical items exist, constraints for trading medical equipment are clearly recognizable. Countries at war would benefit from a centralized structure that deals with the importation procedures for medical items, to assist local companies in their purchasing procedures. A high degree of adaption is needed to continue operating, despite the emerging constraints of armed conflict. Future studies might research the constraints for manufacturers outside the conflict to export medical items to the country of war.

  5. Regional trends in the use of short-acting and long-acting contraception accessed through the private and public sectors.

    PubMed

    Ugaz, Jorge I; Chatterji, Minki; Gribble, James N; Mitchell, Susan

    2015-08-01

    To examine trends in the source of modern contraception (public versus private sector); method choice (long-acting or permanent methods versus short-acting methods); and method and source combined. A retrospective analysis was conducted using data collected by national Demographic and Health Surveys and Reproductive Health Surveys during the period 1992-2012. The dataset included 18 low-income countries in Sub-Saharan Africa, 10 from Latin America and the Caribbean (LAC), and 8 from Asia. A substantial proportion-between 40% and 49%-of modern contraceptive users relied on the private sector in Asia and LAC in the last 20years, yet the proportion has been smaller in Sub-Saharan Africa, between 27% and 30%. Increased use of short-acting methods from both public and private sectors has driven the rise in contraceptive prevalence in Asia and LAC. Similarly, increased contraceptive prevalence in Sub-Saharan Africa reflected the increased use of short-acting methods obtained mainly through the public sector, with only limited use of long-acting or permanent methods through the private sector. The private sector has played a key role in the increase of modern CPR and the provision of modern contraceptives around the world, providing almost half of them in low-income countries. Yet, such increase was driven primarily by a more substantial role in the provision of short-acting methods than long acting and permanent methods. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Private sector involvement in civil space remote sensing. Volume 2: Appendices

    NASA Technical Reports Server (NTRS)

    1980-01-01

    The U.S. Space Policy concerning the investment and direct participation in the establishment and operations of remote sensing systems is addressed. Private sector views and state and local government views are presented. Results of a market analysis are pregiven and the economic feasibility of such a program is considered.

  7. The Decline of Private-Sector Unionism and the Gender Wage Gap.

    ERIC Educational Resources Information Center

    Even, William E.; Macpherson, David A.

    1993-01-01

    Between 1973 and 1988, private sector union membership fell by 9.5 percentage points more for men than women; the gender wage gap decreased by 0.09. Unionism fell more slowly for women. Greater decline in male unionism is responsible for one-seventh of the decline in the wage gap. (SK)

  8. Funding the Military Retirement System: A Private Sector Investment Approach to Accrual Accounting

    DTIC Science & Technology

    1987-12-01

    management firm . Assumptions. In performing this research to determine whether the MRS can be funded through private sector investments, several...to determine any savings that such a strategy might offer to DOD and, ultimately, the American taxpayers. From a "macro" level, this study revealed...government. To accomplish this "macro-level" research, it is necessary to determine representative private investment plans. The real interest returns of the

  9. Private sector participation in delivering tertiary health care: a dichotomy of access and affordability across two Indian states.

    PubMed

    Katyal, Anuradha; Singh, Prabal Vikram; Bergkvist, Sofi; Samarth, Amit; Rao, Mala

    2015-03-01

    Poor quality care in public sector hospitals coupled with the costs of care in the private sector have trapped India's poor in a vicious cycle of poverty, ill health and debt for many decades. To address this, the governments of Andhra Pradesh (AP) and Maharashtra (MH), India, have attempted to improve people's access to hospital care by partnering with the private sector. A number of government-sponsored schemes with differing specifications have been launched to facilitate this strategy. This article aims to compare changes in access to, and affordability and efficiency of private and public hospital inpatient (IP) treatments between MH and AP from 2004 to 2012 and to assess whether the health financing innovations in one state resulted in larger or smaller benefits compared with the other. We used data from household surveys conducted in 2004 and 2012 in the two states and undertook a difference-in-difference (DID) analysis. The results focus on hospitalization, out-of-pocket expenditure and length of stay. The average IP expenditure for private hospital care has increased in both states, but more so in MH. There was also an observable increase in both utilization of and expenditure on nephrology treatment in private hospitals in AP. The duration of stay recorded in days for private hospitals has increased slightly in MH and declined in AP with a significant DID. The utilization of public hospitals has reduced in AP and increased in MH. The state of AP appears to have benefited more than MH in terms of improved access to care by involving the private sector. The Aarogyasri scheme is likely to have contributed to these impacts in AP at least in part. Our study needs to be followed up with repeated evaluations to ascertain the long-term impacts of involving the private sector in providing hospital care. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

  10. Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania

    PubMed Central

    2012-01-01

    Background Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector. Methods To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data. Results ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29–1.18 US$). Conclusions In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs. PMID:22455367

  11. Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania.

    PubMed

    Malisa, Allen Lewis; Kiriba, Deodatus

    2012-03-28

    Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector. To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data. ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29-1.18 US$). In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.

  12. 75 FR 80082 - State, Local, Tribal, and Private Sector Policy Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION State, Local, Tribal, and Private Sector Policy Advisory Committee AGENCY: National Archives and Records Administration. ACTION: Notice of Establishment of a NARA Advisory Committee, Pursuant to the Federal Advisory Committee Act, 5 U.S.C. Appendix 2 and...

  13. Knowledge, expertise and enthusiasm. Governments need the collaboration of the private sector including NGOs in effectively and timely tackling the global issues.

    PubMed

    Taniguchi, H

    1998-01-01

    This article describes the US and Japan's "Common Agenda for Cooperation in Global Perspective." This agenda was launched in July 1993. The aim was to use a bilateral partnership to address critical global challenges in 1) Promotion of Health and Human Development; 2) Protection of the Environment; 3) Responses to Challenges to Global Stability; and 4) Advancement of Science and Technology. The bilateral effort has resulted in 18 initiatives worldwide. Six major accomplishments have occurred in coping with natural disasters in Kobe, Japan, and Los Angeles, US; coral reefs; assistance for women in developing countries; AIDS, children's health; and population problems. The bilateral effort has been successful due to the active involvement of the private sector, including businesses and nongovernmental organizations (NGOs). Many initiatives are developed and implemented in cooperation with local NGOs. The government needs the private sector's technical and managerial fields of expertise. Early investment in NGO efforts ensures the development of self-sustaining programs and public support. An Open Forum was held in March 12-13, 1998, as a commemoration of the 5-year cooperative bilateral effort. Over 300 people attended the Forum. Plenary sessions were devoted to the partnership between public and private sectors under the US-Japan Agenda. Working sessions focused on health and conservation. Participants suggested improved legal systems and social structures for facilitating activities of NGOs, further development by NGOs of their capacities, and support to NGOs from corporations.

  14. Mortality of Department of Veterans Affairs patients undergoing coronary revascularization in private sector hospitals.

    PubMed

    Vaughan-Sarrazin, Mary S; Wakefield, Bonnie; Rosenthal, Gary E

    2007-10-01

    A limitation of studies comparing outcomes of Veterans Affairs (VA) and private sector hospitals is uncertainty about the methods of accounting for risk factors in VA populations. This study estimates whether use of VA services is a marker for increased risk by comparing outcomes of VA users and other patients undergoing coronary revascularization in private sector hospitals. Males 67 years and older undergoing coronary artery bypass graft (CABG; n=687,936) surgery or percutaneous coronary intervention (PCI; n=664,124) during 1996-2002 were identified from Medicare administrative data. Patients using VA services during the 2 years preceding the Medicare admission were identified using VA administrative files. Thirty-, 90-, and 365-day mortality were compared in patients who did and did not use VA services, adjusting for demographic and clinical risk factors using generalized estimating equations and propensity score analysis. Adjusted mortality after CABG was higher (p<.001) in VA users compared with nonusers at 30, 90, and 365 days: odds ratio (OR)=1.07 (95 percent confidence interval [CI], 1.03-1.11), 1.07 (95 percent CI, 1.04-1.10), and 1.09 (95 percent CI, 1.06-1.12), respectively. For PCI, mortality at 30 and 90 days was similar (p>.05) for VA users and nonusers, but was higher at 365 days (OR=1.09; 95 percent CI, 1.06-1.12). The increased risk of death in VA users was limited to patients with service-connected disabilities or low incomes. Odds of death for VA users were slightly lower using samples matched by propensity scores. A small difference in risk-adjusted outcomes for VA users and nonusers undergoing revascularization in private sector hospitals was found. This difference reflects unmeasured severity in VA users undergoing revascularization in private sector hospitals.

  15. [Evaluation of continuing medical training in private sector French cardiologists in 1999].

    PubMed

    Thébaut, J F; Chabot, J M; Durand, J P; Childs, M; Assouline, S; Breton, C; Fraboulet, J Y; Sebaoun, A; Aviérinos, C

    2001-09-01

    The authors present the results of a retrospective national enquiry which took place in 1999 and was mailed and faxed to the 3,800 cardiologists practising in the private sector in order to assess the different types of continuous, individual and collective postgraduate training which they had benefited from in the preceding 12 months. The data was analysed by comparison with that obtained from an individualized representative sample in a panel of private sector cardiologists. The results were then compared with the criteria of a yardstick proposed by the National Committee of Continuous Medical Education of 1997, according to the April 25th 1996 decree. The meeting of these criteria would require carrying out 114,000 to 76,000 hour-equivalents of continuous education whereas the present offer is about 100,000 hour-equivalents. The different forms of individual or collective training were compared in the 327 questionnaires which were exploitable following adhesion to the French Society of Cardiology, to the Cardiologists' Union, to local cardiological societies, by age, gender and type of practice. The average number of annual hours of collective education was 52.2 +/- 60.1 hours (25% quartile = 25 hours, 75% = 60 hours). The average value of hours of individual education was 89.7 +/- 89.3 hours (25% quartile = 25 hours; 75% = 120 hours). This evaluation indicates that about 15% of cardiologists practising in the private sector have inadequate continuous medical education and that 68% would satisfy the criteria laid down in 1997. Moreover, the present offer would seem to be adequate providing the criteria of accreditation have been met.

  16. The Efficacy of Private Sector Providers in Improving Public Educational Outcomes

    ERIC Educational Resources Information Center

    Heinrich, Carolyn; Nisar, Hiren

    2012-01-01

    School districts required under No Child Left Behind to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in service provision. If the market does not work to drive out ineffective providers, students will be less likely to gain…

  17. The Efficacy of Private Sector Providers in Improving Public Educational Outcomes

    ERIC Educational Resources Information Center

    Heinrich, Carolyn J.; Nisar, Hiren

    2013-01-01

    School districts required under No Child Left Behind (NCLB) to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in services. If the market does not drive out ineffective providers, students may not gain through SES participation.…

  18. Public-Private Partnerships in the health sector: the Danish experience.

    PubMed

    Vrangbaek, Karsten

    2008-04-01

    This article investigates the current use of Public-Private Partnerships (PPP) in the Danish health sector based on an initial discussion of theoretical approaches that analyze PPP. The empirical analysis concludes that PPP has been used very sparsely in the Danish health sector. There are few examples of large-scale partnership projects with joint investment and risk taking, but a number of smaller partnerships such as jointly owned companies at the regional level. When defining PPP more broadly, we can identify a long tradition for various types of collaboration between public and private actors in health care in Denmark. An analysis of the regulatory environment is offered as an explanation for the limited use of PPPs in Denmark. Major political and institutional actors at the central level differ in their enthusiasm for the PPP concept, and the regulatory framework is somewhat uncertain. A number of general issues and concerns related to PPPs are also discussed. It is suggested that a risk-based framework can be useful for mapping the potential and challenges for both private and public partners. Such a framework can be used to feed into game theoretical models of pros and cons for PPP projects. In general terms, it is concluded that more empirical research is needed for the assessment of the various risk factors involved in using PPPs in health care. Most PPPs are still very young, and the evidence on performance and broader governance issues is only just emerging. Ideally, such assessments should include comparisons with a purely public alternative.

  19. Training and Jobs Programs in Action: Case Studies in Private-Sector Initiatives for the Hard-to-Employ.

    ERIC Educational Resources Information Center

    Robison, David

    This book contains fifty-three case studies covering a wide variety of private-sector activities and public-private partnerships designed to increase training and employment opportunities for the hard-to-employ and speed the transition of the unemployed from government support and subsidized jobs to permanent private employment. Compiled from a…

  20. Performance reporting for consumers: issues for the Australian private hospital sector.

    PubMed

    Sheahan, Margo; Little, Russ; Leggat, Sandra G

    2007-05-30

    A group of consumers of private hospital services and their carers collaborated with staff of a Melbourne private hospital and with industry representatives to develop a consumer-driven performance report on cardiac services. During the development process participating consumers identified situational and structural barriers to their right to be informed of costs, to choice and to quality care. Their growing appreciation of these barriers led them to a different perspective on performance reporting, which resulted in their redirecting the project. The consumer participants no longer wanted a performance report that provided comparative quantitative data. Instead they designed a report that outlined the structures, systems and processes the hospital had in place to address the quality and safety of services provided. In addition, consumer participants developed a decision support tool for consumers to use in navigating the private health care sector. The journey of these consumers in creating a consumer driven performance report for a private hospital service may assist those responsible for governance of Australia's health system in choosing appropriate strategies and mechanisms to enhance private hospital accountability. The situational and institutional industry barriers to choice, information and quality identified by these consumers need to be addressed before public performance reporting for private hospitals is introduced in Australia.

  1. Performance reporting for consumers: issues for the Australian private hospital sector

    PubMed Central

    Sheahan, Margo; Little, Russ; Leggat, Sandra G

    2007-01-01

    A group of consumers of private hospital services and their carers collaborated with staff of a Melbourne private hospital and with industry representatives to develop a consumer-driven performance report on cardiac services. During the development process participating consumers identified situational and structural barriers to their right to be informed of costs, to choice and to quality care. Their growing appreciation of these barriers led them to a different perspective on performance reporting, which resulted in their redirecting the project. The consumer participants no longer wanted a performance report that provided comparative quantitative data. Instead they designed a report that outlined the structures, systems and processes the hospital had in place to address the quality and safety of services provided. In addition, consumer participants developed a decision support tool for consumers to use in navigating the private health care sector. The journey of these consumers in creating a consumer driven performance report for a private hospital service may assist those responsible for governance of Australia's health system in choosing appropriate strategies and mechanisms to enhance private hospital accountability. The situational and institutional industry barriers to choice, information and quality identified by these consumers need to be addressed before public performance reporting for private hospitals is introduced in Australia. PMID:17537238

  2. Inter-Professional Practices of Private-Sector Physiotherapists for Low Back Pain Management: Who, How, and When?

    PubMed

    Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

    Purpose : Although there have been increasing demands for health care providers to take part in inter-professional practices in recent years, very little attention has been paid to the actualization of such practices in the private sector. This study describes private-sector physiotherapists' inter-professional practices regarding low back pain (LBP) management and identifies organizational and provider-level variables associated with the intensity of such practices. Method : A total of 327 randomly selected physiotherapists were surveyed in the province of Quebec. Data were analyzed using descriptive and multiple regression analyses. Results : Physiotherapists reported frequent interactions with other physiotherapists (daily/weekly for 52.6%), family physicians (51.0%), and physiotherapy (PT) assistants (45.2%), but infrequent interactions with psychologists (3.6%), neurosurgeons (0.9%), and chiropractors (0.3%). Frequently reported means of interactions were written and oral messages sent through clients (55.1% and 24.1%, respectively), face-to-face unplanned discussions (41.9%), and faxed or mailed letters (23.2%). Variables associated with the intensity of inter-professional practices (mean of 6.7 [ SD 1.7] out of 10 on the Intensity of Interprofessional Practices Questionnaire for Private Sector Physiotherapists) were related to physiotherapists' clientele, social activities with other providers, and perceptions of inter-professional practices as well as organizational models, vision, and provision of PT training. Conclusions: There is room to improve inter-professional practices with private-sector physiotherapists involved in managing LBP. Targets for action include physiotherapists and their workplaces.

  3. The politics of managed competition: public abuse of the private interest.

    PubMed

    Robinson, James C

    2003-01-01

    The doctrine of managed competition in health care sought to achieve the social goals of access and efficiency using market incentives and consumer choice rather than governmental regulation and public administration. In retrospect, it demanded too much from both the public and the private sectors. Rather than develop choice-supporting rules and institutions, the public sector has promoted process regulation and benefit mandates. The private health insurance sector has pursued short-term profitability rather than cooperate in the development of fair competition and informed consumer choice. Purchasers have subsidized inefficient insurance designs in order to exploit tax and regulatory loopholes and to retain an image of corporate paternalism. America's health care system suffers from the public abuse of private interests and the private abuse of the public interest.

  4. The contribution of health selection to occupational status inequality in Germany - differences by gender and between the public and private sectors.

    PubMed

    Kröger, H

    2016-04-01

    Estimating the size of health inequalities between hierarchical levels of job status and the contribution of direct health selection to these inequalities for men and women in the private and public sector in Germany. The study uses prospective data from the Socio-Economic Panel study on 11,788 women and 11,494 men working in the public and private sector in Germany. Direct selection effects of self-rated health on job status are estimated using fixed-effects linear probability models. The contribution of health selection to overall health-related inequalities between high and low status jobs is calculated. Women in the private sector who report very good health have a 1.9 [95% CI: 0.275; 3.507] percentage point higher probability of securing a high status job than women in poor self-rated health. This direct selection effect constitutes 20.12% of total health inequalities between women in high and low status jobs. For men in the private and men and women in the public sector no relevant health selection effects were identified. The contribution of health selection to total health inequalities between high and low status jobs varies with gender and public versus private sector. Women in the private sector in Germany experience the strongest health selection. Possible explanations are general occupational disadvantages that women have to overcome to secure high status jobs. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Contractor Past Performance Information (PPI) in Source Selection: A Comparison Study of Public and Private Sector

    DTIC Science & Technology

    2005-03-17

    private sector . However, along the way, Government and private sector industry have begun to disagree about how PPI is collected and how PPI is used. Industry prefers a passive system of collecting delivery and quality data during contract performance, while the Federal Government uses both a passive system (similar to industry) as well as an active system of pulling PPI during contract performance. Industry uses PPI to establish and maintain a preferred vendor list from which to solicit bids, quotes, or proposals, while government uses PPI to assess

  6. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

    PubMed Central

    White, Julia N; Corker, Jamaica

    2016-01-01

    ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

  7. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

    PubMed

    White, Julia N; Corker, Jamaica

    2016-08-11

    Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

  8. Engaging the Online Learner: Perceptions of Public and Private Sector Educators

    ERIC Educational Resources Information Center

    Alagaraja, Meera; Dooley, Larry M.

    2005-01-01

    Engaging the online learner is a prominent issue that is certain to affect the future success of online learning. A critical step in progressing on this issue is to understand how public and private sector educators' adopt distinctive approaches to meet the diverse needs of their environments and their learners. The paper uses a thematic approach…

  9. The association of diagnosis in the private or NHS sector on prostate cancer stage and treatment.

    PubMed

    Barbiere, J M; Greenberg, D C; Wright, K A; Brown, C H; Palmer, C; Neal, D E; Lyratzopoulos, G

    2012-03-01

    To examine associations of private healthcare with stage and management of prostate cancer. Regional population-based cancer registry information on 15 916 prostate cancer patients. Compared with patients diagnosed in the National Health Service (NHS) (94%), those diagnosed in private hospitals (5%) were significantly more affluent (69 versus 52% in deprivation quintiles 1-2), younger (mean 69 versus 73 years) and diagnosed at earlier stage (72 versus 79% in Stages Private hospital of diagnosis was independently associated with lower probability of advanced disease stage [odds ratio (OR) 0.75, P = 0.002], higher probability of surgery use (OR 1.28, P = 0.037) and lower probability of radiotherapy use (OR 0.75, P = 0.001). Private hospital of diagnosis independently predicted higher surgery and lower radiotherapy use, particularly in more deprived patients aged ≤ 70. In prostate cancer patients, private hospital diagnosis predicts earlier disease stage, higher use of surgery and lower use of radiotherapy, independently of case-mix differences between the two sectors. Substantial socioeconomic differences in stage and treatment patterns remain across centres in the NHS, even after adjusting for private sector diagnosis. Cancer registration data could be used to identify private care use on a population basis and the potential associated treatment disparities.

  10. What's yours, mine, and ours : overcoming intellectual property rights issues : a cross-cutting study : facilitating private-sector participation and expediting deployment

    DOT National Transportation Integrated Search

    2000-08-01

    Debate over the ownership and use of intellectual property developed jointly by the public and private sectors has caused delays in ITS deployment projects. While a fundamental business incentive of the private sector for investing in research and de...

  11. Three methods of interfacing with the private sector by mental health agencies.

    PubMed

    McRae, J A

    1989-01-01

    This article outlines three methods of mental health marketing--formal, intermediary, and interactive. It discusses advantages and disadvantages of each method. These approaches are particularly good for public, non-profit agencies and individuals in contacting the private sector. The need for flexibility and marketing mix is emphasized.

  12. Buying Power: The Role of the Private Sector in Education Action Zones.

    ERIC Educational Resources Information Center

    Hallgarten, Joe; Watling, Rob

    2001-01-01

    Examines the private sector's financial and philosophical contributions to the New Labour Party's Education Action Zone policy, based on interview data from 34 EAZ directors. Far from representing a flagship, "third-way" reform, the average zone resembles a traditional school-improvement service combined with an education-business…

  13. Guidelines for Developing a Preschool Level Gifted Program in the Private Sector.

    ERIC Educational Resources Information Center

    McMurtry, Doyleen

    This practicum addresses the creation of an economically viable school in the private sector to meet the educational and social needs of cognitively developmentally accelerated preschool-age children. Anticipated outcomes of the practicum included development of a well-documented philosophical approach to preschool gifted education, curriculum…

  14. Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review

    PubMed Central

    Lussiana, Cristina

    2016-01-01

    The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. PMID:25862732

  15. The Impact of Private Sector Competition on Public Schooling in Kuwait: Some Socio-Educational Implications

    ERIC Educational Resources Information Center

    Al-Shehab, Ali Jasem

    2010-01-01

    With the diminishing model of the welfare state, public education in Kuwait is facing the challenges of the competition of private schools, while the private sector has always struggled against the monopolistic power of the public schools that educate a broad spectrum of K-12 students. This article presents estimates of the effect of private…

  16. Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia.

    PubMed

    Ron Levey, Ilana; Wang, Wenjuan

    2014-07-01

    Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling

  17. Collaboration across private and public sector primary health care services: benefits, costs and policy implications.

    PubMed

    McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark

    2011-07-01

    Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations.

  18. Labour market participation after breast cancer for employees from the private and public sectors: Educational and sector gradients in the effect of cancer.

    PubMed

    Kolodziejczyk, Christophe; Heinesen, Eskil

    2016-05-01

    For employees who get cancer and survive, the probability of returning to work may depend on their ability to work, potential earnings losses if they do not return to work, qualifications and job type, but also on characteristics of the pre-cancer workplace. This paper focuses on differences between public and private sector employees in the effect of breast cancer on the probability of being out of the labour force three years after the diagnosis. We use propensity score weighting methods and a large longitudinal Danish administrative dataset which allows us to control for a wide range of important baseline characteristics such as education, sector of employment, labour market status, income, health, and demographics. We find that the educational gradient in the effect of cancer is significant in the public sector, where the estimated effects are 11.5 and 3.8 percentage points, respectively, for the low- and high-educated. The corresponding estimates for the private sector are 6.2 and 3.2 percentage points and here the educational gradient is only marginally significant. We discuss possible mechanisms behind the large sector gradient for the low-educated. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Barriers to use of oral rehydration salts for child diarrhea in the private sector: evidence from India.

    PubMed

    Wagner, Zachary; Shah, Manan; Sood, Neeraj

    2015-02-01

    Diarrhea is the second leading cause of child mortality in India. Most deaths are cheaply preventable with the use of oral rehydration salts (ORS), yet many health providers still fail to provide ORS to children seeking diarrheal care. In this study, we use survey data to assess whether children visiting private providers for diarrheal care were less likely to use ORS than those visiting public providers. Results suggest that children who visited private providers were 9.5 percentage points less likely to have used ORS than those who visited public providers (95% CI 5-14). We complimented these results with in-depth interviews of 21 public and 17 private doctors in Gujarat, India, assessing potential drivers of public-private disparities in ORS use. Interview results suggested that lack of direct medication dispensing in the private sector might be a key barrier to ORS use in the private sector. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Is healthcare a 'Necessity' or 'Luxury'? an empirical evidence from public and private sector analyses of South-East Asian countries?

    PubMed

    Khan, Jahangir Am; Mahumud, Rashidul Alam

    2015-01-01

    South-East Asian Regional (SEAR) countries range from low- to middle-income countries and have considerable differences in mix of public and private sector expenditure on health. This study intends to estimate the income-elasticities of healthcare expenditure in public and private sectors separately for investigating whether healthcare is a 'necessity' or 'luxury' for citizens of these countries. Panel data from 9 SEAR countries over 16 years (1995-2010) were employed. Fixed- and random-effect models were fitted to estimate income-elasticity of public, private and total healthcare expenditure. Results showed that one percent point increase in GDP per capita increased private expenditure on healthcare by 1.128%, while public expenditure increased by only 0.412%. Inclusion of three-year lagged variables of GDP per capita in the models did not have remarkable influence on the findings. The citizens of SEAR countries consider healthcare as a necessity while provided through public sector and a luxury when delivered by private sector. By increasing the public provisions of healthcare, more redistribution of healthcare resources can be ensured, which can accelerate the journey of SEAR countries towards universal health coverage.

  1. Productivity in the Private Sector and Its Application to the Educational Enterprise.

    ERIC Educational Resources Information Center

    Schwarz, Fred C.

    This paper presents the present dilemma of declining productivity gains in the private sector and illustrates efforts to reverse the trend. Also presented are techniques being used by companies that are successful in improving their productivity. Finally, specific illustrations of techniques for improving productivity in the educational enterprise…

  2. Test Score Gaps between Private and Government Sector Students at School Entry Age in India

    ERIC Educational Resources Information Center

    Singh, Abhijeet

    2014-01-01

    Various studies have noted that students enrolled in private schools in India perform better on average than students in government schools. In this paper, I show that large gaps in the test scores of children in private and public sector education are evident even at the point of initial enrollment in formal schooling and are associated with…

  3. Work disability benefits due to musculoskeletal disorders among Brazilian private sector workers.

    PubMed

    Vieira, E R; Albuquerque-Oliveira, P R; Barbosa-Branco, A

    2011-05-14

    To evaluate the prevalence and characteristics of disability benefits due to musculoskeletal disorders (MSD) granted to Brazilian private sector workers. This was a population-based epidemiological study of MSD-related benefits among registered private sector workers (n=32 959 329). The prevalence (benefits/10 000 workers/year) of work disability benefits was calculated by gender, age, state, Human Development Index (HDI), economic activity, MSD type and work-relatedness. The prevalence of MSD-related benefits in Brazil among registered private sector workers in 2008 was 93.6/10 000 workers. The prevalence increased with age, and was higher for women (112.2) than for men (88.1), although the former had shorter benefit duration. The gender-adjusted prevalence by state varied from 16.6 to 90.3 for non-work-related, and from 7.8 to 59.6 for work-related benefits. The Brazilian states with a high-very high HDI had the highest prevalence. The top four most common types of MSD-related benefits were due to back pain, intervertebral disc disorders, sinovitis/tenosynovitis and shoulder disorders. MSD is a frequent cause of work disability in Brazil. There were differences in prevalence among economic activities and between states grouped by HDI. This study demonstrates that further evaluation of the contributing factors associated with MSD-related disability benefits is required. Factors that should be considered include production processes, political organisation, socioeconomic and educational characteristics, the compensation and recording systems, and employee-employer power relationships. These factors may play an important role in the prevalence of MSD-related disability benefits, especially in countries with large socioeconomic iniquities such as Brazil.

  4. Between hype and veracity; privatization of municipal solid waste management and its impacts on the informal waste sector.

    PubMed

    Sandhu, Kiran; Burton, Paul; Dedekorkut-Howes, Aysin

    2017-01-01

    The informal waste recycling sector has been an indispensable but ironically invisible part of the waste management systems in developing countries as India, often completely disregarded and overlooked by decision makers and policy frameworks. The turn towards liberalization of economy since 1991 in India opened the doors for privatization of urban services and the waste sector found favor with private companies facilitated by the local governments. In joining the privatization bandwagon, the local governments aim to create an image of a progressive city demonstrated most visibly through apt management of municipal solid waste. Resultantly, the long important stakeholder, the informal sector has been sidelined and left to face the adverse impacts of privatization. There is hardly any recognition of its contributions or any attempt to integrate it within the formal waste management systems. The study investigates the impacts of privatization on the waste pickers in waste recycling operations. Highlighting the other dimension of waste collection and management in urban India the study focuses on the waste pickers and small time informal scrap dealers and this is done by taking the case study of Amritsar city, which is an important historic centre and a metropolitan city in the state of Punjab, India. The paper develops an analytical framework, drawing from literature review to analyze the impacts. In conclusion, it supports the case for involving informal waste sector towards achieving sustainable waste management in the city. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Innovation: Attracting and Retaining the Best of the Private Sector

    DTIC Science & Technology

    2014-01-01

    The recommendations seek to open up Innovation: Attracting and Retaining the the Best of the Private Sector Task Group 6 Report FY14-02 what is a...industry structure changes, the Task Group recommends the following: • Require the adoption of an open architecture, modular approach to new mission...essential platforms; and • Take steps to open a closed supply chain; re-examine industry structure and encourage new entrants. With regard to messaging

  6. Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review.

    PubMed

    Hudson, Mollie; Rutherford, George W; Weiser, Sheri; Fair, Elizabeth

    2018-01-01

    Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88-2.08). However, HIV-infected TB patients who sought care in the public sector were

  7. Linking private, for-profit providers to public sector services for HIV and tuberculosis co-infected patients: A systematic review

    PubMed Central

    Hudson, Mollie; Rutherford, George W.; Weiser, Sheri; Fair, Elizabeth

    2018-01-01

    Background Tuberculosis (TB) is the leading cause of infectious disease deaths worldwide and is the leading cause of death among people with HIV. The World Health Organization (WHO) has called for collaboration between public and private healthcare providers to maximize integration of TB/HIV services and minimize costs. We systematically reviewed published models of public-private sector diagnostic and referral services for TB/HIV co-infected patients. Methods We searched PubMed, the Cochrane Central Register of Controlled Trials, Google Scholar, Science Direct, CINAHL and Web of Science. We included studies that discussed programs that linked private and public providers for TB/HIV concurrent diagnostic and referral services and used Review Manager (Version 5.3, 2015) for meta-analysis. Results We found 1,218 unduplicated potentially relevant articles and abstracts; three met our eligibility criteria. All three described public-private TB/HIV diagnostic/referral services with varying degrees of integration. In Kenya private practitioners were able to test for both TB and HIV and offer state-subsidized TB medication, but they could not provide state-subsidized antiretroviral therapy (ART) to co-infected patients. In India private practitioners not contractually engaged with the public sector offered TB/HIV services inconsistently and on a subjective basis. Those partnered with the state, however, could test for both TB and HIV and offer state-subsidized medications. In Nigeria some private providers had access to both state-subsidized medications and diagnostic tests; others required patients to pay out-of-pocket for testing and/or treatment. In a meta-analysis of the two quantitative reports, TB patients who sought care in the public sector were almost twice as likely to have been tested for HIV than TB patients who sought care in the private sector (risk ratio [RR] 1.98, 95% confidence interval [CI] 1.88–2.08). However, HIV-infected TB patients who sought care

  8. Collaboration between Higher Education and the Private Sector: The Case of Thailand.

    ERIC Educational Resources Information Center

    Sinlarat, Paitoon

    Thailand's higher education institutions, once largely involved with the education and training of civil servants, have recently begun to seek collaboration with private sector institutions. This activity began when it was found that there was a limited number of government positions available, and increasing numbers of graduates needed to seek…

  9. Financing for Higher Education Shifts to Private Sector Worldwide

    ERIC Educational Resources Information Center

    Bollag, Burton

    2007-01-01

    This article presents a report released by the Institute for Higher Education Policy, a nonprofit group promoting access and quality in postsecondary education around the world. With college enrollments mushrooming in many nations but public support generally unable to keep up, the world is seeing a historic swing from public to private financing…

  10. Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review.

    PubMed

    Lussiana, Cristina

    2016-09-01

    The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  11. Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria.

    PubMed

    Onwujekwe, Ogochukwu C; Soremekun, Rebecca O; Uzochukwu, Benjamin; Shu, Elvis; Onwujekwe, Obinna

    2012-07-06

    Malaria in pregnancy (MIP) is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers' and consumers' perspectives. The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses) providing ante-natal care (ANC) services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP). The data was collected from May to June 2010. Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p < 0.05). It was found that 50 % of private sector providers and 25 % of public sector providers prescribed chemoprophylaxis using pyrimethamine, chloroquine and proguanil to pregnant women. There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers' knowledge and practices with regards to management of MIP.

  12. Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors.

    PubMed

    Pillay, Rubin

    2009-02-20

    Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. Although there have been several studies of job satisfaction among nurses in South Africa, these are limited because they relate to studies of individual organizations or regions, use small samples or are dated. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. This was a cross-sectional survey of professional nurses conducted throughout South Africa using a pretested and self-administered questionnaire. Univariate and bivariate statistical models were used to evaluate levels of satisfaction with various facets of work and to elicit the differences in satisfaction levels between different groups of nurses. A total of 569 professional nurses participated in the study. Private-sector nurses were generally satisfied, while public-sector nurses were generally dissatisfied. Public-sector nurses were most dissatisfied with their pay, the workload and the resources available to them. They were satisfied only with the social context of the work. Private-sector nurses were dissatisfied only with their pay and career development opportunities. Professional nurses in the more rural provinces, those intending to change sectors and those more likely not to be in their current positions within the next five years were also more likely to be dissatisfied with all facets of their work. This study highlighted the overall dissatisfaction among South African nurses and confirmed the disparity between the levels of job satisfaction between the public and private sectors. Health managers should address those factors that affect job satisfaction, and therefore retention, of nurses in South Africa. Improving the work environment so that it provides a context congruent with the aspirations and values systems of nurses is more

  13. Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors

    PubMed Central

    Pillay, Rubin

    2009-01-01

    Background Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. Although there have been several studies of job satisfaction among nurses in South Africa, these are limited because they relate to studies of individual organizations or regions, use small samples or are dated. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. Methods This was a cross-sectional survey of professional nurses conducted throughout South Africa using a pretested and self-administered questionnaire. Univariate and bivariate statistical models were used to evaluate levels of satisfaction with various facets of work and to elicit the differences in satisfaction levels between different groups of nurses. A total of 569 professional nurses participated in the study. Results Private-sector nurses were generally satisfied, while public-sector nurses were generally dissatisfied. Public-sector nurses were most dissatisfied with their pay, the workload and the resources available to them. They were satisfied only with the social context of the work. Private-sector nurses were dissatisfied only with their pay and career development opportunities. Professional nurses in the more rural provinces, those intending to change sectors and those more likely not to be in their current positions within the next five years were also more likely to be dissatisfied with all facets of their work. Conclusion This study highlighted the overall dissatisfaction among South African nurses and confirmed the disparity between the levels of job satisfaction between the public and private sectors. Health managers should address those factors that affect job satisfaction, and therefore retention, of nurses in South Africa. Improving the work environment so that it provides a context congruent with the aspirations

  14. Manufacturing Consent for Privatization in Public Education: The Rise of a Social Finance Network in Canada

    ERIC Educational Resources Information Center

    Poole, Wendy; Sen, Vicheth; Fallon, Gerald

    2016-01-01

    Multiple forms of privatization are emerging in the Canadian public sector, including public-private partnerships. This article focuses on one approach to public-private partnerships called "social finance," and a network of public, private, and not-for-profit organizations that promotes social finance as a means of funding public…

  15. The Role of the Private Sector in The Right to Read Effort.

    ERIC Educational Resources Information Center

    Jones, Opal C.

    This booklet describes the many ways in which the private sector can become involved in the national Right to Read effort by giving assistance: seminars sponsored by business and industries, on-the-job literacy classes, encouragement from recognized athletes, and the Book Ownership Program (aids the community by making books readily available at…

  16. Use of family planning and child health services in the private sector: an equity analysis of 12 DHS surveys.

    PubMed

    Chakraborty, Nirali M; Sprockett, Andrea

    2018-04-24

    A key component of universal health coverage is the ability to access quality healthcare without financial hardship. Poorer individuals are less likely to receive care than wealthier individuals, leading to important differences in health outcomes, and a needed focus on equity. To improve access to healthcare while minimizing financial hardships or inequitable service delivery we need to understand where individuals of different wealth seek care. To ensure progress toward SDG 3, we need to specifically understand where individuals seek reproductive, maternal, and child health services. We analyzed Demographic and Health Survey data from Bangladesh, Cambodia, DRC, Dominican Republic, Ghana, Haiti, Kenya, Liberia, Mali, Nigeria, Senegal and Zambia. We conducted weighted descriptive analyses on current users of modern FP and the youngest household child under age 5 to understand and compare country-specific care seeking patterns in use of public or private facilities based on urban/rural residence and wealth quintile. Modern contraceptive prevalence rate ranged from 8.1% to 52.6% across countries, generally rising with increasing wealth within countries. For relatively wealthy women in all countries except Ghana, Liberia, Mali, Senegal and Zambia, the private sector was the dominant source. Source of FP and type of method sought across facilities types differed widely across countries. Across all countries women were more likely to use the public sector for permanent and long-acting reversible contraceptive methods. Wealthier women demonstrated greater use of the private sector for FP services than poorer women. Overall prevalence rates for diarrhea and fever/ARI were similar, and generally not associated with wealth. The majority of sick children in Haiti did not seek treatment for either diarrhea or fever/ARI, while over 40% of children with cough or fever did not seek treatment in DRC, Haiti, Mali, and Senegal. Of all children who sought care for diarrhea, more

  17. Private sector risk-sharing agreements in the United States: trends, barriers, and prospects.

    PubMed

    Garrison, Louis P; Carlson, Josh J; Bajaj, Preeti S; Towse, Adrian; Neumann, Peter J; Sullivan, Sean D; Westrich, Kimberly; Dubois, Robert W

    2015-09-01

    Risk-sharing agreements (RSAs) between drug manufacturers and payers link coverage and reimbursement to real-world performance or utilization of medical products. These arrangements have garnered considerable attention in recent years. However, greater use outside the United States raises questions as to why their use has been limited in the US private sector, and whether their use might increase in the evolving US healthcare system. To understand current trends, success factors, and challenges in the use of RSAs, we conducted a review of RSAs, interviews, and a survey to understand key stakeholders' experiences and expectations for RSAs in the US private sector. Trends in the numbers of RSAs were assessed using a database of RSAs. We also conducted in-depth interviews with stakeholders from pharmaceutical companies, payer organizations, and industry experts in the United States and European Union. In addition, we administered an online survey with a broader audience to identify perceptions of the future of RSAs in the United States. Most manufacturers and payers expressed interest in RSAs and see potential value in their use. Due to numerous barriers associated with outcomes-based agreements, stakeholders were more optimistic about financial-based RSAs. In the US private sector, however, there remains considerable interest--improved data systems and shifting incentives (via health reform and accountable care organizations) may generate more action. In the US commercial payer markets, there is continued interest among some manufacturers and payers in outcomes-based RSAs. Despite continued discussion and activity, the number of new agreements is still small.

  18. The Free Trade Agreement and the Mexican health sector.

    PubMed

    Laurell, A C; Ortega, M E

    1992-01-01

    This article presents a discussion of the probable implications for the Mexican health sector of the Free Trade Agreement (FTA) between the United States, Canada, and Mexico. The authors argue that the FTA should be seen as part of neoliberal policies adopted by the Mexican government in 1983 that are based on large-scale privatization and deregulation of labor relations. In this general context the health sector, which traditionally has been dominated by public institutions, is undergoing a deep restructuring. The main trends are the decapitalization of the public sector and a selective process of privatization that tends to constitute the private health sector in a field of capital accumulation. The FTA is likely to force a change in Mexican health legislation, which includes health services in the public social security system and recognizes the right to health, and to accelerate selective privatization. The U.S. insurance industry and hospital corporations are interested in promoting these changes in order to gain access to the Mexican market, estimated at 20 to 25 million persons. This would lead to further deterioration of the public institutions, increasing inequalities in health and strengthening the private sector. The historical trend toward the integration of a National Health Service in Mexico would be interrupted in favor of formation of a dual private-public system.

  19. Economic burden of malaria on businesses in Ghana: a case for private sector investment in malaria control.

    PubMed

    Nonvignon, Justice; Aryeetey, Genevieve Cecilia; Malm, Keziah L; Agyemang, Samuel Agyei; Aubyn, Vivian N A; Peprah, Nana Yaw; Bart-Plange, Constance N; Aikins, Moses

    2016-09-06

    Despite the significant gains made globally in reducing the burden of malaria, the disease remains a major public health challenge, especially in sub-Saharan Africa (SSA) including Ghana. There is a significant gap in financing malaria control globally. The private sector could become a significant source of financing malaria control. To get the private sector to appreciate the need to invest in malaria control, it is important to provide evidence of the economic burden of malaria on businesses. The objective of this study, therefore, was to estimate the economic burden on malaria on businesses in Ghana, so as to stimulate the sector's investment in malaria control. Data covering 2012-2014 were collected from 62 businesses sampled from Greater Accra, Ashanti and Western Regions of Ghana, which have the highest concentration of businesses in the country. Data on the cost of businesses' spending on treatment and prevention of malaria in staff and their dependants as well as staff absenteeism due to malaria and expenditure on other health-related activities were collected. Views of business leaders on the effect of malaria on their businesses were also compiled. The analysis was extrapolated to cover 5828 businesses across the country. The results show that businesses in Ghana lost about US$6.58 million to malaria in 2014, 90 % of which were direct costs. A total of 3913 workdays were lost due to malaria in firms in the study sample during the period 2012-2014. Businesses in the study sample spent an average of 0.5 % of the annual corporate returns on treatment of malaria in employees and their dependants, 0.3 % on malaria prevention, and 0.5 % on other health-related corporate social responsibilities. Again business leaders affirmed that malaria affects their businesses' efficiency, employee attendance and productivity and expenses. Finally, about 93 % of business leaders expressed the need private sector investment in malaria control. The economic burden of

  20. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    PubMed

    Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

    2012-01-01

    Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business

  1. Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

    PubMed Central

    Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

    2012-01-01

    Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have

  2. The private sector role in HIV/AIDS in the context of an expanded global response: expenditure trends in five sub-Saharan African countries.

    PubMed

    Sulzbach, Sara; De, Susna; Wang, Wenjuan

    2011-07-01

    Global financing for the HIV response has reached unprecedented levels in recent years. Over US$10 billion were mobilized in 2007, an effort credited with saving the lives of millions of people living with HIV (PLHIV). A relatively unexamined aspect of the global HIV response is the role of the private sector in financing HIV/AIDS services. As the nature of the response evolves from emergency relief to long-term sustainability, understanding current and potential contributions from the private sector is critical. This paper examines trends in private sector financing, management and resource consumption related to HIV/AIDS in five sub-Saharan African countries, with a particular emphasis on the effects of recently scaled-up donor funding on private sector contributions. We analysed National Health Accounts HIV/AIDS subaccount data for Kenya, Malawi, Rwanda, Tanzania and Zambia between 2002 and 2006. HIV subaccounts provide comparable data on the flow of HIV/AIDS funding from source to use. Findings indicate that private sector contributions decreased in all countries except Tanzania. With regards to managing HIV/AIDS funds, non-governmental organizations are increasingly controlling the largest share of resources relative to other stakeholders, whereas private for-profit entities are managing fewer HIV/AIDS resources since the donor influx. The majority of HIV/AIDS funds were spent in the public sector, although a considerable amount was spent at private facilities, largely fuelled by out-of-pocket (OOP) payments. On the whole, OOP spending by PLHIV decreased over the 4-year period, with the exception of Malawi, demonstrating that PLHIV have increased access to free or subsidized HIV/AIDS services. Our findings suggest that the influx of donor funding has led to decreased private contributions for HIV/AIDS. The reduction in private sector investment and engagement raises concerns about the sustainability of HIV/AIDS programmes over the long term, particularly in

  3. Role of the private sector in childbirth care: cross-sectional survey evidence from 57 low- and middle-income countries using Demographic and Health Surveys.

    PubMed

    Benova, Lenka; Macleod, David; Footman, Katharine; Cavallaro, Francesca; Lynch, Caroline A; Campbell, Oona M R

    2015-12-01

    Maternal mortality rates have decreased globally but remain off track for Millennium Development Goals. Good-quality delivery care is one recognised strategy to address this gap. This study examines the role of the private (non-public) sector in providing delivery care and compares the equity and quality of the sectors. The most recent Demographic and Health Survey (2000-2013) for 57 countries was used to analyse delivery care for most recent birth among >330 000 women. Wealth quintiles were used for equity analysis; skilled birth attendant (SBA) and Caesarean section rates served as proxies for quality of care in cross-sectoral comparisons. The proportion of women who used appropriate delivery care (non-facility with a SBA or facility-based births) varied across regions (49-84%), but wealth-related inequalities were seen in both sectors in all regions. One-fifth of all deliveries occurred in the private sector. Overall, 36% of deliveries with appropriate care occurred in the private sector, ranging from 9% to 46% across regions. The presence of a SBA was comparable between sectors (≥93%) in all regions. In every region, Caesarean section rate was higher in the private compared to public sector. The private sector provided between 13% (Latin America) and 66% (Asia) of Caesarean section deliveries. This study is the most comprehensive assessment to date of coverage, equity and quality indicators of delivery care by sector. The private sector provided a substantial proportion of delivery care in low- and middle-income countries. Further research is necessary to better understand this heterogeneous group of providers and their potential to equitably increase the coverage of good-quality intrapartum care. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  4. Review of the President’s Fiscal Year 2009 Budget Request for the Defense Health Program’s Private Sector Care Budget Activity Group

    DTIC Science & Technology

    2008-05-28

    2009 budget request for the Defense Health Program’s Private Sector Care BAG. To do this, we reviewed (1) DOD’s justification for the request for the... Private Sector Care BAG, including the underlying estimates and the extent to which DOD considered historical information; and (2) changes between this...develop the budget requests for the Private Sector Care BAG in fiscal years 2008 and 2009. We also interviewed officials and analyzed documents from

  5. Private sector development of stem cell technology and therapeutic cloning.

    PubMed

    Lysaght, Michael J; Hazlehurst, Anne L

    2003-06-01

    Based on data collected in June 2002, more than 30 biotechnology startup firms in 11 countries are pursuing commercial development of stem cell technology and therapeutic cloning. These firms employ 950-1000 scientists and support staff and spend just under $200 million on research and development each year. The field has the look and feel of a high-tech cottage industry, with about half the startups employing fewer than 15 FTEs (full time equivalents). Funding is mostly from venture capitalists and private investors. Participants are geographically dispersed, with about 40% of the activity outside the United States. Focus is equally split between embryonic and adult stem cells. Taken as a whole, both the structure and scope of the private sector in stem cell research seem appropriate to the promise and development time frames of this important new technology.

  6. Physiotherapy practice in the private sector: organizational characteristics and models.

    PubMed

    Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

    2014-08-29

    Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of this study was to: 1) describe characteristics of organizations where physiotherapists practice in the private sector, and 2) explore the existence of a taxonomy of organizational models. This was a cross-sectional quantitative survey of 236 randomly-selected physiotherapists. Participants completed a purpose-designed questionnaire online or by telephone, covering organizational vision, resources, structures and practices. Organizational characteristics were analyzed descriptively, while organizational models were identified by multiple correspondence analyses. Most organizations were for-profit (93.2%), located in urban areas (91.5%), and within buildings containing multiple businesses/organizations (76.7%). The majority included multiple providers (89.8%) from diverse professions, mainly physiotherapy assistants (68.7%), massage therapists (67.3%) and osteopaths (50.2%). Four organizational models were identified: 1) solo practice, 2) middle-scale multiprovider, 3) large-scale multiprovider and 4) mixed. The results of this study provide a detailed description of the organizations where physiotherapists practice, and highlight the importance of human resources in differentiating organizational models. Further research examining the influences of these organizational characteristics and models on outcomes such as physiotherapists' professional practices and patient outcomes are needed.

  7. What are private sector physiotherapists' perceptions regarding interprofessional and intraprofessional work for managing low back pain?

    PubMed

    Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

    2018-03-28

    In the last decades, interactions between health professionals have mostly been discussed in the context of interprofessional teamwork where professionals work closely together and share a team identity. Comparatively, little work has been done to explore interactions that occur between professionals in contexts where traditionally formal structures have been less supporting the implementation of interprofessional teamwork, such as in the private healthcare sector. The objective of this study was to identify private sector physiotherapists' perceptions of interprofessional and intraprofessional work regarding interventions for adults with low back pain. This was a cross-sectional survey of 327 randomly-selected physiotherapists. Data were analysed using descriptive statistics. A majority of physiotherapists reported positive effects of interprofessional work for their clients, themselves and their workplaces. Proximity of physiotherapists with other professionals, clinical workloads, and client's financial situation were perceived as important factors influencing the implementation of interprofessional work. Low back pain is a highly prevalent and disabling condition. The results of this study indicate that integrating interprofessional work in the management of low back pain in the private sector is warranted. Furthermore, the implementation of interprofessional work is viewed by practicing physiotherapists as dependent upon certain client-, professional- and organizational-level factors.

  8. The effect of increased private sector involvement in solid waste collection in five cities in Ghana.

    PubMed

    Oduro-Kwarteng, Sampson; van Dijk, Meine Pieter

    2013-10-01

    Private sector involvement in solid waste management in developing countries has increased, but the effect is not always clear. This study assesses how it has been organized in five cities in Ghana, what has been its effect and what lessons for private sector development in developing countries can be drawn. Data were collected from 25 private companies and a sample of 1200 households. More than 60% of solid waste in Ghanaian cities is now collected by private enterprises. Sometimes, and increasingly, competitive bidding takes place, although sometimes no bidding is organized leading to rendering of this service and no contract being signed. Local governments and local solid waste companies have not changed to more customer-oriented delivery because of the slow pace of charging users and the resulting low rate of cost recovery. The participation of the population has been limited, which contributes to low cost recovery. However, a gradual better functioning of the system put in place is shown. We observed an increasing use of competitive bidding, signing of contracts and city-wide user charging.

  9. Indian medical students in public and private sector medical schools: are motivations and career aspirations different? - studies from Madhya Pradesh, India.

    PubMed

    Diwan, Vishal; Minj, Christie; Chhari, Neeraj; De Costa, Ayesha

    2013-09-15

    In recent years, there has been a massive growth in the private medical education sector in South Asia. India's large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions.

  10. What can be done about the private health sector in low-income countries?

    PubMed Central

    Mills, Anne; Brugha, Ruairi; Hanson, Kara; McPake, Barbara

    2002-01-01

    A very large private health sector exists in low-income countries. It consists of a great variety of providers and is used by a wide cross-section of the population. There are substantial concerns about the quality of care given, especially at the more informal end of the range of providers. This is particularly true for diseases of public health importance such as tuberculosis, malaria, and sexually transmitted infections. How can the activities of the private sector in these countries be influenced so that they help to meet national health objectives? Although the evidence base is not good, there is a fair amount of information on the types of intervention that are most successful in directly influencing the behaviour of providers and on what might be the necessary conditions for success. There is much less evidence, however, of effective approaches to interventions on the demand side and policies that involve strengthening the purchasing and regulatory roles of governments. PMID:12075370

  11. The Economics of Private Sector R and D Decisionmaking in Aeronautics

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Information which can be used in planning to insure commercial research and technology programs which are complementary to internally financed private sector activities are presented. The main concern is to identify the characteristics of productive projects in which firms are unlikely to invest. It is shown that: (1) if it is difficult to assess the commercial relevance of an R&D project or it it is characterized by high technical risk, or a relatively long payback period, private funding will be unlikely; and (2) if a project is large relative to the size of the firm, it is unlikely to be funded in the early stages of the R&D process. Firms tend to underinvest in projects with these characteristics.

  12. Perceptions of care of patients undergoing coronary artery bypass surgery in Veterans Health Administration and private sector hospitals.

    PubMed

    Feria, Mary I; Sarrazin, Mary Vaughan; Rosenthal, Gary E

    2003-01-01

    Few studies have examined differences in patient perceptions of care between health care systems. This study compared the perceptions of male patients undergoing coronary artery bypass graft surgery in 43 Veterans Health Administration (VA) hospitals (N = 808) and 102 US private sector hospitals (N = 2271) from 1995 to 1998. Patient perceptions were measured by a validated survey that was mailed to patients after discharge. For 8 of the 9 dimensions assessed by the survey, VA patients were more likely (P < .001) than private sector patients to note a problem with care (eg, Coordination, 48% versus 40%; Patient Education and Communication, 50% versus 40%; Respect for Patient Preferences, 49% versus 41%). In comparisons limited to major teaching hospitals, VA patients were more likely to note a problem for 5 dimensions. The findings indicate that patient perceptions of care may be lower in VA than in private sector hospitals. Future studies should examine whether the VA's recent focus on improving patient satisfaction has narrowed these differences.

  13. Career development. Private lives.

    PubMed

    Hunt, Louise; Mooney, Helen

    2009-01-22

    Ensure the private sector job fits your career aims--don't simply take the first offer. Moving to the private sector can bring more freedom, but also more pressure to be entrepeneurial. A stint in the private sector can prepare you for roles back in the NHS.

  14. Comparing the Costs of Military Treatment Facilities with Private Sector Care

    DTIC Science & Technology

    2016-02-01

    amount and intensity of care would cost if priced at private sector rates for inpatient, outpatient, and prescription drug services, confining the...of the workload performed by both the hospital (equipment, beds, drugs , nursing staff, etc.) and the physician or other clinician performing the...larger had we taken into account the full cost of military manpower. Prescription Drug Costs Prescription drugs are one product for which DoD has a

  15. Investigating Students' Attitudes towards Private Sector Work during Study in Saudi Arabia

    ERIC Educational Resources Information Center

    Al-asqah, Amnah

    2018-01-01

    Purpose: The purpose of this paper is to identify the students' attitudes towards private sector work during study. Design/methodology/approach: This study used a comprehensive social survey (including questionnaire and interviewing) distributed to experts in departments and colleges in King Saud University and Princess Nora University. Findings:…

  16. Collaboration, Competition, and Co-opetition: Interorganizational Dynamics Between Private Child Welfare Agencies and Child Serving Sectors

    PubMed Central

    Collins-Camargo, Crystal; McBeath, Bowen; Chuang, Emmeline; Perez-Jolles, Monica; Wells, Rebecca

    2014-01-01

    Human service agencies are encouraged to collaborate with other public and private agencies in providing services to children and families. However, they also often compete with these same partners for funding, qualified staff, and clientele. Although little is known about complex interagency dynamics of competition and collaboration in the child-serving sector, evidence suggests that competition can undermine collaboration unless managed strategically. This study explores the interrelationship between competition and collaboration, sometimes referred to as “co-opetition.” Using a national dataset of private child and family serving agencies, we examine their relationships with other child serving sectors (N=4460 pair-wise relationships), and explore how variations in patterns of collaboration and competition are associated with several organizational, environmental and relational factors. Results suggest that most relationships between private child welfare agencies and other child serving agencies are characterized by both competition and collaboration (i.e. “co-opetition”), and is most frequently reported with other local private child welfare agencies. Logistic regression analyses indicate that co-opetition is likely to occur when private child welfare agencies have a good perceived relationship or a sub-contract with their partner. Findings have implications for how agency leaders manage partner relationships, and how public child welfare administrators structure contracts. PMID:25267868

  17. Collaboration, Competition, and Co-opetition: Interorganizational Dynamics Between Private Child Welfare Agencies and Child Serving Sectors.

    PubMed

    Bunger, Alicia C; Collins-Camargo, Crystal; McBeath, Bowen; Chuang, Emmeline; Perez-Jolles, Monica; Wells, Rebecca

    2014-03-01

    Human service agencies are encouraged to collaborate with other public and private agencies in providing services to children and families. However, they also often compete with these same partners for funding, qualified staff, and clientele. Although little is known about complex interagency dynamics of competition and collaboration in the child-serving sector, evidence suggests that competition can undermine collaboration unless managed strategically. This study explores the interrelationship between competition and collaboration, sometimes referred to as "co-opetition." Using a national dataset of private child and family serving agencies, we examine their relationships with other child serving sectors (N=4460 pair-wise relationships), and explore how variations in patterns of collaboration and competition are associated with several organizational, environmental and relational factors. Results suggest that most relationships between private child welfare agencies and other child serving agencies are characterized by both competition and collaboration (i.e. "co-opetition"), and is most frequently reported with other local private child welfare agencies. Logistic regression analyses indicate that co-opetition is likely to occur when private child welfare agencies have a good perceived relationship or a sub-contract with their partner. Findings have implications for how agency leaders manage partner relationships, and how public child welfare administrators structure contracts.

  18. Outsourcing vaccine logistics to the private sector: The evidence and lessons learned from the Western Cape Province in South-Africa.

    PubMed

    Lydon, Patrick; Raubenheimer, Ticky; Arnot-Krüger, Michelle; Zaffran, Michel

    2015-06-26

    With few exceptions, immunization supply chains in developing countries continue to face chronic difficulties in providing uninterrupted availability of potent vaccines up to service delivery levels, and in the most efficient manner possible. As these countries struggle to keep pace with an ever growing number of vaccines, more and more Ministries of Health are considering options of engaging the private sector to manage vaccine storage, handling and distribution on their behalf. Despite this emerging trend, there is limited evidence on the benefits or challenges of this option to improve public supply chain performance for national immunization programmes. To bridge this knowledge gap, this study aims to shed light on the value proposition of outsourcing by documenting the specific experience of the Western Cape Province of South Africa. The methodology for this review rested on conducting two key supply chain assessments which allowed juxtaposing the performance of the government managed segments of the vaccine supply chain against those managed by the private sector. In particular, measures of effective vaccine management best practice and temperature control in the cold chain were analysed. In addition, the costs of engaging the private sector were analysed to get a better understanding of the economics underpinning outsourcing vaccine logistics. The results from this analysis confirmed some of the theoretical benefits of outsourcing to the private sector. Yet, if the experience in the Western Cape can be deemed a successful one, there are several policy and practice implications that developing countries should be mindful of when considering engaging the private sector. While outsourcing can help improve the performance of the vaccine supply chain, it has the potential to do the reverse if done incorrectly. The findings and lessons learnt from the Western Cape experience can serve as a step towards understanding the role of the private sector in immunization

  19. Why do some physicians in Portuguese-speaking African countries work exclusively for the private sector? Findings from a mixed-methods study.

    PubMed

    Russo, Giuliano; de Sousa, Bruno; Sidat, Mohsin; Ferrinho, Paulo; Dussault, Gilles

    2014-09-11

    Despite the growing interest in the private health sector in low- and middle-income countries, little is known about physicians working outside the public sector. The present work adopts a mixed-methods approach to explore characteristics, working patterns, choices, and motivations of the physicians working exclusively for the private sector in the capital cities of Cape Verde, Guinea Bissau, and Mozambique. The paper's objective is to contribute to the understanding of such physicians, ultimately informing the policies regulating the medical profession in low- and middle-income countries. The qualitative part of the study involved 48 interviews with physicians and health policy-makers and aimed at understanding the practice in the three locations. The quantitative study included a survey of 329 physicians, and multivariate analysis was conducted to analyse characteristics, time allocation, earnings, and motivations of those physicians working only for the private sector, in comparison to their public sector-only and dual practice peers. Our findings showed that only a limited proportion of physicians in the three locations work exclusively for the private sector (11.2%), with members of this group being older than those practicing only in the public or in both sectors. They were found to work fewer hours per week (49 hours) than their public (56 hours) and dual practice peers (62 hours) (P <0.001 and P = 0.011, respectively). Their median earnings were USD 4,405 per month, with substantial variations across the three locations. Statistically significant differences were found with the earnings of public-only physicians (P <0.001), but not with those of the dual practice group (P = 0.340). The qualitative data from the interviews showed private-only physicians' preference for an independent and more flexible work modality, and this was quoted as a determining factor for their choice of sector. This group appears to include those working in the more

  20. The New Business Look in Employment and Training Programs. The Private Sector Initiative Program (PSIP). Second Edition.

    ERIC Educational Resources Information Center

    Garcia, Uvaldo

    Intended to inform local communities (especially the business sector) of ways to join government-sponsored employment and training programs with the private employment market, this handbook provides broad guidelines for use in the establishment and operation of the Private Industry Council (PIC). (The PIC is the primary vehicle created by Title…

  1. Enhanced disease surveillance through private health care sector cooperation in Karachi, Pakistan: experience from a vaccine trial.

    PubMed Central

    Khan, Mohammad Imran; Sahito, Shah Muhammad; Khan, Mohammad Javed; Wassan, Shafi Mohammad; Shaikh, Abdul Wahab; Maheshwari, Ashok Kumar; Acosta, Camilo J.; Galindo, Claudia M.; Ochiai, Rion Leon; Rasool, Shahid; Peerwani, Sheeraz; Puri, Mahesh K.; Ali, Mohammad; Zafar, Afia; Hassan, Rumina; von Seidlein, Lorenz; Clemens, John D.; Nizami, Shaikh Qamaruddin; Bhutta, Zulfiqar A.

    2006-01-01

    INTRODUCTION: In research projects such as vaccine trials, accurate and complete surveillance of all outcomes of interest is critical. In less developed countries where the private sector is the major health-care provider, the private sector must be included in surveillance systems in order to capture all disease of interest. This, however, poses enormous challenges in practice. The process and outcome of recruiting private practice clinics for surveillance in a vaccine trial are described. METHODS: The project started in January 2002 in two urban squatter settlements of Karachi, Pakistan. At the suggestion of private practitioners, a phlebotomy team was formed to provide support for disease surveillance. Children who had a reported history of fever for more than three days were enrolled for a diagnosis. RESULTS: Between May 2003 and April 2004, 5540 children younger than 16 years with fever for three days or more were enrolled in the study. Of the children, 1312 (24%) were seen first by private practitioners; the remainder presented directly to study centres. In total, 5329 blood samples were obtained for microbiology. The annual incidence of Salmonella typhi diagnosed by blood culture was 407 (95% confidence interval (95% CI), 368-448) per 100 000/year and for Salmonella paratyphi A was 198 (95% CI, 171-227) per 100 000/year. Without the contribution of private practitioners, the rates would have been 240 per 100 000/year (95% CI, 211-271) for S. typhi and 114 (95% CI, 94-136) per 100 000/year for S. paratyphi A. CONCLUSION: The private sector plays a major health-care role in Pakistan. Our experience from a surveillance and burden estimation study in Pakistan indicates that this objective is possible to achieve but requires considerable effort and confidence building. Nonetheless, it is essential to include private health care providers when attempting to accurately estimate the burden of disease in such settings. PMID:16501718

  2. Benchmarking the quality of schizophrenia pharmacotherapy: a comparison of the Department of Veterans Affairs and the private sector.

    PubMed

    Leslie, Douglas L; Rosenheck, Robert A

    2003-09-01

    Comparing quality of care between large health care systems is important for health systems management. This study used measures of the quality of pharmacotherapy for patients with schizophrenia and compared these measures across a sample of patients from the Department of Veterans Affairs (VA) and the private sector. A random sample of all patients diagnosed with schizophrenia in the VA during fiscal year (FY) 2000 was identified using administrative data. In the private sector, a sample of patients diagnosed with schizophrenia in 2000 was identified using MEDSTAT's MarketScan database. For both groups, use of antipsychotic medications was studied and measures of the quality of pharmacotherapy were constructed, including whether patients were prescribed any antipsychotic medication, one of the newer atypical antipsychotics, and whether dosing adhered to established treatment recommendations. These measures were compared across the two groups using logistic regression models, controlling for age, gender, and comorbid diagnoses. Most patients with a diagnosis of schizophrenia (82% in the VA and 73% in the private sector) received an antipsychotic medication, usually one of the newer atypical drugs. Patients in the VA were more likely to be dosed above treatment recommendations, and less likely to be dosed below treatment recommendations. Overall, differences in proportion schizophrenia patients dosed according to recommendations were not statistically different across the two systems (60% in the VA, 58% in the private sector). Differences between the two systems were mixed, with the VA outperforming the private sector with respect to some measures and doing worse on others. Although the VA and the private sector were comparable with respect to the quality measures used in this study, there is room for improvement in both systems. Treatment recommendations are based on the best available clinical evidence of effectiveness and safety. Quality of care might be improved

  3. Does hospital ownership affect patient experience? An investigation into public-private sector differences in England.

    PubMed

    Pérotin, Virginie; Zamora, Bernarda; Reeves, Rachel; Bartlett, Will; Allen, Pauline

    2013-05-01

    Using patient experience survey data, the paper investigates whether hospital ownership affects the level of quality reported by patients whose care is funded by the National Health Service in areas other than clinical quality. We estimate a switching regression model that accounts for (i) some observable characteristics of the patient and the hospital episode; (ii) selection into private hospitals; and (iii) unmeasured hospital characteristics captured by hospital fixed effects. We find that the experience reported by patients in public and private hospitals is different, i.e. most dimensions of quality are delivered differently by the two types of hospitals, with each sector offering greater quality in certain specialties or to certain groups of patients. However, the sum of all ownership effects is not statistically different from zero at sample means. In other words, hospital ownership in and of itself does not affect the level of quality of the average patient's reported experience. Differences in mean reported quality levels between the private and public sectors are entirely attributable to patient characteristics, the selection of patients into public or private hospitals and unobserved characteristics specific to individual hospitals, rather than to hospital ownership. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

    ERIC Educational Resources Information Center

    Beveridge, Scott; Garcia, Jorge; Siblo, Matt

    2015-01-01

    Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

  5. Intervention studies on rational use of drugs in public and private sector in Nepal.

    PubMed

    Kafle, Kumud Kumar; Shrestha, Naveen; Karkee, Shiba Bahadur; Prasad, Radha Raman; Bhuju, Gajendra Bahadur; Das, Prabhakar Lal

    2005-06-01

    In developing countries, inappropriate, inefficient and ineffective use of pharmaceuticals have resulted into the poor health and medical cares for the community people. For improving the situation, various interventions have been tested and proved effective in different settings. In Nepal also, various strategies have been tested and found effective to improve the prescribing and dispensing practices. This paper has examined the process and results of different studies. The educational intervention, the training has not been effective in improving the prescribing practices but has limited effect on dispensing practices in the public sector. However, it becomes effective in improving prescribing practices if combined with a managerial intervention e.g. peer-group discussion. In private sector, training alone is effective in changing the drug recommendation practices of retailers. But none of interventions have been found to be effective in improving dispensing practices. After examining the effectiveness of different interventions, training combined with peer-group discussion is recommended for piloting in all Primary Health Care (PHC) outlets of a district to improve the prescribing practices. For improving the dispensing practices in both public and private sector, additional studies have to be carried out using different strategies.

  6. Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai

    PubMed Central

    Tauro, Carolyn Kavita; Gawde, Nilesh Chandrakant

    2015-01-01

    Majority of children with tuberculosis are treated in private sector in India with no available data on management practices. The study assessed diagnostic and treatment practices related to childhood pulmonary tuberculosis among paediatricians in Mumbai's private sector in comparison with International Standards for Tuberculosis Care (ISTC) 2009. In this cross-sectional study, 64 paediatricians from private sector filled self-administered questionnaires. Cough was reported as a symptom of childhood TB by 77.8% of respondents. 38.1% request sputum smear or culture for diagnosis and fewer (32.8%) use it for patients positive on chest radiographs and 32.8% induce sputum for those unable to produce it. Sputum negative TB suspect is always tested with X-ray or tuberculin skin test. 61.4% prescribe regimen as recommended in ISTC and all monitor progress to treatment clinically. Drug-resistance at beginning of treatment is suspected for child in contact with a drug-resistant patient (67.7%) and with prior history of antitubercular treatment (12.9%). About half of them (48%) request drug-resistance test for rifampicin in case of nonresponse after two to three months of therapy and regimen prescribed by 41.7% for multidrug-resistant TB was as per ISTC. The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among paediatricians in private sector. PMID:26379705

  7. Diagnosis and Treatment of Childhood Pulmonary Tuberculosis: A Cross-Sectional Study of Practices among Paediatricians in Private Sector, Mumbai.

    PubMed

    Tauro, Carolyn Kavita; Gawde, Nilesh Chandrakant

    2015-01-01

    Majority of children with tuberculosis are treated in private sector in India with no available data on management practices. The study assessed diagnostic and treatment practices related to childhood pulmonary tuberculosis among paediatricians in Mumbai's private sector in comparison with International Standards for Tuberculosis Care (ISTC) 2009. In this cross-sectional study, 64 paediatricians from private sector filled self-administered questionnaires. Cough was reported as a symptom of childhood TB by 77.8% of respondents. 38.1% request sputum smear or culture for diagnosis and fewer (32.8%) use it for patients positive on chest radiographs and 32.8% induce sputum for those unable to produce it. Sputum negative TB suspect is always tested with X-ray or tuberculin skin test. 61.4% prescribe regimen as recommended in ISTC and all monitor progress to treatment clinically. Drug-resistance at beginning of treatment is suspected for child in contact with a drug-resistant patient (67.7%) and with prior history of antitubercular treatment (12.9%). About half of them (48%) request drug-resistance test for rifampicin in case of nonresponse after two to three months of therapy and regimen prescribed by 41.7% for multidrug-resistant TB was as per ISTC. The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among paediatricians in private sector.

  8. Private Schools as Battlefields: Contested Visions of Learning and Livelihood in Nepal

    ERIC Educational Resources Information Center

    Caddell, Martha

    2006-01-01

    Current policy and programme considerations of the role of the private sector in the promotion of schooling reform and the achievement of Education For All encompass a somewhat narrow arena of debate. Discussion of the relative merits of private / state schools remain based on measurable, yet partial, markers of efficiency and effectiveness.…

  9. HIV / AIDS in Brazil: the private sector begins to respond.

    PubMed

    Margolis, M

    1995-02-01

    Brazil has one of the highest numbers of reported AIDS cases in the world, while an estimated 500,000 Brazilians are HIV-positive. Brazilian business and labor leaders have slowly come to realize that HIV/AIDS in Brazil can have considerably adverse effects upon the private corporate sector. Social discrimination results from ignorance. Accordingly, employees who are uninformed or misinformed about how HIV is transmitted may be afraid of HIV-positive coworkers, stigmatize them, and generally disrupt the harmony of the workplace. Corporate leaders are also concerned about the loss of productivity and the high health costs which can result from HIV/AIDS morbidity and mortality in the workplace. Business people have therefore taken action to prevent and control the spread of HIV. Companies have distributed thousands of leaflets, financed booklets on safe sex, held congresses on sexually transmitted diseases, and distributed condoms to employees. Some corporate health plans guarantee total care for employees with HIV and AIDS. Policy at Shell Brazil is to not demand the HIV testing of employees or prospective employees and to neither fire nor isolate HIV-positive workers. The company's group health plan has been strengthened to cover all costs of treating people with AIDS and money has been set aside to fund a safe sex promotion campaign. The AIDS Control and Prevention Project (AIDSCAP) is lending technical assistance to Shell and other companies in Brazil.

  10. Strengthening referral of sick children from the private health sector and its impact on referral uptake in Uganda: a cluster randomized controlled trial protocol.

    PubMed

    Buregyeya, Esther; Rutebemberwa, Elizeus; LaRussa, Philip; Mbonye, Anthony

    2016-11-11

    Uganda's under-five mortality is high, currently estimated at 66/1000 live births. Poor referral of sick children that seek care from the private sector is one of the contributory factors. The proposed intervention aims to improve referral and uptake of referral advice for children that seek care from private facilities (registered drug shops/private clinics). A cluster randomized design will be applied to test the intervention in Mukono District, central Uganda. A sample of study clusters will implement the intervention. The intervention will consist of three components: i) raising awareness in the community: village health teams will discuss the importance of referral and encourage households to save money, ii) training and supervision of providers in the private sector to diagnose, treat and refer sick children, iii) regular meetings between the public and private providers (convened by the district health team) to discuss the referral system. Twenty clusters will be included in the study, randomized in the ratio of 1:1. A minimum of 319 sick children per cluster and the total number of sick children to be recruited from all clusters will be 8910; adjusting for a 10 % loss to follow up and possible withdrawal of private outlets. The immediate sustainable impact will be appropriate treatment of sick children. The intervention is likely to impact on private sector practices since the scope of the services they provide will have expanded. The proposed study is also likely to have an impact on families as; i) they may appreciate the importance of timely referral on child illness management, ii) the cost savings related to reduced morbidity will be used by household to access other social services. The linkage between the private and public sectors will create a potential avenue for delivery of other public health interventions and improved working relations in the two sectors. Further, improved quality of services in the private sector will improve provider

  11. Concentration in the Greek private hospital sector: a descriptive analysis.

    PubMed

    Boutsioli, Zoe

    2007-07-01

    Over the last 20 years, governments all around the world have attempted to boost the role of market and competition in health care industries in order to increase efficiency and reduce costs. The increased competition and the significant implications on costs and prices of health care services resulted in health care industries being transformed. Large firms are merging and acquiring other firms. If this trend continues, few firms will dominate the health care markets. In this study, I use the simple concentration ratio (CR) for the largest 4, 8 and 20 companies to measure the concentration of Greek private hospitals during the period 1997-2004. Also, the Gini coefficient for inequality is used. For the two different categories of hospitals used (a) general and neuropsychiatric and (b) obstetric/gynaecological it is evident that the top four firms of the first category accounted for 43% of sales in 1997, and 52% in 2004, while the four largest firms of the second category accounted for almost 83% in 1997, and 81% in 2004. Also, the Gini coefficient increases over the 8-year period examined from 0.69 in 1997 to 0.82 in 2004. It explains that the market of the private health care services becomes less equal in the sense that fewer private hospitals and clinics hold more and more of the share of the total sales. From a cross-industry analysis it is clear that the private hospital sector has the highest concentration rate. Finally, it appears that the market structure of the private hospitals in Greece resembles more closely to an oligopoly rather than a monopolistic competition, since very few firms dominate the market.

  12. Considerations of private sector obstetricians on participation in the state led "Chiranjeevi Yojana" scheme to promote institutional delivery in Gujarat, India: a qualitative study.

    PubMed

    Ganguly, Parthasarathi; Jehan, Kate; de Costa, Ayesha; Mavalankar, Dileep; Smith, Helen

    2014-11-05

    between the public and private health sectors affect retention of private providers in the scheme. Further refinement of the scheme, in consultation with private partners, and trust building initiatives could strengthen the programme. These findings offer lessons to those developing public-private partnerships to widen access to health services for underprivileged groups.

  13. Iran plans huge private sector MTBE plant

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Alperowicz, N.

    1992-01-15

    An export-oriented 1-million m.t./year methyl tert-butyl ether (MTBE) plant is planned as one of Iran`s private sector investment projects. State-owned National Petrochemical Co (NPC; Tehran) and the Dubai-based Iranian businessman Abdul Wahab Galadari have signed a letter of intent allowing Galadari to develop the venture. Colt Engineering (Calgary, AL) is assisting Galadari with costs, planning and technology selection for the estimated $300-million plus venture. An important meeting with NPC is scheduled end of this month, says Galadari, and a financial package should be put together by end of March or April. The facility will most likely be wholly-owned by themore » Galadari family, roughly 50% by members resident in Iran and the remainder by the Dubai-based concern A.W. Galadari Sons. NPC says it may take a token shareholding in the venture.« less

  14. Assessing the Impact of Privatization Policy on Telecommunications Sector Effectiveness and Economic Activity in Sub-Saharan Africa

    ERIC Educational Resources Information Center

    Ngwa, Oneurine B.

    2012-01-01

    In recent years, privatization has been a growing phenomenon in Sub-Saharan Africa. It is viewed as an instrument used by the public sector to reduce the role of the state in the economies while enhancing the scope of private ownership and participation of goods and services (Akram et al, 2011). Researchers have noted that the telecommunication…

  15. Public-private health partnerships: a strategy for WHO.

    PubMed Central

    Buse, K.; Waxman, A.

    2001-01-01

    Following early success with a number of high-profile partnerships, WHO is increasingly working with the private for-profit sector. In so doing, the organization finds itself in the maelstrom of a vibrant debate on the roles of public, civic, and commercial entities in society and on the appropriate modes of interaction among them. This paper examines WHO's involvement with the commercial sector, particularly in partnerships. WHO's approach to this sector is outlined and the criticisms levelled at public-private partnerships are reviewed. An indication is given of the steps recently taken by WHO to confront the concerns that have been expressed. The paper argues that partnership between WHO and the commercial sector is inevitable and that it presents considerable opportunities, but also significant risks, for the organization and for public health. A strategy is proposed for directing the debate on issues critical to WHO and its role in the promotion and protection of public health. PMID:11545332

  16. The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

    PubMed

    Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

    2017-01-01

    Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

  17. The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

    PubMed Central

    Lister, Cameron; Payne, Hannah; Hanson, Carl L.; Barnes, Michael D.; Davis, Siena F.; Manwaring, Todd

    2017-01-01

    Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes. PMID:28824899

  18. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health.

    PubMed

    Hallo De Wolf, Antenor; Toebes, Brigit

    2016-12-01

    The goal of universal health coverage is to "ensure that all people obtain the health services they need without suffering financial hardship when paying for them." There are many connections between this goal and the state's legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors' involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide "public goods"; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?

  19. Collaboration: Vocational Education and the Private Sector. 1984 Yearbook of the American Vocational Association.

    ERIC Educational Resources Information Center

    American Vocational Association, Arlington, VA.

    This yearbook includes 24 papers dealing with collaboration between the vocational education and private sectors. Presented first are the following papers on the foundation for collaboration: "The Changing Nature of Work and Workers" (Joseph F. Coates), "Jobs with a Future" (Marvin J. Cetron), "The Mission of Vocational…

  20. Communication, Relationships, and Religious Difference in the Northern Ireland Workplace: A Study of Private and Public Sector Organizations

    ERIC Educational Resources Information Center

    Dickson, David; Hargie, Owen; Wilson, Noel

    2008-01-01

    Four large organizations, two each from the private and public sectors of the Northern Ireland economy, were selected for this study which, first, explored the effects of religion-based workforce difference on intergroup relationships, second, investigated the contribution of organizational sector to communicative differences, and third, gauged…

  1. Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

    PubMed

    Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J

    2016-01-01

    Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers. This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes. Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS. Health providers generally perceive the NHIS to have had a

  2. Private Higher Education in India: A Study of Two Private Universities

    ERIC Educational Resources Information Center

    Angom, Sangeeta

    2015-01-01

    The Private higher education sector is growing fast in many settings, including India, and there are variations at the national level. Privatization of higher education in India has been the result of changes in the economic policy towards liberalization and privatization by the Government of India. Till 1980, higher education sector was…

  3. WARF's stem cell patents and tensions between public and private sector approaches to research.

    PubMed

    Golden, John M

    2010-01-01

    While society debates whether and how to use public funds to support work on human embryonic stem cells (hESCs), many scientific groups and businesses debate a different question - the extent to which patents that cover such stem cells should be permitted to limit or to tax their research. The Wisconsin Alumni Research Foundation (WARF), a non-profit foundation that manages intellectual property generated by researchers at the University of Wisconsin at Madison, owns three patents that have been at the heart of the latter controversy The story of WARF's patents and the controversy they have fostered highlights not only continuing tensions between proprietary and nonproprietary approaches to developing science and technology, but also an at least partly reassuring capacity of public and private sectors to deal with those tensions in a way that can render them substantially manageable, and frequently more manageable as a technology matures. More particularly, the cumulative story of WARF's patents features three leitmotifs that suggest how an attentive and engaged public sector might commonly succeed in working with public and private sector actors to achieve workable balances between proprietary rights and more general social interests: (1) right holders' decisions to pursue less than full rights assertion or enforcement; (2) the ability of government and other public sector actors to help bring about such decisions through co-option or pressure; and (3) the frequent availability or development of technological alternatives that limit research bottlenecks.

  4. 77 FR 76076 - Information Security Oversight Office; State, Local, Tribal, and Private Sector Policy Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Information Security Oversight Office; State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records....m. to 12:00 noon. ADDRESSES: National Archives and Records Administration, 700 Pennsylvania Avenue...

  5. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety.

    PubMed

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

    2016-04-14

    Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality of care in the private sector that provides almost a half of health services in Uganda. A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. A total of 241 private health facilities were surveyed; 70.5 % were registered drug shops, 24.5 % private clinics and 5.0 % pharmacies. Treatment of fever among pregnant women in accordance with the national treatment guidelines was poor: 40.7 % in private clinics, decreasing to 28.2 % in drug shops and 16.7 % at pharmacies. Anti-malarial monotherapies sulphadoxine-pyrimethamine and quinine were commonly prescribed, often without consideration of gestational age. The majority of providers (>75 %) at all private facilities prescribed SP for intermittent preventive treatment but artemisinin-based combination therapy was prescribed: 8.3, 6.9 and 8.3 % respectively at drug shops, private clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge

  6. Case-Mix and Quality Indicators in Chinese Elder Care Homes: Are There Differences between Government-owned and Private-sector Facilities?

    PubMed Central

    Liu, Chang

    2015-01-01

    Objective To assess the association between ownership of Chinese elder care facilities and their performance quality; and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Design Cross-sectional study. Setting Census of elder care homes surveyed in Nanjing (in 2009) and Tianjin (in 2010). Population 140 (or 95% of all) elder care facilities located in urban Nanjing, and 157 (or 97% of all) facilities in urban Tianjin. Main study outcome measures We created a summary case-mix index based on activities of daily living (ADL) limitations and cognitive impairment to measure levels of care needs among residents in each facility. We selected structure, process, and outcome measures to assess facility-level quality of care. We also developed a structural quality measure, under-staffing relative to residents’ levels of care needs, which indicates potentially inadequate staffing given the residents’ case-mix. Results Government-owned homes have significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but they serve residents who, on average, have fewer ADL and cognitive functioning limitations than do private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages to either ownership type. However, when staffing to resident ratio is gauged relative to residents’ case-mix, private-sector facilities were more likely to be under-staffed than government-owned facilities. Conclusions In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer, on average, than those in government facilities. The case-mix differences are likely the result of selective admission policies that favor relatively healthier residents in government facilities than in private-sector homes. PMID:24433350

  7. Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities?

    PubMed

    Liu, Chang; Feng, Zhanlian; Mor, Vincent

    2014-02-01

    To assess the association between ownership of Chinese elder care facilities and their performance quality and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Cross-sectional study. Census of elder care homes surveyed in Nanjing (2009) and Tianjin (2010). Elder care facilities located in urban Nanjing (n = 140, 95% of all) and urban Tianjin (n = 157, 97% of all). A summary case-mix index based on activity of daily living (ADL) limitations and cognitive impairment was created to measure levels of care needs of residents in each facility. Structure, process, and outcome measures were selected to assess facility-level quality of care. A structural quality measure, understaffing relative to resident levels of care needs, which indicates potentially inadequate staffing given resident case-mix, was also developed. Government-owned homes had significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but served residents who, on average, have fewer ADL and cognitive functioning limitations than those in private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages of either ownership type, although when staffing-to-resident ratio is gauged relative to resident case-mix, private-sector facilities were more likely to be understaffed than government-owned facilities. In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer on average than those in government facilities. It is likely that the case-mix differences are the result of selective admission policies that favor healthier residents in government facilities than in private-sector homes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  8. Assessment of Drinking Water Sold from Private Sector Kiosks in Post-Earthquake Port-au-Prince, Haiti.

    PubMed

    Patrick, Molly; Steenland, Maria; Dismer, Amber; Pierre-Louis, Jocelyne; Murphy, Jennifer L; Kahler, Amy; Mull, Bonnie; Etheart, Melissa D; Rossignol, Emmanuel; Boncy, Jacques; Hill, Vincent; Handzel, Thomas

    2017-10-01

    Consumption of drinking water from private vendors has increased considerably in Port-au-Prince, Haiti, in recent decades. A major type of vendor is private kiosks, advertising reverse osmosis-treated water for sale by volume. To describe the scale and geographical distribution of private kiosks in metropolitan Port-au-Prince, an inventory of private kiosks was conducted from July to August 2013. Coordinates of kiosks were recorded with global positioning system units and a brief questionnaire was administered with the operator to document key kiosk characteristics. To assess the quality of water originating from private kiosks, water quality analyses were also conducted on a sample of those inventoried as well as from the major provider company sites. The parameters tested were Escherichia coli , free chlorine residual, pH, turbidity, and total dissolved solids. More than 1,300 kiosks were inventoried, the majority of which were franchises of four large provider companies. Approximately half of kiosks reported opening within 12 months of the date of the inventory. The kiosk treatment chain and sales price was consistent among a majority of the kiosks. Of the 757 kiosks sampled for water quality, 90.9% of samples met World Health Organization (WHO) microbiological guideline at the point of sale for nondetectable E. coli in a 100-mL sample. Of the eight provider company sites tested, all samples met the WHO microbiological guideline. Because of the increasing role of the private sector in drinking water provision in Port-au-Prince and elsewhere in Haiti, this assessment was an important first step for government regulation of this sector.

  9. Predictors of latent tuberculosis infection treatment completion in the US private sector: an analysis of administrative claims data.

    PubMed

    Stockbridge, Erica L; Miller, Thaddeus L; Carlson, Erin K; Ho, Christine

    2018-05-29

    Factors that affect latent tuberculosis infection (LTBI) treatment completion in the US have not been well studied beyond public health settings. This gap was highlighted by recent health insurance-related regulatory changes that are likely to increase LTBI treatment by private sector healthcare providers. We analyzed LTBI treatment completion in the private healthcare setting to facilitate planning around this important opportunity for tuberculosis (TB) control in the US. We analyzed a national sample of commercial insurance medical and pharmacy claims data for people ages 0 to 64 years who initiated daily dose isoniazid treatment between July 2011 and March 2014 and who had complete data. All individuals resided in the US. Factors associated with treatment completion were examined using multivariable generalized ordered logit models and bivariate Kruskal-Wallis tests or Spearman correlations. We identified 1072 individuals with complete data who initiated isoniazid LTBI treatment. Treatment completion was significantly associated with less restrictive health insurance, age < 15 years, patient location, use of interferon-gamma release assays, non-poverty, HIV diagnosis, immunosuppressive drug therapy, and higher cumulative counts of clinical risk factors. Private sector healthcare claims data provide insights into LTBI treatment completion patterns and patient/provider behaviors. Such information is critical to understanding the opportunities and limitations of private healthcare in the US to support treatment completion as this sector's role in protecting against and eliminating TB grows.

  10. Shifting the burden: the private sector's response to the AIDS epidemic in Africa.

    PubMed

    Rosen, Sydney; Simon, Jonathon L

    2003-01-01

    As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include pre-employment screening, reductions in employee benefits, restructured employment contracts, outsourcing of low skilled jobs, selective retrenchments, and changes in production technologies. Between 1997 and 1999 more than two-thirds of large South African employers reduced the level of health care benefits or increased employee contributions. Most firms also have replaced defined-benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined-contribution funds, which eliminate risks to the firm but provide little for families of younger workers who die of AIDS. Contracting out previously permanent jobs is also shielding firms from benefit and turnover costs, effectively shifting the responsibility to care for affected workers and their families to households, nongovernmental organizations, and the government. Many of these changes are responses to globalization that would have occurred in the absence of AIDS, but they are devastating for the households of employees with HIV/AIDS. We argue that the shift in the economic burden of AIDS is a predictable response by business to which a deliberate public policy response is needed. Countries should make explicit decisions about each sector's responsibilities if a socially desirable allocation is to be achieved.

  11. Shifting the burden: the private sector's response to the AIDS epidemic in Africa.

    PubMed Central

    Rosen, Sydney; Simon, Jonathon L.

    2003-01-01

    As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include pre-employment screening, reductions in employee benefits, restructured employment contracts, outsourcing of low skilled jobs, selective retrenchments, and changes in production technologies. Between 1997 and 1999 more than two-thirds of large South African employers reduced the level of health care benefits or increased employee contributions. Most firms also have replaced defined-benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined-contribution funds, which eliminate risks to the firm but provide little for families of younger workers who die of AIDS. Contracting out previously permanent jobs is also shielding firms from benefit and turnover costs, effectively shifting the responsibility to care for affected workers and their families to households, nongovernmental organizations, and the government. Many of these changes are responses to globalization that would have occurred in the absence of AIDS, but they are devastating for the households of employees with HIV/AIDS. We argue that the shift in the economic burden of AIDS is a predictable response by business to which a deliberate public policy response is needed. Countries should make explicit decisions about each sector's responsibilities if a socially desirable allocation is to be achieved. PMID:12751421

  12. Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

    PubMed Central

    2016-01-01

    Abstract The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care? PMID:28559678

  13. Designing Graduate-Level Plant Breeding Curriculum: A Delphi Study of Private Sector Stakeholder Opinions

    ERIC Educational Resources Information Center

    Miller, Jane K.; Repinski, Shelby L.; Hayes, Kathryn N.; Bliss, Frederick A.; Trexler, Cary J.

    2011-01-01

    A broad-based survey using the Delphi method was conducted to garner current information from private sector stakeholders and build consensus opinions supporting key ideas for enhancing plant breeder education and training. This study asked respondents to suggest and rate topics and content they deemed most important to plant breeding graduate…

  14. Comparison of Environmental Remediation Contracting Approaches between the Department of Defense and the Private Sector

    DTIC Science & Technology

    2001-12-01

    private sector contracts for environmental remediation and apply any applicable best practices to the Department of Defense contracting system. Key findings of this study are: (1) there is no readily available process from either the commercial sector or the Department of Defense that will suffice as a template for all environmental remediation efforts, (2) the Department of Defense has no centralized repository of environmental remediation contracting knowledge, (3) Legislative and regulatory hurdles exist which impede assimilation of new initiatives in the remediation of

  15. Treatment practices in pulmonary tuberculosis by private sector physicians of Meerut, Uttar Pradesh.

    PubMed

    Yadav, A; Garg, S K; Chopra, H; Bajpai, S K; Bano, T; Jain, S; Kumar, A

    2012-01-01

    Majority of the qualified medical practitioners in the country are in the private sector and more than half of patients with tuberculosis (TB) seek treatment from them. The present study was conducted with the objective of assessing the treatment modalities in pulmonary tuberculosis by the private physicians in Meerut City, Uttar Pradesh, India. A cross-sectional study was carried out covering all the private physicians (graduates and postgraduates in Medicine and Chest Diseases) registered under the Indian Medical Association, Meerut Branch (n = 154). The physicians were interviewed by a pre-designed and pre-tested questionnaire about the treatment modalities practiced by them. Only 43.5% private physicians had attended any Revised National Tuberculosis Control Programme (RNTCP) training in the past five years. Only 33.1% of them were aware of the International Standards of Tuberculosis Care (ISTC). Fifty-three different regimens were used to treat the patients. Majority of physicians (76%) prescribed daily regimens while 24% administered both daily and intermittent treatment. None of the private physicians prescribed exclusive intermittent regimen. Eighty-seven different treatment regimens were used for the treatment of multidrug-resistant TB (MDR-TB) with none of them prescribing standard treatment under RNTCP. As majority of private practitioners do not follow RNTCP guidelines for treating TB, there is an urgent need for their continued education in this area.

  16. Surveillance of antibiotic use in the private sector in Namibia using sales and claims data.

    PubMed

    Pereko, Dawn Dineo; Lubbe, Martie S; Essack, Sabiha Y

    2016-11-24

    Antibiotics are among the most commonly used therapeutic agents for humans globally, and their use has been associated with the development of resistance. The objective of this study was to identify sources for quantifying antibiotic usage patterns and to assess such use in ambulatory patients in the private health sector of Namibia. A retrospective analysis of prescription claims data and sales data for the period 2008 to 2011 was conducted. Antibiotic use was expressed in the number of antibiotic-containing prescriptions and volume of units sold and then standardized using defined daily dose per 1,000 inhabitants per day. Antibiotic usage was highest in females (53%), in people 18-45 years of age (41%), and in Windhoek (34%). Overall, wholesale data showed higher antibiotic use than prescription claims data. However, both sources showed similar patterns of antibiotic use. Penicillins were the most used pharmacological group, with amoxicillin/clavulanic acid combination being the most used of the agents. Antibiotic use in the private sector of Namibia is comparable to that of high-consuming European countries such as Italy. A trend observed in this study was the decrease in the use of narrow-spectrum antibiotics in favour of broad-spectrum and newer antibiotics. Since this was the first study to assess antibiotic use in the private sector of Namibia, it could serve as a starting point for continued monitoring of antibiotic use in the whole of Namibia in the context of the World Health Organization's Global Action Plan to contain antibiotic resistance.

  17. Predictors of Return to Work for People with Psychiatric Disabilities: A Private Sector Perspective

    ERIC Educational Resources Information Center

    Pluta, David J.; Accordino, Michael P.

    2006-01-01

    This investigation was a baseline study to determine if the speed of return to work could be predicted for people with psychiatric disabilities in a private sector setting. Participants with psychiatric disability claims who returned to work (N = 300) were obtained from a nationwide "Fortune 500" insurance company. The authors compared the speed…

  18. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India.

    PubMed

    Singh, Priyanka; Hashmi, Gulfam; Swain, Prafulla Kumar

    2018-05-10

    Worldwide rising cesarean section (CS) births is an issue of concern. In India, with increase in institutional deliveries there has also been an increase in cesarean section births. Aim of the study is to quantify the prevalence of cesarean section births in public and private health facility, and also to determine the factors associated with cesarean section births. We analyzed data from district level household survey data 4 (DLHS-4) combined individual level dataset for 19 states/UTs of India comprising 24,398 deliveries resulting in 22,111 live births for year 2011. The percentages and Chi-square has been computed for the select variables viz. Socio demographic, maternal, antenatal care and delivery related based on type of births (CS Vs normal births). The multiple logistic regression model has been used to identify the potential risk factors associated with CS births. Of 22,111 live birth analyzed 49.2% were delivered at public sector, 31.9% at private sector and 18.9% were home deliveries. Prevalence of CS births were 13.7% (95% CI; 13.0- 14.3%) and 37.9% (95% CI; 36.7- 39.0%) in the public and private sectors, respectively. Higher odds of CS births were observed with- delivery at private health facility (OR 3.79; 95% C.I 3.06-4.72), urban residence (OR 1.15; 95% C.I 1.00- 1.35), first delivery after 35 years of maternal age (OR 5.5; 95% C.I 1.85- 16.4), hypertension in pregnancy (OR 1.32; 95% C.I 1.06- 1.65) and breach presentation (OR 2.37; 95% C.I. 1.63- 3.43). Our findings shows that CS births are nearly three times more in private as compared to public sector health facilities.The higher rates of CS births, especially in private sector, not only increase the cost of care but may pose unnecessary risks to women (when there is no indications for CS). The government of India need to take measures to strengthen existing public health facilities as well as ensure that cesarean sections are performed based upon medical indications in both public and private

  19. The Rise and Decline of U.S. Private Sector Investments in Energy R&D since the Arab Oil Embargo of 1973

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dooley, James J.

    2010-11-01

    This paper presents two distinct datasets that describe investments in energy research and development (R&D) by the US private sector since the mid1970s, which is when the US government began to systematically collect these data. The first dataset is based upon a broad survey of more than 20,000 firms’ industrial R&D activities. This broad survey of US industry is coordinated by the US National Science Foundation. The second dataset discussed here is a much narrower accounting of the energy R&D activities of the approximately two dozen largest US oil and gas companies conducted by the US Department of Energy’s Energymore » Information Agency. Even given the large disparity in the breadth and scope of these two surveys of the private sector’s support for energy R&D, both datasets tell the same story in terms of the broad outlines of the private sector’s investments in energy R&D since the mid 1970s. The broad outlines of the US private sector’s support for energy R&D since the mid 1970s is: (1) In the immediate aftermath of the Arab Oil Embargo of 1973, there is a large surge in US private sector investments in energy R&D that peaked in the period between 1980 and 1982 at approximately $3.7 billion to $6.7 billion per year (in inflation adjusted 2010 US dollars) depending upon which survey is used (2) Private sector investments in energy R&D declined from this peak until bottoming out at approximately $1.8 billion to $1 billion per year in 1999; (3) US private sector support for energy R&D has recovered somewhat over the past decade and stands at $2.2 billion to $3.4 billion. Both data sets indicate that the US private sector’s support for energy R&D has been and remains dominated by fossil energy R&D and in particular R&D related to the needs of the oil and gas industry.« less

  20. Assessment of Drinking Water Sold from Private Sector Kiosks in Post-Earthquake Port-au-Prince, Haiti

    PubMed Central

    Steenland, Maria; Dismer, Amber; Pierre-Louis, Jocelyne; Murphy, Jennifer L.; Kahler, Amy; Mull, Bonnie; Etheart, Melissa D.; Rossignol, Emmanuel; Boncy, Jacques; Hill, Vincent; Handzel, Thomas

    2017-01-01

    Abstract. Consumption of drinking water from private vendors has increased considerably in Port-au-Prince, Haiti, in recent decades. A major type of vendor is private kiosks, advertising reverse osmosis-treated water for sale by volume. To describe the scale and geographical distribution of private kiosks in metropolitan Port-au-Prince, an inventory of private kiosks was conducted from July to August 2013. Coordinates of kiosks were recorded with global positioning system units and a brief questionnaire was administered with the operator to document key kiosk characteristics. To assess the quality of water originating from private kiosks, water quality analyses were also conducted on a sample of those inventoried as well as from the major provider company sites. The parameters tested were Escherichia coli, free chlorine residual, pH, turbidity, and total dissolved solids. More than 1,300 kiosks were inventoried, the majority of which were franchises of four large provider companies. Approximately half of kiosks reported opening within 12 months of the date of the inventory. The kiosk treatment chain and sales price was consistent among a majority of the kiosks. Of the 757 kiosks sampled for water quality, 90.9% of samples met World Health Organization (WHO) microbiological guideline at the point of sale for nondetectable E. coli in a 100-mL sample. Of the eight provider company sites tested, all samples met the WHO microbiological guideline. Because of the increasing role of the private sector in drinking water provision in Port-au-Prince and elsewhere in Haiti, this assessment was an important first step for government regulation of this sector. PMID:29064355

  1. Erosion of the At-Will Rule and Freedom of Communication in Private Sector Organizations.

    ERIC Educational Resources Information Center

    Sanders, Wayne

    The "at-will" rule in American law is defined as the right of a private sector employer to dismiss an employee without a contract for virtually any reason. The rule has thrived since the nineteenth century and is still a major factor in the employer-employee relationship. However, recent court decisions have fashioned common law…

  2. The role of the private sector in the provision of antenatal care: a study of Demographic and Health Surveys from 46 low- and middle-income countries.

    PubMed

    Powell-Jackson, Timothy; Macleod, David; Benova, Lenka; Lynch, Caroline; Campbell, Oona M R

    2015-02-01

    To examine the role of the private sector in the provision of antenatal care (ANC) across low- and middle-income countries. Demographic and Health Survey (DHS) data from 46 countries (representing 2.6 billion people) on components of ANC given to 303 908 women aged 15-49 years for most recent birth were used. We identified 79 unique sources of care which were re-coded into home, public, private (commercial) and private (not-for-profit). Use of ANC and a quality of care index (scaled 0-1) were stratified by type of provider, region and wealth quintile. Linear regressions were used to examine the association between provider type and antenatal quality of care score. Across all countries, the main source of ANC was public (54%), followed by private commercial (36%) and home (5%), but there were large variations by region. Home-based ANC was associated with worse quality of care (0.2; 95% CI -0.2 to -0.19) relative to the public sector, while the private not-for-profit sector (0.03; 95% CI 0.02 to 0.04) was better. There were no differences in quality of care between public and private commercial providers. The market for ANC varies considerably between regions. The two largest sectors - public and private commercial - perform similarly in terms of quality of care. Future research should examine the role of the private sector in other health service domains across multiple countries and test what policies and programmes can encourage private providers to contribute to increased coverage, quality and equity of maternal care. © 2014 John Wiley & Sons Ltd.

  3. Phase II Private Sector Financed Military Family Housing Elmendorf Air Force Base, Alaska

    DTIC Science & Technology

    2004-06-01

    collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and...of Proposed Action and Alternatives Phase II Private Sector Financed Military Family Housing 2-11 Existing mature trees within the housing area...would be retained in place to the maximum extent practicable. Removal of mature trees would be avoided wherever possible in order to retain the

  4. Competition, Jobs, and Information Policy: The Case for Private-Sector Information Services: U.S. Patents.

    ERIC Educational Resources Information Center

    Ebersole, Joseph L.

    1994-01-01

    Discusses the argument for private-sector involvement in the distribution of government information, using U.S. patents as an example. Highlights include industry competitiveness; jobs creation; public access; identifying users; costs; user fees; existing systems of information dissemination; and implications of the Internet and NREN (National…

  5. Community Resilience: Workshops on Private Sector and Property Owner Requirements for Recovery and Restoration from a Diasaster

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Judd, Kathleen S.; Stein, Steven L.; Lesperance, Ann M.

    2008-12-22

    This report summarizes the results of a proejct sponsored by DTRA to 1) Assess the readiness of private-sector businesses, building owners, and service providers to restore property and recover operations in the aftermath of a wide-area dispersal of anthrax; and 2) Understand what private property owners and businesses "want and need" from federal, state, and local government to support recovery and restoration from such an incident.

  6. Promoting High Quality Education at Small Private Universities: Leadership Challenges and Strategies

    ERIC Educational Resources Information Center

    Ngo, Kim Lien Thi

    2010-01-01

    The problem: The purpose of this study was to explore the characteristics, roles, and contributions of non-profit, small private universities to the overall quality of higher education in the United States, as well as leadership challenges and strategies in promoting a total quality education at small private higher education institutions. …

  7. State Relationships to the Private Sector.

    ERIC Educational Resources Information Center

    Norton, James A.

    The relationships between state government and private higher education are considered with emphasis on Ohio. It is noted that state colleges have received land and financial support from private sources and that there have been reciprocal arrangements of public support given to private colleges. These arrangements include different types of tax…

  8. Private sector approaches to workforce enhancement.

    PubMed

    Wendling, Wayne R

    2010-06-01

    This paper addresses the private practice model of dental care delivery in the US. The great majority of dental care services are delivered through this model and thus changes in the model represent a means to substantially change the supply and availability of dental services. The two main forces that change how private practices function are broad economic factors, which alter the demand for dental care and innovations in practice structure and function which alter the supply and cost of services. Economics has long recognized that although there are private market solutions for many issues, not all problems can be addressed through this model. The private practice of dentistry is a private market solution that works for a substantial share of the market. However, the private market may not work to resolve all issues associated with access and utilization. Solutions for some problems call for creative private - public arrangements - another form of innovation; and market-based solutions may not be feasible for each and every problem. This paper discusses these economic factors and innovation as they relate to the private practice of dentistry, with special emphasis on those elements that have increased the capacity of the dental practice to offer services to those with limited means to access fee-based care. Innovations are frequently described as new care delivery models or new workforce models. However, innovation can occur on an ongoing and regular basis as dental practices examine new ways to combine capital and human resources and to leverage the education and skill of the dentists to a greater number of patients. Innovation occurs within a market context as the current and projected economic returns reward the innovation. Innovation can also occur through private-public arrangements. There are indications of available capacity within the existing delivery system to expand service delivery. The Michigan Medicaid Healthy Kids Dental program is discussed as

  9. The Vermont Survey of Employer Receptivity to Wage Subsidy Programs in the Private Sector.

    ERIC Educational Resources Information Center

    Cashman, John R.; Mattson, Robert E.

    The Vermont study details employer responses to a two-phase survey designed to gauge employer receptivity to the use of wage subsidies in the private sector. The "mail survey" obtained from a sample of 1,084 employers (of whom 71% responded) elicited responses to a limited number of questions, while the "face-to-face survey"…

  10. Cost and affordability of non-communicable disease screening, diagnosis and treatment in Kenya: Patient payments in the private and public sectors

    PubMed Central

    Gakunga, Robai; Kibachio, Joseph; Gathecha, Gladwell; Edwards, Patrick; Ogola, Elijah; Yonga, Gerald; Busakhala, Naftali; Munyoro, Esther; Chakaya, Jeremiah; Ngugi, Nancy; Mwangi, Nyawira; Von Rege, Daniel; Wangari, Lili-Marie; Wata, David; Makori, Robert; Mwangi, Julius; Mwanda, Walter

    2018-01-01

    Introduction The prevalence of non-communicable diseases (NCDs) is rising in low- and middle-income countries, including Kenya, disproportionately to the rest of the world. Our objective was to quantify patient payments to obtain NCD screening, diagnosis, and treatment services in the public and private sector in Kenya and evaluate patients’ ability to pay for the services. Methods and findings We collected payment data on cardiovascular diseases, diabetes, breast and cervical cancer, and respiratory diseases from Kenyatta National Hospital, the main tertiary public hospital, and the Kibera South Health Center—a public outpatient facility, and private sector practitioners and hospitals. We developed detailed treatment frameworks for each NCD and used an itemization cost approach to estimate payments. Patient affordability metrics were derived from Kenyan government surveys and national datasets. Results compare public and private costs in U.S. dollars. NCD screening costs ranged from $4 to $36, while diagnostic procedures, particularly for breast and cervical cancer, were substantially more expensive. Annual hypertension medication costs ranged from $26 to $234 and $418 to $987 in public and private facilities, respectively. Stroke admissions ($1,874 versus $16,711) and dialysis for chronic kidney disease ($5,338 versus $11,024) were among the most expensive treatments. Cervical and breast cancer treatment cost for stage III (curative approach) was about $1,500 in public facilities and more than $7,500 in the private facilities. A large proportion of Kenyans aged 15 to 49 years do not have health insurance, which makes NCD services unaffordable for most people given the overall high cost of services relative to income (average household expenditure per adult is $413 per annum). Conclusions There is substantial variation in patient costs between the public and private sectors. Most NCD diagnosis and treatment costs, even in the public sector, represent a

  11. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector medicare HMOs.

    PubMed

    Barnett, Mitchell J; Perry, Paul J; Langstaff, Jodi D; Kaboli, Peter J

    2006-06-01

    Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. A cross-sectional study design compared administrative pharmacy claims from 10 distinct geographic regions in the United States in the VA health care system and 10 analogous regions for patients enrolled in Medicare HMOs. The cohorts included 123,633 VA and 157,517 Medicare HMO patients aged 65 years and older. Inappropriate medication use was identified using the Zhan modification of the Beers criteria, which categorizes 33 potentially inappropriate drugs into 3 major classifications: "always avoid," "rarely appropriate," and "some indications." Comparisons between the VA health care system and the private sector Medicare HMO were performed for overall differences and stratified by gender and age. The drug formulary status of the Zhan-criteria drugs was known for the VA health system but not for the Medicare HMO patients. Compared with private sector patients, VA patients were less likely to receive any inappropriate medication (21% vs. 29%, P <0.001), and in each classification: always avoid (2% vs. 5%, P <0.001), rarely appropriate (8% vs. 13%, P<0.001), and some indications (15% vs. 17%, P <0.001). The rate of inappropriate drug use was lower in the VA compared with the private sector for males (21% vs. 24%, P <0.001) and females (28% vs. 32%, P <0.001). Differences were consistent when stratified by age. Compared with private sector Medicare HMOs, elderly VA patients were less likely to receive medications defined by the Zhan criteria as potentially inappropriate. A restrictive formulary that excludes 12 of the 33 Zhan criteria drugs may be a factor in the reduction of undesired prescribing

  12. The private sector: revenue source of the 80's.

    PubMed

    York, D R

    1985-01-01

    An important and largely untapped source of revenue for community mental health centers is private business and industry. A model describes how one center is meeting the challenge of decreased government funding and budget cutbacks by offering profitable and needed services to local industry. Through the center's human resource consulting firm, Hamilton Associates, five programs are being delivered to businesses: Needs Assessment Programs, Management Training and Development Programs, Employee Assistance Programs, Health and Wellness Promotion Programs, and Selection and Appraisal Programs. The consulting firm publishes a bimonthly newsletter on human resource topics, conducts training workshops for the community, delivers regular speaking presentations to various business associations, and holds "wellness" luncheons to promote individual health. Suggestions and recommendations are given about service offerings, marketing, and development of such services.

  13. Recruitment and Selection in Business and Industry: Learning from the Private Sector Theory and Practice.

    ERIC Educational Resources Information Center

    Munoz, Maria D.; Munoz, Marco A.

    Recruitment and selection practices in the private sector were examined through a literature review to identify strategies that human resource (HR) departments can use in designing new employee recruitment and selection processes or improving existing processes. The following were among the findings: (1) new employees recruited by using informal…

  14. Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

    PubMed Central

    Musa, E.; Cooper, C.; Van den Bergh, R.; Owiti, P.; Baller, A.; Siafa, T.; Woldeyohannes, D.; Shringarpure, K.; Gasasira, A.

    2017-01-01

    Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC. PMID:28744446

  15. Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector!

    PubMed

    Tremblay, N; Musa, E; Cooper, C; Van den Bergh, R; Owiti, P; Baller, A; Siafa, T; Woldeyohannes, D; Shringarpure, K; Gasasira, A

    2017-06-21

    Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC.

  16. Employment of Geoscientists in the Private Sector

    NASA Astrophysics Data System (ADS)

    Russell, J. L.

    2001-05-01

    In the private sector, major employers of geoscientists engage in diverse activities ranging from resource exploration and extraction, assessment of geologic hazards, and determination of environmental impacts. These firms actively recruit, from the breadth of geoscience disciplines, technically qualified individuals with the ability to make pragmatic decisions in the context of multidisciplinary teams that commonly include non-scientists. Moreover, they expect applicants to communicate effectively verbally and in writing, as well as demonstrate skills and experience in integrating field investigations, conducting laboratory studies, and accomplishing computer modeling. These applicants should be capable of simultaneously working in multiple projects which are rapidly evolving. Successful recruiting and employment requires interactions between the job applicant and potential employer conducted with honesty and integrity. Resumes and associated transmittal letters should be directed to specific employers based on the applicant's review of information on the firm from the Internet and other sources. "Shotgun" or blanket approaches are seldom productive. Participation in pertinent professional societies, internships, and summer employment can provide valuable experiences and opportunities for networking with potential employers.

  17. Expansion in the private sector provision of institutional delivery services and horizontal equity: evidence from Nepal and Bangladesh

    PubMed Central

    Hotchkiss, David R; Godha, Deepali; Do, Mai

    2014-01-01

    Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality—Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. PMID:25012794

  18. Effect of an expansion in private sector provision of contraceptive supplies on horizontal inequity in modern contraceptive use: evidence from Africa and Asia.

    PubMed

    Hotchkiss, David R; Godha, Deepali; Do, Mai

    2011-08-19

    One strategic approach available to policy makers to improve the availability of reproductive and child health care supplies and services as well as the sustainability of programs is to expand the role of the private sector in providing these services. However, critics of this approach argue that increased reliance on the private sector will not serve the needs of the poor, and could lead to increases in socio-economic disparities in the use of health care services. The purpose of this study is to investigate whether the expansion of the role of private providers in the provision of modern contraceptive supplies is associated with increased horizontal inequity in modern contraceptive use. The study is based on multiple rounds of Demographic and Health Survey data from four selected countries (Nigeria, Uganda, Bangladesh, and Indonesia) in which there was an increase in the private sector supply of contraceptives. The methodology involves estimating concentration indices to assess the degree of inequality and inequity in contraceptive use by wealth groups across time. In order to measure inequity in the use of modern contraceptives, the study uses multivariate methods to control for differences in the need for family planning services in relation to household wealth. The results suggest that the expansion of the private commercial sector supply of contraceptives in the four study countries did not lead to increased inequity in the use of modern contraceptives. In Nigeria and Uganda, inequity actually decreased over time; while in Bangladesh and Indonesia, inequity fluctuated. The study results do not offer support to the hypothesis that the increased role of the private commercial sector in the supply of contraceptive supplies led to increased inequity in modern contraceptive use.

  19. Effect of an expansion in private sector provision of contraceptive supplies on horizontal inequity in modern contraceptive use: evidence from Africa and Asia

    PubMed Central

    2011-01-01

    Background One strategic approach available to policy makers to improve the availability of reproductive and child health care supplies and services as well as the sustainability of programs is to expand the role of the private sector in providing these services. However, critics of this approach argue that increased reliance on the private sector will not serve the needs of the poor, and could lead to increases in socio-economic disparities in the use of health care services. The purpose of this study is to investigate whether the expansion of the role of private providers in the provision of modern contraceptive supplies is associated with increased horizontal inequity in modern contraceptive use. Methods The study is based on multiple rounds of Demographic and Health Survey data from four selected countries (Nigeria, Uganda, Bangladesh, and Indonesia) in which there was an increase in the private sector supply of contraceptives. The methodology involves estimating concentration indices to assess the degree of inequality and inequity in contraceptive use by wealth groups across time. In order to measure inequity in the use of modern contraceptives, the study uses multivariate methods to control for differences in the need for family planning services in relation to household wealth. Results The results suggest that the expansion of the private commercial sector supply of contraceptives in the four study countries did not lead to increased inequity in the use of modern contraceptives. In Nigeria and Uganda, inequity actually decreased over time; while in Bangladesh and Indonesia, inequity fluctuated. Conclusions The study results do not offer support to the hypothesis that the increased role of the private commercial sector in the supply of contraceptive supplies led to increased inequity in modern contraceptive use. PMID:21854584

  20. Crafting Legitimate Identities: Promotional Strategies in the Ontario Non-Elite Private School Sector

    ERIC Educational Resources Information Center

    Milian, Roger Pizarro; Quirke, Linda

    2017-01-01

    Conventional wisdom within the sociology of education and organizations posits that schools achieve legitimacy by conforming to institutionalized norms and mimicking the actions of successful peers. Recent work on non-elite private schools (NEPS) shows that this institutional type may serve as an exception to this logic, generally adopting what…

  1. Family planning, antenatal and delivery care: cross-sectional survey evidence on levels of coverage and inequalities by public and private sector in 57 low- and middle-income countries.

    PubMed

    Campbell, Oona M R; Benova, Lenka; MacLeod, David; Baggaley, Rebecca F; Rodrigues, Laura C; Hanson, Kara; Powell-Jackson, Timothy; Penn-Kekana, Loveday; Polonsky, Reen; Footman, Katharine; Vahanian, Alice; Pereira, Shreya K; Santos, Andreia Costa; Filippi, Veronique G A; Lynch, Caroline A; Goodman, Catherine

    2016-04-01

    The objective of this study was to assess the role of the private sector in low- and middle-income countries (LMICs). We used Demographic and Health Surveys for 57 countries (2000-2013) to evaluate the private sector's share in providing three reproductive and maternal/newborn health services (family planning, antenatal and delivery care), in total and by socio-economic position. We used data from 865 547 women aged 15-49, representing a total of 3 billion people. We defined 'met and unmet need for services' and 'use of appropriate service types' clearly and developed explicit classifications of source and sector of provision. Across the four regions (sub-Saharan Africa, Middle East/Europe, Asia and Latin America), unmet need ranged from 28% to 61% for family planning, 8% to 22% for ANC and 21% to 51% for delivery care. The private-sector share among users of family planning services was 37-39% across regions (overall mean: 37%; median across countries: 41%). The private-sector market share among users of ANC was 13-61% across regions (overall mean: 44%; median across countries: 15%). The private-sector share among appropriate deliveries was 9-56% across regions (overall mean: 40%; median across countries: 14%). For all three healthcare services, women in the richest wealth quintile used private services more than the poorest. Wealth gaps in met need for services were smallest for family planning and largest for delivery care. The private sector serves substantial numbers of women in LMICs, particularly the richest. To achieve universal health coverage, including adequate quality care, it is imperative to understand this sector, starting with improved data collection on healthcare provision. © 2016 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  2. How well can physicians manage tuberculosis? A public-private sector comparison from Karachi, Pakistan.

    PubMed

    Naseer, Maliha; Khawaja, Ali; Pethani, Amin S; Aleem, Salik

    2013-10-25

    Tuberculosis (TB) is endemic in Pakistan which ranks fifth amongst the twenty two countries designated to be highly burdened by TB according to the World Health Organization. However, there is paucity of data regarding the knowledge of diagnosis of TB and its management amongst public and private practitioners. In this study, we endeavor to identify this gap in knowledge regarding the diagnosis and management of TB between public and private doctors and the factors affecting these knowledge scores in urban Pakistan. This cross sectional survey was conducted between June and December 2011. Doctors from public hospitals, private hospitals and private clinics scattered in all eighteen towns of Karachi were included in the study. Qualified MBBS doctors working in any specialty were eligible to participate whereas doctors working in both the public and private sectors were excluded from the study. Vignette based clinical scenarios were given to assess the knowledge score regarding the diagnosis and management of TB. A total of 196 doctors participated in the study. There was a significant difference between private and public physicians in terms of age and years of practice (p-value <0.05). Significant differences in the proportion of knowledge scores were observed between the public and private doctors and National TB Control Program trained and untrained doctors in Karachi. Factors associated with inadequate knowledge scores were being female gender [OR: 2.76 (95% CI: 1.418-5.384)], private employment status [OR: 1.50 (95% CI: 1.258-2.439)], and not trained by NTP [OR: 2.98 (95% CI: 1.286-3.225)] on multivariate logistic regression analysis. It is concluded that a knowledge gap exists between the public and private doctors in Karachi. Strengthening of currently implemented public private mix model along with improvement in the trainings of public and private practitioners is highly recommended to control TB in Pakistan.

  3. Fear and Privatization

    ERIC Educational Resources Information Center

    Cooper, Bruce S.; Randall, E. Vance

    2008-01-01

    Supporters of public education fear attempts to privatize schools, while the private sector has always struggled against the monopolistic power of the public schools that educates almost 90% of all K-12 students. This trepidation has recently been intensified by the creation of a "third sector" that includes charter schools, voucher…

  4. A Conceptual Development Framework for Management and Leadership Learning in the UK Incubator Sector

    ERIC Educational Resources Information Center

    D. Hannon, Paul

    2003-01-01

    Focuses attention upon a recent phenomenon promoted by public sector policy and government funding and adopted within the private sector as a vehicle for wealth creation, where wealth can mean the development of different forms of capital such as financial, intellectual and social. Incubators and incubation programmes have established themselves…

  5. Mild cognitive impairment: Profile of a cohort from a private sector memory clinic.

    PubMed

    Srinivasan, Srikanth

    2014-07-01

    Private hospital memory clinics might see a different clientele than university or academic institutes due to referral biases. To characterize the profile of patients with mild cognitive impairment (MCI) from a private sector memory clinic. MCI was diagnosed according to revised clinical criteria of Petersen et al. For a subset of patients with MCI medial temporal atrophy and cerebral small vessel disease (white matter lesions and lacunes) were rated on magnetic resonance imaging (MRI) scans and analyzed for their contribution towards cognitive impairment. Subjects with MCI formed one-third (113/371) of this memory clinic sample from a private hospital. MCI could be effectively diagnosed and subtyped using a brief cognitive scale (Concise Cognitive Test (CONCOG)). The amnestic MCI (single and multiple domains) subtype comprised the majority of cases with MCI. In a subsample of 33 patients, lacunar infarcts were more common than white matter lesions and hippocampal atrophy and were inversely associated with verbal fluency. MCI may be more commonly encountered in private hospital settings probably due to early referrals. It is possible to diagnose and subtype MCI using a brief cognitive instrument such as the CONCOG. In this sample, lacunar infarcts were more commonly encountered than medial temporal atrophy in such patients.

  6. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

    PubMed Central

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-01-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  7. Private Rehabilitation.

    ERIC Educational Resources Information Center

    McMahon, Brian T., Ed.

    1983-01-01

    Discusses the expanding role of the rehabilitation counselor into private sector rehabilitation in the seven articles of this special issue. Topics cover private rehabilitation in an insurance context including forensics issues, computer applications, recent trends, services in a multiprogram private clinic, and rehabilitation counselor training.…

  8. Healthcare identities at the crossroads of service modernisation: the transfer of NHS clinicians to the independent sector?

    PubMed

    Waring, Justin; Bishop, Simon

    2011-07-01

    Health policies increasingly support private businesses to take an active role in the organisation and delivery of public healthcare services. For the English NHS, this is exemplified by the introduction of Independent Sector Treatment Centres. A number of these facilities involve the wholesale secondment of NHS clinicians to the private sector which, we suggest, raises important questions about the identities of healthcare professionals accustomed to working in the public sector. Our paper investigates this transition highlighting three prominent discontinuities in clinical work: the ethos of private sector ownership, new lines of authority and fragmented relationships. Drawing on Giddens, we examine how clinicians experience and interpret these changes and how they keep their biographical 'narrative going'. The 'pioneers' interpreted the independent sector as an opportunity to re-invigorate their practice through new roles, relationships and higher quality care; the 'guardians' as an opportunity to replicate and protect the customs and standards of the NHS in the private sector; whilst the 'marooned' longed to return to the NHS. Our study illustrates how the sectoral context can shape healthcare identities, and how contemporary reforms aimed at promoting partnerships across public and private sectors can have profound implications for clinicians. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  9. Private sector provision of oral rehydration therapy for child diarrhea in sub-Saharan Africa.

    PubMed

    Sood, Neeraj; Wagner, Zachary

    2014-05-01

    Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13-17) than public providers and 12% points more likely to provide other treatments (95% CI 10-15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored.

  10. 5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

  11. 5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

  12. 5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

  13. 5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

  14. 5 CFR 2641.207 - One-year restriction on any former private sector assignee under the Information Technology...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... private sector assignee under the Information Technology Exchange Program representing, aiding, counseling... assignee under the Information Technology Exchange Program representing, aiding, counseling or assisting in... the Information Technology Exchange Program, 5 U.S.C. chapter 37, no former assignee shall knowingly...

  15. How do countries regulate the health sector? Evidence from Tanzania and Zimbabwe.

    PubMed

    Kumaranayake, L; Mujinja, P; Hongoro, C; Mpembeni, R

    2000-12-01

    The health sectors in many low- and middle-income countries have been characterized in recent years by extensive private sector activity. This has been complemented by increasing public-private linkages, such as the contracting-out of selected services or facilities, development of new purchasing arrangements, franchising and the introduction of vouchers. Increasingly, however, experience with the private sector has indicated a number of problems with the quality, price and distribution of private health services, and thus led to a growing focus on the role of government in regulation. This paper presents the existing network of regulations governing private activity in the health sectors of Tanzania and Zimbabwe, and their appropriateness in the context of emerging market realities. It draws on a comparative mapping exercise reviewing the complexity of the variables currently being regulated, the level of the health system at which they apply, and the specific instruments being used. Findings indicate that much of the existing regulation occurs through legislation. There is still very much a focus on the 'social' rather than 'economic' aspects of regulation within the health sector. Recent changes have attempted to address aspects of private health provision, but some very key gaps remain. In particular, current regulations in Tanzania and Zimbabwe: (1) focus on individual inputs rather than health system organizations; (2) aim to control entry and quality rather than explicitly quantity, price or distribution; and (3) fail to address the market-level problems of anti-competitive practices and lack of patient rights. This highlights the need for additional measures to promote consumer protection and address the development of new private markets such as for health insurance or laboratory and other ancillary services.

  16. Anti-malarial landscape in Myanmar: results from a nationally representative survey among community health workers and the private sector outlets in 2015/2016.

    PubMed

    Thein, Si Thu; Khin, Hnin Su Su; Thi, Aung

    2017-04-25

    In 2015/2016, an ACTwatch outlet survey was implemented to assess the anti-malarial and malaria testing landscape in Myanmar across four domains (Eastern, Central, Coastal, Western regions). Indicators provide an important benchmark to guide Myanmar's new National Strategic Plan to eliminate malaria by 2030. This was a cross-sectional survey, which employed stratified cluster-random sampling across four regions in Myanmar. A census of community health workers (CHWs) and private outlets with potential to distribute malaria testing and/or treatment was conducted. An audit was completed for all anti-malarials, malaria rapid diagnostic tests. A total of 28,664 outlets were approached and 4416 met the screening criteria. The anti-malarial market composition comprised CHWs (41.5%), general retailers (27.9%), itinerant drug vendors (11.8%), pharmacies (10.9%), and private for-profit facilities (7.9%). Availability of different anti-malarials and diagnostic testing among anti-malarial-stocking CHWs was as follows: artemisinin-based combination therapy (ACT) (81.3%), chloroquine (67.0%), confirmatory malaria test (77.7%). Less than half of the anti-malarial-stocking private sector had first-line treatment in stock: ACT (41.7%) chloroquine (41.8%), and malaria diagnostic testing was rare (15.4%). Oral artemisinin monotherapy (AMT) was available in 27.7% of private sector outlets (Western, 54.1%; Central, 31.4%; Eastern; 25.0%, Coastal; 15.4%). The private-sector anti-malarial market share comprised ACT (44.0%), chloroquine (26.6%), and oral AMT (19.6%). Among CHW the market share was ACT (71.6%), chloroquine (22.3%); oral AMT (3.8%). More than half of CHWs could correctly state the national first-line treatment for uncomplicated falciparum and vivax malaria (59.2 and 56.9%, respectively) compared to the private sector (15.8 and 13.2%, respectively). Indicators on support and engagement were as follows for CHWs: reportedly received training on malaria diagnosis (60.7%) or

  17. Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study

    PubMed Central

    Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

    2017-01-01

    Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of

  18. Examination of the factors and issues for an environmental technology utilization partnership between the private sector and the Department of Energy. Final report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brouse, P.

    1997-05-01

    The Department of Energy (DOE) held a meeting on November 12, 1992 to evaluate the DOE relations with industry and university partners concerning environmental technology utilization. The goal of this meeting was to receive feedback from DOE industry and university partners for the identification of opportunities to improve the DOE cooperative work processes with the private sector. The meeting was designed to collect information and to turn that information into action to improve private sector partnerships with DOE.

  19. Comparing the quality of antidepressant pharmacotherapy in the Department of Veterans Affairs and the private sector.

    PubMed

    Busch, Susan H; Leslie, Douglas L; Rosenheck, Robert A

    2004-12-01

    Comparing quality of care between large health care systems is important for health systems management. This study compared measures of the quality of pharmacotherapy for patients with major depression across a sample of patients from the Department of Veterans Affairs (VA) and the private sector. In this observational study, all patients who were given a new prescription for an antidepressant and a diagnosis of major depression in the VA during fiscal year 2000 were identified by using administrative data (N=27,713). In the private sector, a similar sample of patients were identified by using Medstat's MarketScan database (N=4,852). For both groups, measures of the quality of antidepressant pharmacotherapy were constructed. These measures were compared across the two groups by using logistic regression models. Controls for age, gender, comorbid disorders, and initial antidepressant drug prescribed were included in some models. Although the populations had different demographic and clinical characteristics, differences in the quality measures between the two systems were few, with the VA slightly outperforming the private sector in the prescription of antidepressants during the acute phase of treatment, the first 84 days (84.7 compared with 81 percent) and during the maintenance phase of treatment, the first 181 days (53.9 compared with 50.9 percent). Patient characteristics that were associated with quality measures included being older, being female, and having a comorbid diagnosis of substance use disorder, bipolar disorder, or anxiety or adjustment disorder. Both systems had relatively high rates of adherence to pharmacotherapy guidelines. Even though the populations in the two systems were different, adjusting the analyses for clinical characteristics did little to change the measured differences between the two systems.

  20. Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

    PubMed

    Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

    2017-01-01

    Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

  1. Learning from the private sector: towards a keener understanding of the end-user for microbicide introduction planning.

    PubMed

    Lin, Amy H; Breger, Tiffany L; Barnhart, Matthew; Kim, Ann; Vangsgaard, Charlotte; Harris, Emily

    2014-01-01

    In planning for the introduction of vaginal microbicides and other new antiretroviral (ARV)-based prevention products for women, an in-depth understanding of potential end-users will be critically important to inform strategies to optimize uptake and long-term adherence. User-centred private sector companies have contributed to the successful launch of many different types of products, employing methods drawn from behavioural and social sciences to shape product designs, marketing messages and communication channels. Examples of how the private sector has adapted and applied these techniques to make decisions around product messaging and targeting may be instructive for adaptation to microbicide introduction. In preparing to introduce a product, user-centred private sector companies employ diverse methods to understand the target population and their lifestyles, values and motivations. ReD Associates' observational research on user behaviours in the packaged food and diabetes fields illustrates how 'tag along' or 'shadowing' techniques can identify sources of non-adherence. Another open-ended method is self-documentation, and IDEO's mammography research utilized this to uncover user motivations that extended beyond health. Mapping the user journey is a quantitative approach for outlining critical decision-making stages, and Monitor Inclusive Markets applied this framework to identify toilet design opportunities for the rural poor. Through an iterative process, these various techniques can generate hypotheses on user drop-off points, quantify where drop-off is highest and prioritize areas of further research to uncover usage barriers. Although research constraints exist, these types of user-centred techniques have helped create effective messaging, product positioning and packaging of health products as well as family planning information. These methods can be applied to microbicide acceptability testing outside of clinical trials to design microbicide marketing

  2. Learning from the private sector: towards a keener understanding of the end-user for microbicide introduction planning

    PubMed Central

    Lin, Amy H; Breger, Tiffany L; Barnhart, Matthew; Kim, Ann; Vangsgaard, Charlotte; Harris, Emily

    2014-01-01

    Introduction In planning for the introduction of vaginal microbicides and other new antiretroviral (ARV)-based prevention products for women, an in-depth understanding of potential end-users will be critically important to inform strategies to optimize uptake and long-term adherence. User-centred private sector companies have contributed to the successful launch of many different types of products, employing methods drawn from behavioural and social sciences to shape product designs, marketing messages and communication channels. Examples of how the private sector has adapted and applied these techniques to make decisions around product messaging and targeting may be instructive for adaptation to microbicide introduction. Discussion In preparing to introduce a product, user-centred private sector companies employ diverse methods to understand the target population and their lifestyles, values and motivations. ReD Associates’ observational research on user behaviours in the packaged food and diabetes fields illustrates how ‘tag along’ or ‘shadowing’ techniques can identify sources of non-adherence. Another open-ended method is self-documentation, and IDEO's mammography research utilized this to uncover user motivations that extended beyond health. Mapping the user journey is a quantitative approach for outlining critical decision-making stages, and Monitor Inclusive Markets applied this framework to identify toilet design opportunities for the rural poor. Through an iterative process, these various techniques can generate hypotheses on user drop-off points, quantify where drop-off is highest and prioritize areas of further research to uncover usage barriers. Although research constraints exist, these types of user-centred techniques have helped create effective messaging, product positioning and packaging of health products as well as family planning information. These methods can be applied to microbicide acceptability testing outside of clinical trials

  3. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature.

    PubMed

    Patouillard, Edith; Goodman, Catherine A; Hanson, Kara G; Mills, Anne J

    2007-11-07

    There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions. Few studies provided evidence on the impact of private sector

  4. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature

    PubMed Central

    Patouillard, Edith; Goodman, Catherine A; Hanson, Kara G; Mills, Anne J

    2007-01-01

    Background There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. Methods The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. Results A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions. Conclusion Few studies provided

  5. The transboundary EIA convention in the context of private sector operations co-financed by an International Financial Institution: two case studies from Azerbaijan and Turkmenistan

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nazari, Mehrdad M

    This paper presents two case studies involving private sector, offshore, oil field developments in the Caspian Sea. Environmental Impact Assessments (EIAs) of these operations indicated that major and unmitigated oil spills could potentially result in transboundary impacts. Both projects were co-financed by the European Bank for Reconstruction and Development (EBRD), an International Financial Institution (IFI). Project review and financing decision by the EBRD occurred when neither country hosting the projects was a Party to the 1991 Convention on EIA in a Transboundary Context (Espoo Convention). Discussions with government agencies during project review highlighted their limited institutional capacity to pursue transboundarymore » notification and consultation activities. However, without being formal Parties or having clearly defined roles under the Convention, the combined presence of the EBRD, the private sector developer and its project needing financing became important drivers to promote the Espoo Convention. Surveying for similar IFI-project combinations in developing and transition economies could provide a 'bottom up' input to further optimise the Convention Secretariat's awareness raising, intervention design, and alliance-building strategies. The knowledge management model and user-friendly Web site of the 1992 Convention on Biological Diversity highlight approaches that may also prove effective for the Espoo Convention.« less

  6. Private sector opportunities and threats to achieving malaria elimination in the Greater Mekong Subregion: results from malaria outlet surveys in Cambodia, the Lao PDR, Myanmar, and Thailand.

    PubMed

    Phok, Sochea; Phanalasy, Saysana; Thein, Si Thu; Likhitsup, Asawin

    2017-05-02

    The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current coverage of private sector engagement and support through ACTwatch outlet surveys implemented in 2015 and 2016. Over 76,168 outlets were screened, and approximately 6500 interviews were conducted (Cambodia, N = 1303; the Lao People's Democratic Republic (PDR), N = 724; Myanmar, N = 4395; and Thailand, N = 74). There was diversity in the types of private sector outlets providing malaria treatment across countries, and the extent to which they were authorized to test and treat for malaria differed. Among outlets stocking at least one anti-malarial, public sector availability of the first-line treatment for uncomplicated Plasmodium falciparum or Plasmodium vivax malaria was >75%. In the anti-malarial stocking private sector, first-line treatment availability was variable (Cambodia, 70.9%; the Lao PDR, 40.8%; Myanmar P. falciparum = 42.7%, P. vivax = 19.6%; Thailand P. falciparum = 19.6%, P. vivax = 73.3%), as was availability of second-line treatment (the Lao PDR, 74.9%; Thailand, 39.1%; Myanmar, 19.8%; and Cambodia, 0.7%). Treatment not in the National Treatment Guidelines (NTGs) was most common in Myanmar (35.8%) and Cambodia (34.0%), and was typically stocked by the informal sector. The majority of anti-malarials distributed in Cambodia and Myanmar were first-line P. falciparum or P. vivax treatments (90.3% and 77.1%, respectively), however, 8.8% of the market share in Cambodia was treatment not in the NTGs (namely chloroquine) and 17.6% in Myanmar (namely oral artemisinin monotherapy). In the Lao PDR, approximately 9 in 10 anti-malarials distributed in the private sector were second-line treatments-typically locally manufactured chloroquine. In Cambodia, 90% of anti-malarials were distributed through outlets that had confirmatory testing

  7. 31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Entities that do not share profits and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM State Residual Market Insurance Entities; Workers...

  8. 31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Entities that do not share profits and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM State Residual Market Insurance Entities; Workers...

  9. 31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Entities that do not share profits and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM State Residual Market Insurance Entities; Workers...

  10. 31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Entities that do not share profits and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM State Residual Market Insurance Entities; Workers...

  11. Public–private interaction in pharmaceutical research

    PubMed Central

    Cockburn, Iain; Henderson, Rebecca

    1996-01-01

    We empirically examine interaction between the public and private sectors in pharmaceutical research using qualitative data on the drug discovery process and quantitative data on the incidence of coauthorship between public and private institutions. We find evidence of significant reciprocal interaction, and reject a simple “linear” dichotomous model in which the public sector performs basic research and the private sector exploits it. Linkages to the public sector differ across firms, reflecting variation in internal incentives and policy choices, and the nature of these linkages correlates with their research performance. PMID:8917485

  12. Funding long-term care: applications of the trade-off principle in both public and private sectors.

    PubMed

    Chen, Yung-Ping

    2003-02-01

    The uncertain need for long-term care services is a risk best protected by insurance. However, the current funding relies heavily on personal payment and public welfare, and only lightly on social and private insurances. This method, akin to sitting on a two-legged stool, is unlikely to be sustainable. To incorporate insurance as a key component of funding and to mobilize public and private resources more effectively, we propose a three-legged-stool funding model under which social insurance would provide a basic protection, to be supplemented by private insurance and personal payment. When these sources do not provide sufficient protection for some individuals, Medicaid as public welfare would serve as a safety net. This article (a) discusses how to implement this funding model by using the trade-off principle in both the public and private sectors when resources for long-term care are scarce, and (b) analyzes several objections to this model from cognitive psychology/behavioral economics

  13. Implementation of RNTCP in a private medical college: five years' experience.

    PubMed

    Arora, Vijay; Jaiswal, Ashish K; Gupta, Sonisha; Gupta, Mohan B; Jain, Vidhushi; Ghanchi, Firoz

    2012-07-01

    Revised National Tuberculosis Control Programme (RNTCP) recognizes the need for involvement of all sectors, public and private, to create an epidemiological impact on Tuberculosis control. The private health sector in the country is an important source of care, even with the availability of public health services and Directly Observed Treatment Strategy (DOTS). The data regarding Private-Private mix in our country is lacking. To evaluate the contribution of {private health sector (Private Medical Colleges and Private practioners (PP)} in TB case-detection, diagnosis and treatment outcomes in Delhi NCR, Ghaziabad, India. We analyzed the TB registers from May 2006-Dec 2010 from our institution and recruited the patients in our study, irrespective of the source. We strengthened the referral by promoting educational intra and inter departmental activities and awareness programme with more stress on retrieval action by contact tracing and counselling. We made a list of PP in our drainage area and regularly met them and tried to understand the barriers in referring cases to DOTS centre. During the study, we tried to maintain the flow of information working as a single window information system. We regularly passed on the information of follow up of patients to private practioners referred to us by them to generate confidence in them. During the study, no incentive was offered to any patient. Various indicators and data were collected annually and analyzed statistically. Retrospective, Descriptive Analysis. There was a substantial increase of 116.3% in the total patients referred from all sources to Santosh Hospital. The proportion of extra-pulmonary cases was 29.1% to 34.4% of all total cases from the year 2006 to 2010. During subsequent years, we found a significant increase in referral from Private Practioners that was the result of our activities performed in private set up. It was 12.5%, 21.2%, 30.8%, 27.3%, and 29% during 2006, 2007, 2008, 2009 and 2010 respectively

  14. Expansion in the private sector provision of institutional delivery services and horizontal equity: evidence from Nepal and Bangladesh.

    PubMed

    Hotchkiss, David R; Godha, Deepali; Do, Mai

    2014-07-01

    Wealth-related inequity in the use of maternal healthcare services continues to be a substantial problem in most low- and middle-income countries. One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality-Nepal and Bangladesh. The study is based on multiple rounds of nationally representative household survey data collected in Nepal and Bangladesh from 1996 to 2011. The methodology involves estimating a concentration index for each survey to assess changes in wealth-related inequity in the use of institutional delivery assistance over time. The results of the study suggest that the expansion of private sector supply of institutional-based delivery services in Nepal and Bangladesh has not led to increased horizontal inequity. In fact, in both countries, inequity was shown to have decreased over the study period. The study findings also suggest that the provision of government delivery services to the poor protects against increased wealth-related inequity in service use. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  15. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

    PubMed

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

    2016-09-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. © The Author 2016. Published by Oxford

  16. Policies to Spur Energy Access. Executive Summary; Volume 1, Engaging the Private Sector in Expanding Access to Electricity; Volume 2, Case Studies to Public-Private Models to Finance Decentralized Electricity Access

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Walters, Terri; Rai, Neha; Esterly, Sean

    Government policy is one of the most important factors in engaging the private sector in providing universal access to electricity. In particular, the private sector is well positioned to provide decentralized electricity products and services. While policy uncertainty and regulatory barriers can keep enterprises and investors from engaging in the market, targeted policies can create opportunities to leverage private investment and skills to expand electricity access. However, creating a sustainable market requires policies beyond traditional electricity regulation. The report reviews the range of policy issues that impact the development and expansion of a market for decentralized electricity services from establishingmore » an enabling policy environment to catalyzing finance, building human capacity, and integrating energy access with development programs. The case studies in this report show that robust policy frameworks--addressing a wide range of market issues--can lead to rapid transformation in energy access. The report highlights examples of these policies in action Bangladesh, Ethiopia, Mali, Mexico, and Nepal.« less

  17. A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand.

    PubMed

    Reynolds, Jaratdao; Wisaijohn, Thunthita; Pudpong, Nareerut; Watthayu, Nantiya; Dalliston, Alex; Suphanchaimat, Rapeepong; Putthasri, Weerasak; Sawaengdee, Krisada

    2013-04-12

    The demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries. A scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy. The review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions. Strategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced.

  18. A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand

    PubMed Central

    2013-01-01

    Background The demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries. Methods A scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy. Results The review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions. Conclusion Strategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced. PMID:23587128

  19. Assessing gaps and poverty-related inequalities in the public and private sector family planning supply environment of urban Nigeria.

    PubMed

    Levy, Jessica K; Curtis, Sian; Zimmer, Catherine; Speizer, Ilene S

    2014-02-01

    Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between public sector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas.

  20. [Availability of generic drugs in the public sector and prices in the private sector in different regions of Brazil].

    PubMed

    Miranda, Elaine Silva; Pinto, Cláudia Du Bocage Santos; dos Reis, André Luis de Almeida; Emmerick, Isabel Cristina Martins; Campos, Mônica Rodrigues; Luiza, Vera Lucia; Osorio-de-Castro, Claudia Garcia Serpa

    2009-10-01

    A study to identify availability and prices of medicines, according to type of provider, was conducted in the five regions of Brazil. A list of medicines to treat prevalent diseases was investigated, using the medicines price methodology developed by the World Health Organization and Health Action International, adapted for Brazil. In the public sector, bioequivalent (vis-à-vis reference brand) generics are less available than multisource products. For most medicines (71.4%), the availability of bioequivalent generics was less than 10%. In the private sector, the average number of different bioequivalent generic versions in the outlets was far smaller than the number of versions on the market. There was a positive correlation between the number of generics on the market, or those found at outlets, and the price variation in bioequivalent generic products, in relation to the maximum consumer price. It is estimated that price competition is occurring among bioequivalent generic drugs and between them and multisource products for the same substance, but not with reference brands.

  1. Quality, quantity and distribution of medical education and care: regulation by the private sector or mandate by government?

    PubMed Central

    Anlyan, W G

    1975-01-01

    The public, the federal government and most state governments have become increasingly concerned with the lack of access to primary care as well as the specialty and geographic maldistribution problems. Currently, there is a race in progress between the private sector and the federal government to devise solutions to these problems. In the federal sector, varying pieces of legislation are under active consideration to mandate the correction of specialty and geographic maldistribution; proposals include: 1) setting up federal machinery to regulate the numbers and types of residencies; 2) make obligatory the creation of Departments of Family Practice in each medical school; 3) withdraw current education support from medical schools causing tuition levels to increase substantially--federal student loans would then provide the necessary leverage to obligate the borrower to two years of service in an under-served area in exchange for loan forgiveness. In the private sector, for the first time in the history of the United States, the five major organizations involved in medical care have organized to form the Coordinating Council on Medical Education (CCME) and the Liaison Committee on Graduate Medical Education (LCGME). One of the initial major endeavors of the CCME has been to address itself to the problem of specialty maldistribution. The LCGME has been tooling up to become the accrediting group for residency training thus providing an overview of the quality and quantity of specialty training. It will be the intent of this presentation to bring the membership of the Southern Surgical Association an up-to-date report on these parallel efforts. The author's personal hope is that the private sector can move sufficiently rapidly to set up its own regulatory mechanisms and avert another federally controlled bureaucracy that will forever change the character of the medical profession in the United States. PMID:1130889

  2. Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia.

    PubMed

    Bell, Carolyn A; Ilomäki, Jenni; Pichenda, Koeut; Duncan, Gregory J; Saini, Bandana

    2015-04-01

    Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their closest public sector clinic for diagnosis and treatment. The study objective was to investigate factors associated with referral of TB symptomatic clients from pharmacies to public sector clinics in Phnom Penh, Cambodia. Face-to-face structured interviews were conducted with staff from a stratified random sample of 180 private pharmacies in Phnom Penh in 2012. Trained interviewers were Khmer speakers. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with self-reported referral during the previous 3 months. Fifty (29.6%) pharmacies reported that they had referred 125 clients (range 1-10) to public sector clinics during the previous 3 months. In total, 164 (96.5%) pharmacies reported that they always referred all TB symptomatic clients to DOTS (directly observed treatment, short course) clinics. More than 6-year participation in the programme (OR 5.23, 95% CI 1.93-14.18) and willingness to always continue referring (OR 12.24, 95% CI 11.61-93.10) were associated with referral of one or more clients in the previous 3 months. Referral to the client's closest clinic was negatively associated with referral (OR 0.45, 95% CI 0.23-0.99). Pharmacies' ongoing commitment to the Referral Programme was strongly associated with referral. Increased advocacy among the high number of non-referring pharmacies may improve programme performance. Factors negatively associated with referral may need investigation. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  3. The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans.

    PubMed

    Watkins, Katherine E; Smith, Brad; Akincigil, Ayse; Sorbero, Melony E; Paddock, Susan; Woodroffe, Abigail; Huang, Cecilia; Crystal, Stephen; Pincus, Harold Alan

    2016-04-01

    The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector. Two cohorts of individuals with mental disorders (schizophrenia, bipolar disorder, posttraumatic stress disorder, major depression, and substance use disorders) were created with VA administrative data (N=836,519) and MarketScan data (N=545,484). The authors computed VA and MarketScan national means for seven process-based quality measures related to medication evaluation and management and estimated national-level performance by age and gender. In every case, VA performance was superior to that of the private sector by more than 30%. Compared with individuals in private plans, veterans with schizophrenia or major depression were more than twice as likely to receive appropriate initial medication treatment, and veterans with depression were more than twice as likely to receive appropriate long-term treatment. Findings demonstrate the significant advantages that accrue from an organized, nationwide system of care. The much higher performance of the VA has important clinical and policy implications.

  4. Private Sector Participation in Urban Water and Sanitation Provision in Ghana: Experiences from the Tamale Metropolitan Area (TMA)

    NASA Astrophysics Data System (ADS)

    Osumanu, Issaka Kanton

    2008-07-01

    African governments, like most countries in the developing world, face daunting tasks in their attempts to provide effective and equitable water and sanitation services for their ever increasing urban populations. Consequently, the past few years have witnessed increased private sector participation in urban water and sanitation provision, as many African governments strive to improve access to water and sanitation services for their citizens in line with Millennium Development Goal 7 (MDG7). Since the early 1990s, the government of Ghana and many local authorities have entered into various forms of public-private partnerships in urban water and sanitation provision. This article examines the outcome of such partnerships using the Tamale Metropolitan Area (TMA) as a case study with the aim of providing policy guidelines for the way forward. The article argues that the public-private arrangement for water supply and sanitation infrastructure management in the Tamale Metropolis has done nothing that an invigorated public sector could not have possibly achieved. It concludes that there can be no sustainable improvement in water and sanitation provision without political commitment, stakeholder ownership, and strong support for community driven initiatives.

  5. Private sector participation in urban water and sanitation provision in Ghana: experiences from the Tamale Metropolitan Area (TMA).

    PubMed

    Osumanu, Issaka Kanton

    2008-07-01

    African governments, like most countries in the developing world, face daunting tasks in their attempts to provide effective and equitable water and sanitation services for their ever increasing urban populations. Consequently, the past few years have witnessed increased private sector participation in urban water and sanitation provision, as many African governments strive to improve access to water and sanitation services for their citizens in line with Millennium Development Goal 7 (MDG7). Since the early 1990s, the government of Ghana and many local authorities have entered into various forms of public-private partnerships in urban water and sanitation provision. This article examines the outcome of such partnerships using the Tamale Metropolitan Area (TMA) as a case study with the aim of providing policy guidelines for the way forward. The article argues that the public-private arrangement for water supply and sanitation infrastructure management in the Tamale Metropolis has done nothing that an invigorated public sector could not have possibly achieved. It concludes that there can be no sustainable improvement in water and sanitation provision without political commitment, stakeholder ownership, and strong support for community driven initiatives.

  6. Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries.

    PubMed

    O'Connell, Kathryn A; Gatakaa, Hellen; Poyer, Stephen; Njogu, Julius; Evance, Illah; Munroe, Erik; Solomon, Tsione; Goodman, Catherine; Hanson, Kara; Zinsou, Cyprien; Akulayi, Louis; Raharinjatovo, Jacky; Arogundade, Ekundayo; Buyungo, Peter; Mpasela, Felton; Adjibabi, Chérifatou Bello; Agbango, Jean Angbalu; Ramarosandratana, Benjamin Fanomezana; Coker, Babajide; Rubahika, Denis; Hamainza, Busiku; Chapman, Steven; Shewchuk, Tanya; Chavasse, Desmond

    2011-10-31

    Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia. Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were

  7. Got ACTs? Availability, price, market share and provider knowledge of anti-malarial medicines in public and private sector outlets in six malaria-endemic countries

    PubMed Central

    2011-01-01

    Background Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia. Methods Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. Results 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share

  8. Private Education in Poland: Breaking the Mould?

    NASA Astrophysics Data System (ADS)

    Klus-Stanska, Dorota; Olek, Hilary

    1998-03-01

    The burgeoning private sector is perhaps the most tangible of the changes in education which followed the upheavals of 1989/90 in Central and Eastern Europe. This article sets out to analyse the growth of private education in Poland and its contribution to the ongoing processes of democratisation and educational development. The authors argue that the euphoria of the period immediately following the overthrow of one-party communism encouraged unrealistic expectations of educational reform. Their analysis of private sector schooling in Poland suggests that its development has occurred in a haphazard fashion, reflecting the uncertainties of a society undergoing a painful process of transition. Symptomatic of this has been the failure to establish a clear regulatory framework for the private sector - an omission which has undermined the credibility of private schools. Nevertheless, the authors argue that the development of private sector schooling in Poland has brought diversity and a degree of innovation to a system previously almost devoid of either. There is now an urgent need for the evaluation and dissemination of private sector initiatives, which can serve as examples for future educational decision-making in Poland.

  9. The Switch to Private Pension Plans for Teachers, 1982-2002: A Case of Freedom of Choice or Financial Scandal?

    ERIC Educational Resources Information Center

    Griggs, Clive

    2009-01-01

    In the early 1980s the Conservative Administration introduced legislation to promote private personal pension plans for public sector workers. An army of commission-driven sales staff from the financial services industry sought to persuade teachers and others to abandon their inflation-proof pension schemes for those offered by private companies.…

  10. Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage

    PubMed Central

    Schneider, Helen; Dixit, Priyanka

    2017-01-01

    Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India’s National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

  11. Preliminary enquiry into the availability, price and quality of malaria rapid diagnostic tests in the private health sector of six malaria-endemic countries.

    PubMed

    Albertini, A; Djalle, D; Faye, B; Gamboa, D; Luchavez, J; Mationg, M L; Mwangoka, G; Oyibo, W; Bennett, J; Incardona, S; Lee, E

    2012-02-01

    This enquiry aimed to provide a snap-shot of availability, price and quality of malaria rapid diagnostic tests (RDTs) in private health facilities at selected sites in six malaria-endemic countries in Africa, South East Asia and South America. In each study site, data collectors surveyed private healthcare facilities which were selected based on accessibility from their home institution. Using a questionnaire, information was recorded about the facility itself and the malaria RDT(s) available. Where possible, a small number of RDTs were procured and quality control tested using a standardized procedure. Of the 324 private healthcare facilities visited, 35 outlets (mainly private clinics and hospitals) were found to supply 10 different types of RDTs products. RDT prices across the six countries ranged from US$1.00 to $16.81. Five of the 14 malaria RDTs collected failed quality control testing. In the private outlets sampled, the availability of RDTs was limited. Some of the RDTs whose quality we tested demonstrated inadequate sensitivity. This presents a number of risks. Given the more widespread distribution of antimalarials currently planned for private sector facilities, parasite-based diagnosis in this sector will be essential to adhere to the WHO guidelines for effective case management of malaria. Considerable regulation and quality control are also necessary to assure the availability of accurate and reliable RDTs, as well as adequate case management and provider adherence to RDT results. Public sector engagement is likely to be essential in this process. © 2011 Blackwell Publishing Ltd.

  12. Public-Private Partnerships for Health Promotion: The Experiences of the S[superscript 5] Project

    ERIC Educational Resources Information Center

    Gold, J.; Hellard, M. E.; Lim, M. S.; Dixon, H.; Wakefield, M.; Aitken, C. K.

    2012-01-01

    There is increasing emphasis on involving the private sector in public health to harness the considerable resources and skills of the business world to address significant health issues. While such collaboration should be encouraged, the involvement of business in public health campaigns can raise unexpected challenges when the approaches and…

  13. Net present value analysis to select public R&D programs and valuate expected private sector participation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hinman, N.D.; Yancey, M.A.

    1997-12-31

    One of the main functions of government is to invest taxpayers dollars in projects, programs, and properties that will result in social benefit. Public programs focused on the development of technology are examples of such opportunities. Selecting these programs requires the same investment analysis approaches that private companies and individuals use. Good use of investment analysis approaches to these programs will minimize our tax costs and maximize public benefit from tax dollars invested. This article describes the use of the net present value (NPV) analysis approach to select public R&D programs and valuate expected private sector participation in the programs.more » 5 refs.« less

  14. Quantifying solid waste and recycling employment in Florida, USA: Trends in public and private sectors.

    PubMed

    Park, Sunjoo; Yi, Hongtao; Feiock, Richard C

    2015-12-01

    Measuring and tracking the numbers of jobs in solid waste management and recycling industries over time provide basic data to inform decision makers about the important role played by this sector in a state or region's 'green economy'. This study estimates the number of people employed in the solid waste and recycling industry from 1989 through 2011 in the state of Florida (USA), applying a classification scheme based on the Standard Industrial Code (SIC) and utilizing the National Establishment Time Series (NETS) database. The results indicate that solid waste and recycling jobs in the private sector steadily increased from 1989 to 2011, whereas government employment for solid waste management fluctuated over the same period. © The Author(s) 2015.

  15. Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

    PubMed

    Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

    2017-06-22

    Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public-private

  16. Privatization of solid waste collection services: Lessons from Gaborone

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bolaane, Benjamin, E-mail: bolaaneb@mopipi.ub.bw; Isaac, Emmanuel, E-mail: eisaac300@gmail.com

    Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste managementmore » experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process.« less

  17. Pension vesting and preretirement lump sums among full-time private sector employees.

    PubMed

    Woods, J R

    1993-01-01

    Vesting among full-time private sector employees has increased dramatically over the past two decades. With further increases expected, it seems likely that almost all workers covered by a pension plan will eventually receive some kind of benefit. Coverage, however, remains a problem. According to the most recently available data, only 46 percent of full-time private employees in 1988 were covered by a pension plan on their current jobs, 35 percent were vested, and an additional 4 percent were vested from a previous job. Vesting rates would have been higher if some workers had not cashed out their retirement benefits when they left previous jobs, but the impact is slight; most lump-sum recipients were also vested or covered on their current jobs. Vesting is higher among older workers and among men, though the gender gap has narrowed appreciably over time. Based on trends in vesting and 1988 rates for all types of workers aged 50-59, the analysis suggests that pension receipt rates among the elderly will continue to increase over the next decade.

  18. Private health care.

    PubMed

    Uplekar, M W

    2000-09-01

    During the last decade there has been considerable international mobilisation around shrinking the role of States in health care. The World Bank reports that, in many low and middle-income countries, private sources of finance comprise the largest share of total national health expenditures. Private sector health care is ubiquitous, reaches throughout the population, preferred by the people and is significant from both economic as well as health perspective. Resources are limited, governments are weak, and a new approach is needed. This paper provides a broad overview and raises key issues with regard to private health care. The focus is on provision of health care by private medical providers. On the background of the world's common health problems and interventions available to tackle them, the place of private health care in the overall context is first discussed. The concept of privatisation within the various forms of health care systems is then explained. The paper then describes the genesis and key elements of rapidly enhancing role of the private sector in health care and points to the paucity of literature from low and middle-income countries. Common concerns about private health care are outlined. Two illustrative examples--tuberculosis, the top infectious killer among the poor and coronary heart disease, the top non-infectious killer among the rich--are presented to understand the current and possible role of private sector in provision of health care. Highlighting the need to distinguish between health care as a public good or a market commodity, the paper leaves it to the reader to draw conclusions.

  19. Private sector data collection on optoelectronics markets and technologies in the U.S.

    NASA Astrophysics Data System (ADS)

    Polishuk, Paul J.; Taylor, K.

    1992-05-01

    Information Gatekeepers Inc. has been in the business of collecting and analyzing information in the fiber optics and optoelectronics industries for the past fourteen years through its publishing and consulting businesses. Since optoelectronic technologies are well reported by the scientific journals and conferences, only data on markets, competitive trends, production capabilities, etc., are discussed in this paper. The paper reviews the present situation of private sector data collection on optoelectronics technologies and markets, the problems that exist in data collection, and possible solutions to what is perceived as a serious national problem.

  20. Is family-friendly policy (FFP) working in the private sector of South Korea?

    PubMed

    Kang, Young-Hee

    2013-01-01

    Using the Korean Labor and Income Panel Study (KLIPS), I investigated the impact of family-friendly policies (FFPs) on job satisfaction and organizational commitment in the private sector of South Korea. Paid leave, childcare leave, and support for housing are positively related to both job satisfaction and organizational commitment. Sick leave is positively related to organizational commitment. However, subsidized family event cost is a marginally significant predictor of job satisfaction and organizational commitment. In addition, the relationships between subsidized childcare cost and employee attitudes were not supported. Implications and suggestions for future research are discussed.