Provides an overview of public sector reform in Australia, focusing on the Commonwealth Government and Australian Public Service. Describes management reform packages, human resources management reforms, and industrial relations reforms. Discusses the impact of these changes on public libraries. (AEF)
Bauman, Paul C.
Americans are facing a critical choice between two different systems of school control the continuance of the current system of public governance or a move to a privatized approach to schooling. The purpose of this book is to help educators and citizens better understand the issues and opportunities associated with changes in educational…
Bhiwajee, Soolakshna Lukea; Garavan, Thomas N.
Purpose: The purpose of this study is to provide insights about the usefulness of management education for the public sector in the Republic of Mauritius, which embarked on reforms initiatives around two decades ago. In this context, public officers were encouraged to follow specialised management courses. However, as at date, there is…
Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie
Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation—namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability—have been eroded by NPM reforms. Despite improvements in specific operational tasks of the public sector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in public sector administration reform.
Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie
Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation--namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability--have been eroded by NPM reforms. Despite improvements in specific operational tasks of the public sector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in public sector administration reform. PMID:21229245
This paper analyses changes in university management structures and practices as a response to public sector reforms in Ugandan higher education using Makerere University as a case study. The study uses the organisational learning theory and a review of the higher education literature. Two adaptive responses in the management structures and…
Denis, Jean L; Lamothe, Lise; Langley, Ann; Stéphane, Guérard
The article examines various healthcare systems reform projects in Canada and some Canadian provinces and reveals some tendencies in governance renewal. The analisis is based on the hypothesis that reform is an exercise aiming at the renewal of governance conception and practices. In renewing governance, reform leaders hope to use adequate and effective levers to attain announced reform objectives. The article shows that the conceptions and operational modalities of governance have changed over time and that they reveal tensions inherent to the transformation and legitimation process of public healthcare systems. The first section discusses the relationships between reform and change. The second section defines the conception of gouvernance used for the analisis. Based on a content analisis of the various reform reports, the third section reveals the evolution of the conception of governance in healthcare systems in Canada. In order to expose the new tendencies, ideologies and operational principles at the heart of the reform projects are analysed. Five ideologies are identified: the democratic ideology, the "population health" ideology, the business ideology, the managerial ideology and the ideology of equity and humanism. This leads to a discussion on the dominant influence of the managerial ideology in the current reform projects. PMID:20963305
Bloom, G; Xingyuan, G
As a result of China's transition to a socialist market economy, its rural health services have undergone many of the changes commonly associated with health sector reform. These have included a decreased reliance on state funding, decentralisation of public health services, increased autonomy of health facilities, increased freedom of movement of health workers, and decreased political control. These changes have been associated with growing inequality in access to health services, increases in the cost of medical care, and the deterioration of preventive programmes in some poor areas. This paper argues that the government's strategy for addressing these problems has overemphasised the identification of new sources of revenue and has paid inadequate attention to factors that influence provider behaviour. The strategy also does not address contextual issues such as public sector employment practices and systems of local government finance. Other countries can learn from China's experience by taking a systematic approach to the formulation and implementation of strategies for health sector reform. PMID:9232730
Oborn, Eivor; Barrett, Michael; Exworthy, Mark
The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform. PMID:22069793
Stoddard, Christiana; Kuhn, Peter
Beyond some contracted minimum, salaried workers' hours are largely chosen at the worker's discretion and should respond to the strength of contract incentives. Accordingly, we consider the response of teacher hours to accountability and school choice laws introduced in US public schools over the past two decades. Total weekly hours of full-time…
The health care system in Pakistan is beset with numerous problems--structural fragmentation, gender insensitivity, resource scarcity, inefficiency and lack of functional specificity and accessibility. Faced with a precarious economic situation characterized by heavy external debt and faltering productivity, Pakistan's room to maneuver with health sector reform is quite limited. Although the recently announced Devolution Plan provides a window of opportunity, it must go beyond and introduce far-reaching changes in the health and social sectors. Regionalization of health care services in an integrated manner with functional specificity for each level of care is an essential step. Integration of current vertical programs within the framework of a need-based comprehensive primary health care system is another necessary step. Most importantly, fostering a public-private partnership to share the cost of basic primary health care and public health services must be an integral part of any reform. Pakistan must also make the health care system more gender sensitive through appropriate training programs for the service providers along with wide community participation in decision-making processes. Relevant WHO/World Bank/UNDP developed tools could be extremely useful in this respect. The article is based on a critical analysis of secondary data from the public domain as well as from various research projects undertaken by the Aga Khan University. It also draws from the experiences of health sector reform carried out in other countries, particularly those in the Asia-Pacific region. The purpose is to inform and hopefully influence, public policy as the country moves towards devolution. PMID:12174483
Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech
Background The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses. Methods A review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health. Findings Health sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms. Conclusions The process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems. PMID:24560261
Vadakin, James C.
The subject of collective bargaining negotiation impasse procedures in the public sector, which includes public school systems, is a broad one. In this speech, the author introduces the various procedures, explains how they are used, and lists their advantages and disadvantages. Procedures discussed are mediation, fact-finding, arbitration,…
Organisation for Economic Cooperation and Development, Paris (France).
This report synthesizes the findings from several areas of work undertaken to assess what impact public sector employment has had on both the level and structure of employment. It also examines the impact of the public sector as employer on the labor market from two viewpoints: the level and share of public sector employment and the structure of…
Semansky, Rafael M.; Hodgkin, Dominic; Willging, Cathleen E.
In 2005, New Mexico began a comprehensive reform of state-funded mental health care. This paper reports on differences in characteristics, infrastructure, financial status, and available services across mental health agencies. We administered a telephone survey to senior leadership to assess agency status prior to and during the first year of reform. Non-profit/public agencies were more likely than others to report reductions or no changes in administrative staff. CMHCs were more likely to report a decline in their financial situation. Findings demonstrated that CMHCs, non-profit/public agencies and rural agencies were more likely to offer critical services to adults with serious mental illness in the first year of reform. The comprehensiveness of services offered by these types of agencies may be an advantage as the state moves to a core service agency approach. PMID:21688132
Wilson, George; Roscigno, Vincent J.; Huffman, Matt L.
New "governance" reforms entailing shifts toward privatization have permeated the public sector over the last decade, possibly affecting workplace-based attainments. We examine the consequences of this reform for African American men, who during the civil rights era reached relative parity with whites. We analyze race-based inequities on one…
Carbonaro, William; Covay, Elizabeth
The authors examine whether standards based accountability reforms of the past two decades have closed the achievement gap among public and private high school students. They analyzed data from the Education Longitudinal Study (ELS) to examine sector differences in high school achievement in the era of standards based reforms. The authors found…
Graham, Harry; Wallace, Virginia
Presents developments in grievance arbitration in government employment by examining all public sector arbitration cases from 1971 through 1979. Predicts that issues of employee discipline and discharge will comprise the largest number of cases proceeding to arbitration. (Author/MLF)
Van Den Heever, A M
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. PMID:9683089
Gore, Christopher David
In 2007, Uganda had one of the lowest levels of access to electricity in the world. Given the influence of multilateral and bilateral agencies in Uganda; the strong international reputation and domestic influence of its President; the country's historic achievements in public sector and economic reform; and the intimate connection between economic performance, social well-being and access to electricity, the problems with Uganda's electricity sector have proven deeply frustrating and, indeed, puzzling. Following increased scholarly attention to the relationship between political change, policymaking, and public sector reform in sub-Saharan Africa and the developing world generally, this thesis examines the multilevel politics of Uganda's electricity sector reform process. This study contends that explanations for Uganda's electricity sector reform problems generally, and hydroelectric dam construction efforts specifically, must move beyond technical and financial factors. Problems in this sector have also been the result of a model of reform (promoted by the World Bank) that failed adequately to account for the character of political change. Indeed, the model of reform that was promoted and implemented was risky and it was deeply antagonistic to domestic and international civil society organizations. In addition, it was presented as a linear, technical, apolitical exercise. Finally the model was inconsistent with key principles the Bank itself, and public policy literature generally, suggest are needed for success. Based on this analysis, the thesis contends that policymaking and reform must be understood as deeply political processes, which not only define access to services, but also participation in, and exclusion from, national debates. Future approaches to reform and policymaking must anticipate the complex, multilevel, non-linear character of 'second-generation' policy issues like electricity, and the political and institutional capacity needed to increase
Kemp, Donna R.; Verlinde, Beverly
This document discusses employee assistance programs (EAPs), programs which have been developed to help employees deal with personal problems that seriously affect job performance. It reviews literature which specifically addresses EAPs in the public sector, noting that there are no exact figures on how many public entities have EAPs. Previous…
Talukder, Md Noorunnabi; Rob, Ubaidur; Mahabub-Ul-Anwar, Md
Various reforms have been undertaken to improve the functioning of health systems in developing countries, but there is limited comparative analysis of reform initiatives. This article discusses health sector reform experiences of four developing countries and identifies the lessons learned. The article is based on the review of background papers on Bangladesh, Pakistan, Indonesia, and Tanzania prepared as part of a multi-country study on health sector reform. Findings suggest that decentralization works effectively while implementing primary and secondary health programs. Decentralization of power and authority to local authorities requires strengthening and supporting these units. Along with the public sector, the private sector plays an effective role in institutional and human resources development as well as in improving service delivery. Community participation facilitates recruitment and development of field workers, facility improvement, and service delivery. For providing financial protection to the poor, there is a need to review user fees and develop affordable health insurance with an exemption mechanism. There is no uniform health sector reform approach; therefore, the experiences of other countries will help countries undertake appropriate reforms. Here, it is important to examine the context and determine the reform measures that constitute the best means in terms of equity, efficiency, and sustainability. PMID:19131306
Gollust, Sarah E.; Jacobson, Peter D.
The public health and the public education systems in the United States have encountered problems in quality of service, accountability, and availability of resources. Both systems are under pressure to adopt the general organizational reform of privatization. The debate over privatization in public education is contentious, but in public health, the shift of functions from the public to the private sector has been accepted with limited deliberation. We assess the benefits and concerns of privatization and suggest that shifting public health functions to the private sector raises questions about the values and mission of public health. Public health officials need to be more engaged in a public debate over the desirability of privatization as the future of public health. PMID:17008563
Monahan, Amy B.
There is significant interest in reforming retirement plans for public school employees, particularly in light of current market conditions. This article presents an overview of the various types of state regulation of public pension plans that affect possibilities for reform. Nearly all of the various approaches to public pension plan protection…
This case study examines why public-sector reform in education often fails to deliver expected performance gains. Longitudinal evidence from a secondary comprehensive located in a former coalfield is used to identify constraints that frustrate government policies. Although the head and senior staff at Norcross School adopted transformational,…
Langer, A.; Nigenda, G.; Catino, J.
Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproductive health. The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care, and by the involvement of the public in setting health sector priorities. However, there is a serious risk that health reforms will be driven mainly by financial and/or political considerations and not by the need to improve the quality of health services as a basic human right. With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms, the gap between rhetoric and practice remains wide. PMID:10859860
Phillips, Simone; Pholsena, Soulivanh; Gao, Jun; Oliveira Cruz, Valeria
Development organizations and academic institutions have expressed the need for increased research to guide the development and implementation of policies to strengthen health systems in low- and middle-income countries. The extent to which evidence-based policies alone can produce changes in health systems remains a point of debate; other factors, such as a country's political climate and the level of actor engagement, have been identified as influential variables in effective policy development and implementation. In response to this debate, this article contends that the success of health sector reform depends largely on policy learning-the degree to which research recommendations saturate a given political environment in order to successfully inform the ideas, opinions and perceived interests of relevant actors. Using a stakeholder analysis approach to analyze the case of health sector reform in Lao PDR, we examine the ways that actors' understanding and interests affect the success of reform-and how attitudes towards reform can be shaped by exposure to policy research and international health policy priorities. The stakeholder analysis was conducted by the WHO during the early stages of health sector reform in Lao PDR, with the purpose of providing the Ministry of Health with concrete recommendations for increasing actor involvement and strengthening stakeholder support. We found that dissemination of research findings to a broad array of actors and the inclusion of diverse stakeholder groups in policy design and implementation increases the probability of a sustainable and successful health sector reform. PMID:27008856
De Vos, Pol; De Ceukelaire, Wim; Van der Stuyft, Patrick
Latin American national health systems were drastically overhauled by the health sector reforms the 1990s. Governments were urged by donors and by the international financial institutions to make major institutional changes, including the separation of purchaser and provider functions and privatization. This article first analyses a striking paradox of the far-reaching reform measures: contrary to what is imposed on public health services, after privatization purchaser and provider functions are reunited. Then we compare two contrasting examples: Colombia, which is internationally promoted as a successful--and radical--example of 'market-oriented' health care reform, and Cuba, which followed a highly 'conservative' path to adapt its public system to the new conditions since the 1990s, going against the model of the international institutions. The Colombian reform has not been able to materialize its promises of universality, improved equity, efficiency and better quality, while Cuban health care remains free, accessible for everybody and of good quality. Finally, we argue that the basic premises of the ongoing health sector reforms in Latin America are not based on the people's needs, but are strongly influenced by the needs of foreign--especially North American--corporations. However, an alternative model of health sector reform, such as the Cuban one, can probably not be pursued without fundamental changes in the economic and political foundations of Latin American societies. PMID:17002735
Møller, Jorunn; Skedsmo, Guri
Since the end of the 1980s, the Norwegian education system has gone through major reform, influenced largely by new managerialist ideas. Strategies to renew the public sector were promoted as the new public management (NPM). This paper investigates the way ideas connected to NPM reforms have been introduced and interpreted in the Norwegian…
Rennie, John C.
Restates the underlying rationale for the importance of high-quality K-12 public education and describes some of the difficulties reformers encounter in engendering support for, and determining, the most cogent elements of reform. Summarizes the process followed by the Massachusetts Business Alliance for Education in developing a framework for…
Bodart, C; Servais, G; Mohamed, Y L; Schmidt-Ehry, B
Despite health reform and increasing public investment in the health sector, utilization of curative health services, immunization coverage and patient satisfaction with the public health care system are steadily decreasing in Burkina Faso. It seems that the health care system itself is "ill". This paper examines the major symptoms associated with this illness. The central thesis suggests that any further improvement of health care performance in Burkina Faso will be subject to profound central reform in the area of human resources and financial management of the sector. Such a broad reform package cannot be achieved through the current project approach, but a sector-wide approach (SWAp) does not seem to be realistic at the present time. Policy discussions at a level higher than the Ministry of Health could be beneficial for achieving better donor coordination and increasing the commitment of the Ministry of Health to a sector-wide approach. Health sector reform issues and priorities and the role of international cooperation are reviewed and discussed. PMID:11238434
The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own. PMID:25878456
The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40–70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21st century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of “integrative healthcare” because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own. PMID:25878456
This paper discusses health sector reforms and what they have meant for sexual and reproductive health advocacy in low-income countries. Beginning in the late 1980s, it outlines the main macro-economic shifts and policy trends which affect countries dependent on external aid and the main health sector reforms taking place. It then considers the implications of successive macro-economic and reform agendas for reproductive and sexual health advocacy. International debate today is focused on the conditions necessary for socio-economic development and the role of governments in these, and how to improve the performance of health sector bureaucracies and delivery systems. A critical challenge is how to re-negotiate the policy and financial space for sexual and reproductive health services within national health systems and at international level. Advocacy for sexual and reproductive health has to tread the line between a vision of reproductive health for all and action on priority conditions, which means articulating an informed view on needs and priorities. In pressing for greater funding for reproductive health, advocates need to find an appropriate balance between concern with health systems strengthening and service delivery and programmes, and create alliances with progressive health sector reformers. PMID:12557639
This paper examines the ways in which private- and public-sector location affects organizational structure and functions, and the implications for school reform. It identifies the differences that are often overlooked when policymakers utilize market-based organizational reform models to address public school problems. Two fundamental questions…
Borthwick, C; Galbally, R
The political, technological and economic changes that have occurred over the past decade are increasingly difficult to manage within the traditional framework of health-care, and the organisation of health-care is seen to need radical reform to sweep away many of the internal barriers that now divide one form of health-care, and one profession, from another. Nursing must equip itself with skills in advocacy and political action to influence the direction the system will take. Nursing currently suffers from a weakness in self-concept that goes hand in hand with a weakness in political status, and nursing leadership must build the foundations for both advocacy for others and self-advocacy for the nursing movement. The profession faces tensions between different conceptions of its role and status, its relationship to medicine, and its relationship to health. Health indices are tightly linked to status, and to trust, hope, and control of one's own life. Can nurses help empower others when they are not particularly good at empowering themselves? What will the role of the nurse be in creating the information flows that will guide people toward health? Nursing's long history of adaptation to an unsettled and negotiated status may mean that it is better fitted to make this adaptation than other more confident disciplines. PMID:11882205
Zhonghua, Cai; Ye, Wang
In "New Public Management" era, performance measurement has been widely used in managerial practices of public sectors. From the content and features of performance measurement, this paper aims to explore inspirations on Chinese public sector performance measurement, which based on a review of prior literatures including influencial factors, methods and indicators of public sector performance evaluation. In the end, arguments are presented in this paper pointed out the direction of future researches in this field.
Albert Einstein and the Emergency Committee of Atomic Scientists (ECAS) conducted a reform-based public communication campaign for the international control of atomic energy after the Second World War. The Committee raised funds and sought publicity for its proposed solution to the problem of war and the management of peace. Its solution was the…
In Argentina, health sector reforms put particular emphasis on decentralization and self-management of the tax-funded health sector, and the restructuring of the social health insurance during the 1990s. Unlike other countries in the region, there was no comprehensive plan to reform and unify the sector. In order to assess the effects of the reforms on the performance of the health financing system, this study looks at impacts on the three inter-related functions of revenue collection, pooling, and purchasing/provision of health services. Data from various sources are used to illustrate the findings. It was found that the introduction of cost recovery by self-managed hospitals increased their budgets only marginally and competition among social health insurance funds did not reduce fragmentation as expected. Although reforming the Solidarity Redistribution Fund and implementing a single basic package for the insured was an important step towards equity and transparency, the extent of risk pooling is still very limited. This study also provides recommendations regarding strengthening reimbursement mechanisms for public hospitals, and regulating the private sector as approaches to improving the fairness of the health financing system and protecting people from financial hardship as a result of illness. PMID:18378350
Iriart, C; Merhy, E E; Waitzkin, H
This article presents the results of the comparative research project "Managed Care in Latin America: Its Role in Health Reform". The project was conducted by teams in Argentina, Brazil, Chile, Ecuador, and the United States. The study's objective was to analyze the process by which managed care is exported, especially from the United States, and how managed care is adopted in Latin American countries. Our research methods included qualitative and quantitative techniques. Adoption of managed care reflects transnationalization of the health sector. Our findings demonstrate the entrance of large multinational financial capital into the private insurance and health services sectors and their intention of participating in the administration of government institutions and medical/social security funds. We conclude that this basic change involving the slow adoption of managed care is facilitated by ideological changes with discourses accepting the inexorable nature of public sector reform. PMID:10738154
Stoddard, Christiana; Kuhn, Peter
Beyond some contracted minimum, salaried workers' hours are largely chosen at the worker's discretion and should respond to the strength of contract incentives. Accordingly, we consider the response of teacher hours to accountability and school choice laws introduced in U.S. public schools over the past two decades. Total weekly hours of full-time…
Hamermesh, Daniel S., Ed.
Originally presented at a Conference on Labor in Nonprofit Industry and Government held at Princeton University, the studies are the first to provide an economic discussion of the public sector labor market. Melvin Reder examines the effect of the absence of the profit motive on employment and wage determination in the public sector. Orley…
Khademian, Anne Meredith
This report looks at recent changes in governance across the public sector to provide context and examples for the National Commission on Governing America's Schools' efforts. The report is presented in six sections. Following a brief introduction in section 1, section 2 provides an overview of the forces that have changed public-sector governance…
Zielke, Laurence J.
Examines Kentucky's statutory and decisional law concerning public sector labor relations, as well as the practice and future of public sector relations as perceived by city and county officials. Available from Salmon P. Chase College of Law, 1401 Dixie Highway, Covington, Kentucky 41011; 1.50 per reprint. (Author/IRT)
Gregory, Mary Volk
Argues for a public sector collective bargaining statute in Colorado and analyzes the issues that must be addressed in effective public sector collective bargaining legislation. Available from University of Colorado Law Review, Inc., Fleming Law Building, University of Colorado, Boulder, CO 80309. (Author/IRT)
Baaj, M. Hadi
Civil aviation is one of the key contributors to a successful economic system. This has been recognized within Lebanon, which is undertaking developing a new civil aviation strategy encompassing a program of organizational reform, coordinated internationally, to meet the challenges of the new century. Such strategy is vital, as it will provide a coherent vision for the sector, compliment the extensive investments deployed by Lebanon in its aviation infrastructure, and guide future planning and investments. The proposed Civil Aviation Strategy for Lebanon has two major components: (1) institutional reform aiming at creating effective overall legal and regulatory frameworks in-line with current international best practice; and (2) implementation of liberalization measures and open skies policy. This paper aims to: (1) present Lebanon's current institutional arrangements; (2) review the institutional arrangements in key select countries (in order to define current trends in best institutional practice); (3) discuss the proposed institutional reform (which are at the basis of Lebanon's Draft Civil Aviation Reform Law) while showing that they conform with the identified best institutional trends; and (4) outline an implementation plan. The Draft Law has been approved by the Council of Ministers and now awaits Parliamentary endorsement.
Alwan, Ala'; Hornby, Peter
The authors argue that "health for all" is not achievable in most countries without health sector reform that incorporates a process of coordinated health and human resources development. They examine the situation in countries in the Eastern Mediterranean Region of the World Health Organization. Though advances have been made, further progress is inhibited by the limited adaptation of traditional health service structures and processes in many of these countries. National reform strategies are needed. These require the active participation of health professional associations and academic training institutions as well as health service managers. The paper indicates some of the initiatives required and suggests that the starting point for many countries should be a rigorous appraisal of the current state of human resources development in health. PMID:11884974
Wright, F A C; List, P F
Australia has a complex history of providing public dental services to its communities. From the early days of Colonial settlement, the provision of dental care to the Australian public has largely been driven and influenced by organized groups and associations of dentists. The Constitution of Australia, under Section 51 xxiii A, allows for the Commonwealth to provide for medical and dental services. Unlike the United Kingdom, however, dental services have not been embedded into a universal national health service agenda. In 1974, that the Australian Government through the Australian School Dental Program provided the first funding and national direction for public dental services - and that, limited to children. The Commonwealth Dental Health Program 1993-1997 was the second national endeavor to provide public dental services, this time to financially disadvantaged adults. Since that time, public dental service responsibility has been shuttled between States/Territories and the Commonwealth. A new paradigm for public dental services in Australia requires strong Commonwealth leadership, as well as the commitment of State and Territories and the organized dental profession. The National Health and Hospitals Reform Commission provided the most recent scenario for a radical change in mission. This paper canvases the competing roles of strategic, functional, and structural issues in relationship to social network and policy issues, which must be recognized if Australians truly seek to reform public dental services. PMID:22998313
After the collapse of the Former Soviet Union a health reform process was undertaken in Georgia beginning in 1994. This process was intended to encompass all aspects of the health-care sector and to transform the Soviet-style health system into one that was directed towards quality of care, improved access, efficiency, and a strengthened focus on Primary Health Care (PHC). Health sector reform fundamentally changed the ways health care is financed in Georgia. There has been a transition to program-based financing, and payroll-tax-based social insurance schemes have been introduced. Despite these measures, the performance of the health system is still disappointing. All health programs are severely under-funded, and when the majority of the population is unemployed or self-employed, collection of taxes seems impossible. Overall, Georgian consumers are uninformed about the basic principles of health reforms and their entitlements and therefore do not support them. The analysis introduced in this paper of the current situation in Georgia establishes that the rush to insurance-based medicine was more a rush from the previous system than a well-thought-out policy direction. After 70 years of a Soviet rule, the country had no institutional capacity to provide insurance-based health care. To achieve universal coverage, or at least ensure that the majority of the population has access to basic health services, government intervention is essential. In addition, educating the public on reforms would allow the reform initiators to fundamentally change the nature of the reform process from a "top-down" centralized process to one that is demand-driven and collaborative. PMID:12705312
Abolhallaje, Masoud; Jafari, Mehdi; Seyedin, Hesam; Salehi, Masoud
Background: Financial management and accounting reform in the public sectors was started in 2000. Moving from cash-based to accrual-based is considered as the key component of these reforms and adjustments in the public sector. Performing this reform in the health system is a part of a bigger reform under the new public management. Objectives: The current study aimed to analyze the movement from cash-based to accrual-based accounting in the health sector in Iran. Patients and Methods: This comparative study was conducted in 2013 to compare financial management and movement from cash-based to accrual-based accounting in health sector in the countries such as the United States, Britain, Canada, Australia, New Zealand, and Iran. Library resources and reputable databases such as Medline, Elsevier, Index Copernicus, DOAJ, EBSCO-CINAHL and SID, and Iranmedex were searched. Fish cards were used to collect the data. Data were compared and analyzed using comparative tables. Results: Developed countries have implemented accrual-based accounting and utilized the valid, reliable and practical information in accrual-based reporting in different areas such as price and tariffs setting, operational budgeting, public accounting, performance evaluation and comparison and evidence based decision making. In Iran, however, only a few public organizations such as the municipalities and the universities of medical sciences use accrual-based accounting, but despite what is required by law, the other public organizations do not use accrual-based accounting. Conclusions: There are advantages in applying accrual-based accounting in the public sector which certainly depends on how this system is implemented in the sector. PMID:25763194
Ejughemre, Ufuoma John
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. PMID:24596895
Research for Action, 2004
This document presents findings on the impact of privatization to date at a meeting at the Ford Foundation co hosted by the William Penn Foundation, Carnegie Corporation of New York, and Ford. Increasingly, the private sector (both for-profit and non-profit) is providing resources and alternative delivery models for urban public schools. Beyond…
Niehaves, Björn; Malsch, Robert
‘Open Innovation’ has been heavily discussed for product innovations; however, an information systems (IS) perspective on ‘process innovation’ has not yet been taken. Analyzing the example of the public sector in Germany, the paper seeks to investigate the factors that hinder and support ‘open process innovation’, a concept we define as the involvement of citizens in business process management (BPM) activities. With the help of a quantitative study (n=358), six factors are examined for their impact on citizen involvement in local government BPM initiatives. The results show that citizen involvement in reform processes is not primarily motivated by the aim of cost reduction, but rather related to legitimacy reasons and the intent to increase employee motivation. Based on these findings, implications for (design) theory and practice are discussed: Instead of detailed collaborative business processes modeling, the key of citizen involvement in public sector BPM lies in communication and mutual understanding.
In December 2008, a national wide survey was conducted to identify priorities for cucumber research in the public sector. The questions in the survey were in four categories: diseases, insects, abiotic stresses and other issues. The survey was sent to cucumber-related researchers in the public insti...
Oyaya, Charles O; Rifkin, Susan B
The paper examines health sector reforms in Kenya at the district level based on the Government of Kenya's Health Policy Framework of 1994. The authors present the context of and historical perspective to health sector reforms in Kenya and discuss the major reform policies including decentralization to the district level. The authors then review intended policy outcomes, investigating assumptions on which the implementation and effectiveness of the reform agenda at the local level are based. The authors argue that emphasis on outcomes rather than process has not supported sustainable reforms or achieved the government's goal of improving health and ensuring equity for the citizens of the country. PMID:12644333
Almeida, C; Travassos, C; Porto, S; Labra, M E
Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education. PMID:10707303
Buffler, P A; Kyle, A D
The U.S. Congress is considering legislation that would change policy for environmental health in important ways. Current approaches have been criticized for addressing the wrong set of priorities and consuming too many resources. The legislation requires additional analyses and sets new decision criteria to be applied to federal agency actions taken to protect the environment and public health. Close review of the legislation suggests that though it is intended to address identified problems, it is unlikely to lead to an improved basis for public policy and is likely to paralyze the regulatory process. Reform proposals that reduce rather than increase fragmentation of decision-making and that address problems comprehensively rather than selectively are needed. PMID:8732938
The impact of conflict on population health and health infrastructure has been well documented; however the efforts of the international community to rebuild health systems in post-conflict periods have not been systematically examined. Based on a review of relevant literature, this paper develops a framework for analyzing health reform in post-conflict settings, and applies this framework to the case study of health system reform in post-conflict Kosovo. The paper examines two questions: first, the selection of health reform measures; and second, the outcome of the reform process. It measures the success of reforms by the extent to which reform achieved its objectives. Through an examination of primary documents and interviews with key stakeholders, the paper demonstrates that the external nature of the reform process, the compressed time period for reform, and weak state capacity undermined the ability of the success of the reform program. PMID:20398389
Sakyi, E Kojo
Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have either not been thoroughly studied or overlooked. The analysis identified lack of leadership; weak communication and consultation; lack of stakeholder participation, corruption and unethical professional behaviour as some of the missing variables in the literature. The study, therefore, indicated that there are gaps in the literature that needed to be filled through rigorous reform evaluation based on empirical research particularly at district, sub-district and community levels. It further suggested that future research should be concerned with the effects of both systems and structures and behavioural factors on reform implementation. PMID:18536006
Scanlan, Martin; Tichy, Karen
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…
Shakeshaft, Charol; Trachtman, Roberta
Although there is widespread publicity about the involvement of businesses with schools, and as President Reagan as well as authors of reform reports continue to call upon the private sector to help education, it is unclear to what extent such relationships exist and what they are accomplishing. A 10-page, 55-question survey was mailed to the…
The "Victorian Free Library Service Board Act" of 1946 was the culmination of a long campaign to replace the mechanics' institute model of library provision with free libraries funded by state and local government. Given that library reform required legislation by the state government, this paper is mainly concerned with the political campaign…
Roche, Ann; Kostadinov, Victoria; White, Michael
Australian vocational education and training (VET) has undergone major reforms since the 1990s, including the introduction of competency based training (CBT) and the "streamlining" of qualifications. This paper examines the impact of these reforms, using the alcohol and other drugs sector as a case illustration. A survey of alcohol and…
;Contents: Background and Characteristics of the Energy Sector at the Beginning of the Reform Process; Energy Demand and Efficiency; Major Energy Production Issues in Central and Eastern Europe and Former Soviet Union; Changing Structure of East-West Energy Trade; Energy Pricing; Energy Sector Revenues and Finances; Experience in Energy Reform Commercialization, Privatization and Links to the Macroeconomy; Lessons, Conclusions and Approaches to Improve; and Annexes.
Nelson Nels E.
Surveys the legal status of union security in the public sector and indicates that the basic policy options are to limit union security to the voluntary dues check-off, to authorize the parties to negotiate union or agency shop agreements, or to establish a mandatory fee for the exclusive representative. (Author/IRT)
This article examines the participation of "third-sector" organisations in public education in England. These organisations act as a cross-sectoral policy network made up of new kinds of policy experts: mediators and brokers with entrepreneurial careers in ideas. They have sought to make education reform thinkable, intelligible and…
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procurement under public sector procedures. 201... § 201.22 Procurement under public sector procedures. (a) General requirements. When the importer is the... contracts for commodities shall be awarded under public sector procedures in this section unless...
This study provides a status report on the food and agriculture sector in the Republic Armenia and assesses the progress of ongoing sectoral reforms. In addition to giving an account of the reforms in private agriculture, it recommends a set of policies to complete the transition to a sector based on private ownership and market control. Chapters 1-6 of the report presents the major conclusions of the review. Chapters 7-11 provides background analysis of major subsectors in food and agriculture and contains the statistical annex.
Kroeger, Axel; Ordoñez-Gonzalez, José; Aviña, Ana Isabel
The consequences of health sector reforms on control of malaria were analysed using Colombia as an example. One of the most complex health sector reform programmes in Latin America took place in the 1990s; it included transferring the vertical vector-borne disease control (VBDC) programme into health systems at state and district levels. A series of studies was undertaken in 1998-2000 at the national level (Ministry of Health Study), at the state level (Departamento Study) and at the health district level (District Study) using formal and informal interviews among control staff and document analysis as data collection tools. A government-financed national training programme for VBDC staff - which included direct observation of control operations - was also used to analyse health workers' performance in the postreform period (longitudinal study). The results showed that some shortcomings of the old vertical system, such as the negative aspects of trade union activity, have not been overcome while some positive aspects of the old system, such as capacity building, operational planning and supervision have been lost. This has contributed to a decrease in control activity which, in turn, has been associated with more malaria cases. Malaria control had to be reinvented at a much larger scale than anticipated by the reformers caused by a whole series of problems: complex financing of public health interventions in the new system, massive staff reductions, the difficulty of gaining access to district and state budgets, redefining entire organizations and - in addition to the reforms - introducing alternative strategies based on insecticide-treated materials and the growth of areas of general insecurity in many parts of Colombia itself. However, positive signs in the transformed system include: the strengthening of central control staff (albeit insufficient in numbers) when transferred from the Ministry of Health to the National Institute of Health, the opportunities
Reese, William J.
Americans from all walks of life espouse the cause of school reform. The past generation has witnessed the rise of education governors and education presidents. The CEO's of major corporations, big-city mayors, private sector entrepreneurs, inner city parents, the heads of teachers' unions, and every politician under the sun have often found the…
Harris, Mark Cameron
This study explored the factors that are critical to the success of public (government) sector knowledge management initiatives and the lessons from private sector knowledge management and organizational learning that apply in the public sector. The goal was to create a concise guide, based on research-validated success factors, to aid government…
Niederjohn, Matthew Scott
This paper examines trends in employment and earnings in the U.S. electricity sector during a period of regulatory reform. Econometric models are specified using a large data set of individual employees from the Current Population Survey. OLS earnings estimations find no evidence of an adverse effect on employee earnings during the period of regulatory reform, even after correction for sample selectivity bias using the Heckman two-step approach. In fact, earnings premiums in the electricity sector have increased over the period of regulatory reform. Probit models do find strong evidence that declines in the probability of electricity sector employment, for many occupations, have occurred during the regulatory reform period. These findings deviate significantly from other restructured industries, with the electricity sector being the first industry to show significant employment declines associated with regulatory reform. Using the Blinder-Oaxaca technique, earnings premiums are calculated for electricity sector employees by occupation. These earnings differential variables are found to have a significant negative impact on employment for a number of occupations. Lastly, a longitudinal analysis is used to examine the experiences of electricity sector workers who leave this industry for new employment. This longitudinal procedure allows for analyzing whether electricity sector earnings premiums depict a compensating differential. While the sample size for this analysis is small, an examination of the mean wages of the employees that made an industry change from the electricity sector suggest they continue to receive high earnings in their new positions. These findings suggest that electric utilities, either unable or unwilling to cut employee earnings, have chosen to become more competitive in a deregulated environment through employment actions.
Because their resources are inadequate, philanthropic foundations cannot bring about educational reform by themselves. Foundations are best when serving as midwives, parking garages, conversations pits, burning glasses (to focus thought), levers, and lighthouse tenders. The American people are responsible for acting voluntarily to support public…
Weiss, Steven J.
The purposes of this report are (1) to document the present inequalities in public school spending and local tax burdens and to identify the principal reasons for existing disparities; and (2) to review and evaluate proposals for reform of the currently inadequate public school finance systems. Previous studies, current State and Federal aid…
Lamborn, Robert L.
This paper considers factors contributing to the perspectives on educational reform held by educators in the public and private school systems of the United States and suggests a common perspective that can be used by both parties. The paper first defends four assertions: (1) the perspectives of those debating the appropriate roles of public and…
Homedes, Núria; Ugalde, Antonio
Human resources are the most important assets of any health system, and health workforce problems have for decades limited the efficiency and quality of Latin America health systems. World Bank-led reforms aimed at increasing equity, efficiency, quality of care and user satisfaction did not attempt to resolve the human resources problems that had been identified in multiple health sector assessments. However, the two most important reform policies – decentralization and privatization – have had a negative impact on the conditions of employment and prompted opposition from organized professionals and unions. In several countries of the region, the workforce became the most important obstacle to successful reform. This article is based on fieldwork and a review of the literature. It discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region. The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. The authors suggest that autochthonous solutions are more likely to succeed than solutions imported from the outside. PMID:15659241
Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health
Rigoli, Felix; Dussault, Gilles
The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways – reacting to transformations, supporting, blocking and distorting the proposed ways of action. This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them. PMID:14613523
Around the world, network utilities (i.e., electricity, natural gas, railway, telecommunications, and water supply industries) are undergoing major structural transformation. A new wave of market liberalization, together with rapid technological changes, has challenged the previously dominant monopoly organization of these industries. A global trend toward deregulation and restructuring is evident in countries at different levels of social and economic development. The challenges of transition from a monopolistic to an open market competitive structure are numerous. Understanding these problems and finding solutions are essential to successful restructuring. In developing countries and economies in transition (i.e., the Eastern Europe and the former Soviet Union), government-owned utilities are often considered to be highly inefficient. The dominant power sector restructuring strategies seek to promote economic efficiency through a gradual introduction of competition into the power sector. Five components of power sector reform are commonly proposed by the World Bank and others for these countries: commercialization, privatization, establishment of an independent regulatory agency, unbundling and gradual introduction of competition in generation and retail markets. The Republic of Georgia, like many economies in transition (e.g., Hungary, Ukraine, and Kazakhstan) has followed this reform model. However, outcomes of the reform have not been as promised. The acute economic problems facing Georgia after it regained independence have compounded problems in the power sector. A review of Georgia's utility reforms reveals that the country has undertaken electricity industry restructuring without giving substantial consideration to the problems that these reforms might have created within the industry or society. The main task of this dissertation is to find the restructuring model, which can best serve economic, social and environmental goals under circumstances similar
Evaluation and Training Inst., Los Angeles, CA.
Designed to assist community college administrators and faculty in enhancing vocational education programs and services, this resource package contains information on successful partnership programs between California Community Colleges (CCC) and public sector entities. Following a brief overview of public sector partnerships, the report presents…
... 29 Labor 3 2010-07-01 2010-07-01 false Exclusion for public sector employers. 801.10 Section 801... public sector employers. (a) Section 7(a) provides an exclusion from the Act's coverage for the United States Government, any State or local government, or any political subdivision of a State or...
This monograph was prepared as an initial effort in development of a body of material for training public sector managers. It sets forth the basic principles of grievance arbitration covering discipline in the public sector. Major sections are devoted to the topics of just or proper cause for discipline, due process, the nature of discipline, and…
The decline in perceived happiness within economic prosperity in Chinese society calls for further examination. In this research, we investigate the effect of employment in public sector work units on perceived happiness through the mediation of economic and social status relative deprivations. In the reform era of China, work unit is still an important mechanism maintaining social inequality, and those working in government/Communist Party agencies and public institutions have advantages of getting access to high wage, comprehensive welfare and the manipulation of administrative public power. Such economic and social status advantages are expected to reduce their relative deprivation and further promote their perceived happiness. Using a nationwide survey data conducted in 2006, we find working in public sector can significantly reduce the odds of experiencing economic relative deprivation, which is further contributive to the improvement of subjective wellbeing. PMID:22717616
Reese, William J.
In this article, the author answers the question: "Why do Americans love to reform the public schools?" His answer has three parts. First, there is an old and persistent cultural strain in American history, derived from many sources, that seeks human perfection and sees education and schooling as essential to that perfectibility. That goal is high…
Erickson, Paul W.
The King of Jordan's vision for education is resulting in innovative projects for the country. King Abdullah II wants Jordan to develop its human resources through public education to equip the workforce with skills for the future. From King Abdullah II's vision, the Education Reform for a Knowledge Economy (ERfKE) project implemented by the…
The article focuses on the similarities and differences in using new public management (NPM) administrative arrangements in educational policy as they have been presented in the educational reform process carried out this millennium by two governments in Norway: the Centre-Conservative government and the current Red-Green coalition government.…
Crosby, Danielle A.; Hatfield, Bridget E.
The Personal Responsibility and Work Reconciliation Act of 1996 reformed public assistance programs and reduced the safety net of supports for low-income families. Children living in low-income immigrant families face particular challenges in the current policy environment. In this article, the authors consider what these changes have meant for…
Kanyongo, Gibbs Y.
The purpose of this article is to discuss Zimbabwe's public education system. First, the article provides a brief look at pre-independence education in Zimbabwe. Second, it discusses some of the reforms that took place in the Zimbabwe education system following independence. Third, it looks at the current structure of Zimbabwe's education system…
Bales, Susan Nall
Recent polling data suggest that there is a growing consensus to pay special attention to children's needs in the health care reform debate. The public generally desires children to have greater access to health care services, even if this would mean higher taxes, but is unsure that government is the best vehicle to provide such services. (MDM)
Garuba, Habibat A; Kohler, Jillian C; Huisman, Anna M
Background Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries . Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC) underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals . Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments), and distribution. Methods Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. Results The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Conclusion Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of
Ssengooba, Freddie; Rahman, Syed Azizur; Hongoro, Charles; Rutebemberwa, Elizeus; Mustafa, Ahmed; Kielmann, Tara; McPake, Barbara
Background Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers' responses to the changes in their working environments by taking a 'realistic evaluation' approach. Methods The study findings were generated by triangulating both qualitative and quantitative methods of data collection and analysis among policy technocrats, health managers and groups of health providers. Quantitative surveys were conducted with over 700 individual health workers in both Bangladesh and Uganda and supplemented with qualitative data obtained from focus group discussions and key interviews with professional cadres, health managers and key institutions involved in the design, implementation and evaluation of the reforms of interest. Results The reforms in both countries affected the workforce through various mechanisms. In Bangladesh, the effects of the unification efforts resulted in a power struggle and general mistrust between the two former workforce tracts, family planning and health. However positive effects of the reforms were felt regarding the changes in payment schemes. Ugandan findings show how the workforce responded to a strong and rapidly implemented system of decentralisation where the power of new local authorities was influenced by resource constraints and nepotism in recruitment. On the other hand, closer ties to local authorities provided the opportunity to gain insight into the operational constraints originating from higher levels that health staff were dealing with. Conclusion Findings from the study suggest that a) reform planners should use the proposed dynamic responses model to help design reform objectives
Brown, L D
As political pressure for affordable universal coverage intensifies, various proposals have been crafted to improve the system without sacrificing the role of the private sector. Some analysts view the preservation of a mixed public-private system as an exercise in incrementalism, avoiding disquieting departures from familiar arrangements. A review of the political and administrative challenges of several main options--market innovation, tax credits, play or pay, and Medicaid expansion--suggests that the path to true reform is a slippery slope. Over time, changes in particular sectors, such as insurance, employers, government, and providers, will very likely implicate the others too. Although redefining the public-private mix may be more incremental than (say) adoption of a Canadian model, it will also entail considerable "creative destruction" of existing patterns and cannot fail to disturb the institutional status quo substantially. PMID:1612719
Bricknell, M C M; Thompson, D
This is the second in a series of three papers that examine the role of international military medical services in stability operations in unstable countries. The paper discusses security sector reform in general terms and highlights the interdependency of the armed forces, police, judiciary and penal systems in creating a 'secure environment'. The paper then looks at components of a local military medical system for a counter-insurgency campaign operating on interior lines and the contribution and challenges faced by the international military medical community in supporting the development of this system. Finally the paper highlights the importance of planning the medical support of the international military personnel who will be supporting wider aspects of security sector reform. The paper is based on background research and my personal experience as Medical Director in the Headquarters of the NATO International Stability Assistance Force in Afghanistan in 2006. PMID:17896536
Alexander, Debbie; Heaviside, Sheila; Farris, Elizabeth
This volume examines education-reform efforts in U.S. public schools. The report, which focuses on higher standards for student achievement, is based on two nation-wide studies: the Public School Teacher Survey on Education Reform and the Public School Survey on Education Reform. The survey included questions on teachers' understanding of higher…
There is widespread interest within academia to work on public good genetically engineered (GE) projects to the benefit of the poor, especially to use GE-technology to contribute to food security. Not a single product from this work has reached the market. The major cause is GE-regulation, which prevents use of the technology for public good beyond proof-of-concept (Potrykus, I. (2010) Lessons from the Humanitarian Golden Rice project: Regulation prevents development of public good GE-products (these Proceedings)). There is, however, another key problem responsible for the lack of deployment of public good GE-plants: the public sector is incompetent and disinterested for work beyond proof-of-concept, and has neither capability nor funding to develop GE-plant products and introduce them to growers and consumers. The private sector has the expertise for both and in the right circumstances can be ready to support the public sector in public good enterprises. Public-private-partnerships are the best solution so far, to advance exploitation of GE-technology to the benefit of the poor. Public-private-partnerships are viable, however, only, if there is mutual interest from the private sector and initiative and funding from the public sector. PMID:20637908
GIACAMAN, RITA; ABDUL-RAHIM, HANAN F; WICK, LAURA
Since the signing of the Oslo Peace Accords and the establishment of the Palestinian Authority in 1994, reform activities have targeted various spheres, including the health sector. Several international aid and UN organizations have been involved, as well as local and international non-governmental organizations, with considerable financial and technical investments. Although important achievements have been made, it is not evident that the quality of care has improved or that the most pressing health needs have been addressed, even before the second Palestinian Uprising that began in September 2000. The crisis of the Israeli re-invasion of Palestinian-controlled towns and villages since April 2002 and the attendant collapse of state structures and services have raised the problems to critical levels. This paper attempts to analyze some of the obstacles that have faced reform efforts. In our assessment, those include: ongoing conflict, frail Palestinian quasi-state structures and institutions, multiple and at times inappropriate donor policies and practices in the health sector, and a policy vacuum characterized by the absence of internal Palestinian debate on the type and direction of reform the country needs to take. In the face of all these considerations, it is important that reform efforts be flexible and consider realistically the political and economic contexts of the health system, rather than focus on mere narrow technical, managerial and financial solutions imported from the outside. PMID:12582108
BESHEARS, JOHN; CHOI, JAMES J.; LAIBSON, DAVID; MADRIAN, BRIGITTE C.
We describe the pension plan features of the states and the largest cities and counties in the U.S. Unlike in the private sector, defined benefit (DB) pensions are still the norm in the public sector. However, a few jurisdictions have shifted toward defined contribution (DC) plans as their primary savings plan, and fiscal pressures are likely to generate more movement in this direction. Holding fixed a public employee’s work and salary history, we show that DB retirement income replacement ratios vary greatly across jurisdictions. This creates large variation in workers’ need to save for retirement in other accounts. There is also substantial heterogeneity across jurisdictions in the savings generated in primary DC plans because of differences in the level of mandatory employer and employee contributions. One notable difference between public and private sector DC plans is that public sector primary DC plans are characterized by required employee or employer contributions (or both), whereas private sector plans largely feature voluntary employee contributions that are supplemented by an employer match. We conclude by applying lessons from savings behavior in private sector savings plans to the design of public sector plans. PMID:21789032
Fischhendler, Itay; Zilberman, David
Existing water policies often deviate from measures suggested by economic and environmental analysis. This is particularly true in the case of drought response policies, where effective policies are rarely adopted. This study focuses on how to enhance the political feasibility of options rather than identifying the optimal water policies. It argues that a legislative policy package may be a mechanism both to unite divergent interest groups into a coalition with common policy agendas and also to fragment or realign existing and traditional alliances. This majority building approach may have a greater chance of obtaining the required political support to advance water reforms. The negotiation over the Central Valley Project Improvement Act in California is used as an example. The case study illustrates how the policy packaging strategy split the traditional power alliance between the agricultural sector and the urban sector in California and between the agricultural sector in California and their allies in other U.S. western states. At the same time, policy packaging has created new regional and sectoral advocacy coalitions in support of water reform. As a result, the Bureau of Reclamation changed its policies in the Central Valley in California relating to the establishment of water markets, water pricing, and wildlife restoration fund and allocating water for the environment.
Healy, J; Mckee, M
The success or failure of health sector reform in the countries of Central and Eastern Europe depends, to a large extent, on their health care staff. Commentators have focused on the structures to be put in place, such as mechanisms of financing or changes in ownership of facilities, but less attention has been paid to the role and status of the different groups working in health care services. This paper draws on a study of trends in staffing and working conditions throughout the region. It identifies several key issues including the traditionally lower status and pay of health sector workers compared to the West, the credibility crisis of trade unions, and the under-developed roles of professional associations. In order to implement health sector reforms and to address the deteriorating health status of the population, the health sector workforce has to be restructured and training programmes reoriented towards primary care. Finally, the paper identifies emerging issues such as the erosion of 'workplace welfare' and its adverse effects upon a predominantly female health care workforce. PMID:10176264
Lubben, Marianne; Mayhew, Susannah H.; Collins, Charles; Green, Andrew
It is not clear how policy-making in the field of reproductive health relates to changes associated with programmes for the reform of the health sector in developing countries. There has been little communication between these two areas, yet policy on reproductive health has to be implemented in the context of structural change. This paper examines factors that limit dialogue between the two areas and proposes the following framework for encouraging it: the identification of policy groups and the development of bases for collaborative links between them; the introduction of a common understanding around relevant policy contexts; reaching agreement on compatible aims relating to reproductive health and health sector change; developing causal links between policy content in reproductive health and health sector change as a basis for evidence-based policy-making; and strengthening policy-making structures, systems, skills, and values. PMID:12219159
As a state legislator, you're well aware of the fiscal pressures that have caused many states to change their pension systems. But you should also be aware of the impact that pension reform has on public education. This brief guide shows you how and why pension programs affect your state's efforts to attract and retain the best teachers. It…
Alper, M. E.
Approximately four years ago the Jet Propulsion Laboratory, under NASA sponsorship, began to devote some of its resources to examining ways to transfer space technology to the civil sector. As experience accumulated under this program, certain principles basic to success in technology transfer became apparent. An adequate definition of each problem must be developed before any substantial effort is expended on a solution. In most instances, a source of funds other than the potential user is required to support the problem definition phase of the work. Sensitivity to the user's concerns and effective interpersonal communications between the user and technical personnel are essential to success.
Infante Durana, Maria Dolores
This dissertation looks into the reasons that pushed European countries to liberalize their electricity industries. The analysis of the political process leading to that decision in the areas pioneers of regulatory reform in this sector (United Kingdom, Sweden and the European Commission) shows that the liberalization of the European power sectors does not conform to the traditional theoretical explanations for regulatory reform that put interests and industry-specific considerations at the forefront of the explanation. The central argument of this dissertation is that, contrary to what most of the literature assumes and the theories predict, the primary impetus for the reforms in European electricity sectors did not come from industrial or economic worries, but rather from a neo-liberal turn to the ideas shared by European intellectual and political elites. The reform followed a political spill-over process by which the liberalization policy was emulated and introduced as a direct result of the international and sectoral diffusion of the new "efficiency regime" and the belief in the economic superiority of free markets over any form of government intervention. As an idea-driven policy, liberalization was not always coherent with the stated goals and, with means and ends that were not always consistent with each other, the reforms were often hampered and their results ambiguous. Liberalization transformed energy policy priorities in member states by adding the promotion and development of market-based mechanisms to the previous two of ensuring that security of supply, was adequate and of achieving ambitious environmental targets. By adding economic efficiency (and its political corollary, low prices) to its policy goals, governments effectively rendered the realization of the other two goals all the more difficult. As a result, liberalization did not entail the expected government disengagement from the affairs of the industry. On the contrary, it became
Vian, Taryn; Bicknell, William J
Lesotho has been implementing financial management reforms, including performance-based budgeting (PBB) since 2005 in an effort to increase accountability, transparency and effectiveness in governance, yet little is known about how these efforts are affecting the health sector. Supported by several development partners and $24 million in external resources, the PBB reform is intended to strengthen government capacity to manage aid funds directly and to target assistance to pressing social priorities. This study designed and tested a methodology for measuring implementation progress for PBB reform in the hospital sector in Lesotho. We found that despite some efforts on the national level to promote and support reform implementation, staff at the hospital level were largely unaware of the purpose of the reform and had made almost no progress in transforming institutions and systems to fully realize reform goals. Problems can be traced to a complex reform design, inadequate personnel and capacity to implement, professional boundaries between financial and clinical personnel and weak leadership. The Lesotho reform experience suggests that less complex designs for budget reform, better adapted to the context and realities of health sectors in developing countries, may be needed to improve governance. It also highlights the importance of measuring reform implementation at the sectoral level. PMID:23293099
Clark, Robert L; Mitchell, Olivia S
Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. PMID:25479891
In this dissertation, I study the performance impact of information technology (IT) investments in the public sector. IT has been one of the key assets in public administration since the early MIS era. Even though the information systems (IS) discipline has witnessed a considerable amount of research efforts on the subject of IT business value for…
... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procurement under public sector procedures. 201.22 Section 201.22 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Procurement Procedures; Responsibilities of Importers § 201.22 Procurement under public...
... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procurement under public sector procedures. 201.22 Section 201.22 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Procurement Procedures; Responsibilities of Importers § 201.22 Procurement under public...
... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procurement under public sector procedures. 201.22 Section 201.22 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Procurement Procedures; Responsibilities of Importers § 201.22 Procurement under public...
Smith, David A.
This report provides an overview of the training and education received by public sector employees, estimates of public funds expended for this training, recent trends, and identification of policy issues for future study. Chapter 1, an introduction, summarizes the content of chapters 2 and 3. Chapter 2 describes the major portions of the public…
Giovanella, Lígia; Stegmüller, Klaus
The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms' impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems. PMID:25493982
Edward James, workstream lead, Estates, Facilities and Professional Services Workstream, at NHS London Procurement Partnership (pictured), looks at the workings and benefits of Dynamic Purchasing Systems--electronic systems used by a public bodies to purchase commonly used goods, works, or services. One of the major benefits, he explains, is that under a 'DPS'--an 'open market' system revised in 2015--smaller businesses have a greater opportunity to win business than in traditional ('closed') framework agreements. PMID:27132302
Ibragimov, A Iu; Asadov, D A; Menlikulov, P R
The article covers the directive documents regulating the development of public health. The main directions of reforms of public health system of the Republic of Uzbekistan are covered too. The statistical data reflecting the structural changes in public health is presented. The purpose and tasks of reformation of the key public health issues in the Republic of Uzbekistan are explained. PMID:23373349
Ramos, Tomás B; Alves, Inês; Subtil, Rui; Joanaz de Melo, João
The development of environmental performance policy indicators for public services, and in particular for the defence sector, is an emerging issue. Despite a number of recent initiatives there has been little work done in this area, since the other sectors usually focused on are agriculture, transport, industry, tourism and energy. This type of tool can be an important component for environmental performance evaluation at policy level, when integrated in the general performance assessment system of public missions and activities. The main objective of this research was to develop environmental performance policy indicators for the public sector, specifically applied to the defence sector. Previous research included an assessment of the environmental profile, through the evaluation of how environmental management practices have been adopted in this sector and an assessment of environmental aspects and impacts. This paper builds upon that previous research, developing an indicator framework--SEPI--supported by the selection and construction of environmental performance indicators. Another aim is to discuss how the current environmental indicator framework can be integrated into overall performance management. The Portuguese defence sector is presented and the usefulness of this methodology demonstrated. Feasibility and relevancy criteria are applied to evaluate the set of indicators proposed, allowing indicators to be scored and indicators for the policy level to be obtained. PMID:16580128
Zodpey, Sanjay P.; Negandhi, Himanshu; Yeravdekar, Rajiv
Health systems globally are experiencing a shortage of competent public health professionals. Public health education across developing countries is stretched by capacity generation and maintaining an adequate ‘standard’ and ‘quality’ of their graduate product. We analyzed the Indian public health education scenario using the institutional and instructional reforms framework advanced by the Lancet Commission report on Education of Health Professionals. The emergence of a new century necessitates a re-visit on the institutional and instructional challenges surrounding public health education. Currently, there is neither an accreditation council nor a formal structure or system of collaboration between academic stakeholders. Health systems have little say in health professional training with limited dialogue between health systems and public health education institutions. Despite a recognized shortfall of public health professionals, there are limited job opportunities for public health graduates within the health system and absence of a structured career pathway for them. Public health institutions need to evolve strategies to prevent faculty attrition. A structured development program in teaching–learning methods and pedagogy is the need of the hour. PMID:25295242
Rivera, William M.
This paper is organized into two main sections. The first section examines extension as an engine for innovation and reviews the numerous priorities confronting extension systems. Section two highlights the current knowledge imperative and the critical connection of extension to post-secondary higher education and training, organizational…
Schmandt, J. (Editor)
The NASA Meal System was developed with three simple concepts in mind: (1) nutritious, conventional foods are packaged in single-serving units and assembled into complete meals; (2) the meals have an extended shelf-life and can be transported and stored without need for refrigeration or freezing; (3) preparation of the meal by the consumer is an easy task which is accomplished in ten minutes or less. The meal system was tested in 1975 and 1976 by different groups of elderly individuals. NASA and the LBJ School of Public Affairs sponsored a national conference to report on the demonstration of the meal system for the elderly and to explore potential uses of the system for social services, institutional feeding programs, disaster relief, and international aid. The proceedings of the conference and how different groups assessed the potential of the meal system are reported.
Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen) 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines) to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme initiated a reform programme
Fajans, Peter; Simmons, Ruth; Ghiron, Laura
Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability. PMID:16449594
Lake Snell Perry & Associates, Inc., Washington, DC.
A recent national survey of U.S. adults examined public opinion about welfare reform and measured support for specific policy recommendations. Respondents report ambivalence about the success of welfare reform, though they agree on what the goals of welfare should be and what shape future reforms should take. They favor welfare policies that help…
Brookhart, Susan M.
The United States education system depends on legislation and funding at the federal, state and local levels. Public understanding of assessment therefore is important to educational reform in the USA. Educational reformers often invoke assessment information as a reason for reform, typically by citing unacceptable achievement on some measure or…
The Australian Federal and state governments have been introducing neoliberal reforms to the governance of their education systems for a number of decades. One of the most recent programs of reform is the Western Australian Independent Public Schools (IPS) initiative. Similar to decentralizing reforms around the world, the IPS program seeks…
Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…
... 29 Labor 3 2011-07-01 2011-07-01 false Exclusion for public sector employers. 801.10 Section 801.10 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Exemptions § 801.10 Exclusion...
... 29 Labor 3 2012-07-01 2012-07-01 false Exclusion for public sector employers. 801.10 Section 801.10 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Exemptions § 801.10 Exclusion...
... 29 Labor 3 2014-07-01 2014-07-01 false Exclusion for public sector employers. 801.10 Section 801.10 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Exemptions § 801.10 Exclusion...
... 29 Labor 3 2013-07-01 2013-07-01 false Exclusion for public sector employers. 801.10 Section 801.10 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS APPLICATION OF THE EMPLOYEE POLYGRAPH PROTECTION ACT OF 1988 Exemptions § 801.10 Exclusion...
Hill, LaVerne Williamson
Decision making in the public sector encompasses many topics of interest to the academic researcher--environmental issues, health and human services, budget planning, and so on. Expertise in data collection and analysis is critical to the policy-making process and can be provided by academic researchers. But the "real world" policymaker…
Olsheski, Jerry; Growick, Bruce
In 1979, Ohio passed a law creating a Rehabilitation Division within its Industrial Commission and authorizing the building of two comprehensive rehabilitation centers to serve disabled workers. Ohio provides industrial rehabilitation services almost entirely through the public sector. This paper describes industrial rehabilitation policies and…
Berkovich, Izhak; Foldes, Vincent Jonathan
Purpose: The purpose of this article is to address the involvement of third sector organizations in state public education in Israel, with emphasis on the decision-making processes affecting the geographic distribution of service provision. Design/methodology/approach: A collective case study approach was used to investigate non-governmental…
Neal, Richard G.
This guide contains practical, field-tested advice concerning the development of a suitable negotiating strategy for management's use in public sector collective bargaining. The author stresses that strategies are long-term plans of action and that this book does not consider bargaining tactics--the individual methods used to achieve the strategic…
van Loo, Jasper B.
HRD is extensively concerned with human capital investment, but only focuses on how skills and knowledge become obsolete to a limited extent. In this paper we look at the speed of obsolescence. Using data from a survey among Dutch public sector employees, we find that the yearly rate of skills obsolescence is 2.6%. Subsequent analyses show that…
Conrad, Cynthia; Coleman, Charles
Teaching Chinese students in an American university can be both challenging and rewarding. Cultural and language differences can lead to some superficial confusion and interpretational problems. However, the vast differences in the ways Chinese students view the role of the public sector, as compared to the US, can mean that the instructors and…
Chouinard, Jill Anne
In the original paper, it was argued that while there is an array of methods and methodologies available, their use is delimited by the culture of accountability that prevails in public sector institutions, a fact that is particularly problematic given the complexity and diversity of evaluation contexts today. This short rejoinder, to responses…
Heinrich, Carolyn J.; Marschke, Gerald
We use the principal-agent model as a focal theoretical frame for synthesizing what we know, both theoretically and empirically, about the design and dynamics of the implementation of performance management systems in the public sector. In this context, we review the growing body of evidence about how performance measurement and incentive systems…
Grodin, Joseph R.
Having analyzed the records of all Nevada factfinding cases in 1972 and 1973, and interviewed most principals involved, the author concludes that Nevada's experience shows that arbitration of public sector disputes can be consistent with both effective bargaining and political responsibility. (Author/MW)
Shifman, Burton R.
This paper focuses on recent, significant court decisions in public sector collective bargaining under the following categories: the job security clause, the choice of instructional materials as the province of the school board under collective bargaining agreements, the effect of open meetings acts on the board of education in collective…
The aim of this article is to discuss how learning opportunities can be organized to promote expansive learning in work practice. The discussion draws on results from a case study examining local development work and conditions that facilitate processes of expansive learning in a work team within a public sector organization in a Swedish…
Ali, Raja Haslinda Raja Mohd; Mohamad, Rosli; Sudin, Suhizaz
Growing interest over big data mainly linked to its great potential to unveil unforeseen pattern or profiles that support organisation's key business decisions. Following private sector moves to embrace big data, the government sector has now getting into the bandwagon. Big data has been considered as one of the potential tools to enhance service delivery of the public sector within its financial resources constraints. Malaysian government, particularly, has considered big data as one of the main national agenda. Regardless of government commitment to promote big data amongst government agencies, degrees of readiness of the government agencies as well as their employees are crucial in ensuring successful deployment of big data. This paper, therefore, proposes a conceptual framework to investigate perceived readiness of big data potentials amongst Malaysian government agencies. Perceived readiness of 28 ministries and their respective employees will be assessed using both qualitative (interview) and quantitative (survey) approaches. The outcome of the study is expected to offer meaningful insight on factors affecting change readiness among public agencies on big data potentials and the expected outcome from greater/lower change readiness among the public sectors.
Carpenter, Jacqueline; Doverspike, Dennis; Miguel, Rosanna F.
According to public service motivation theory, individuals with a strong public service orientation are attracted to government jobs. This proposition was investigated in three studies by measuring public sector motivation at a pre-entry level as an individual difference variable affecting perceptions of fit and organizational attraction. Results…
Segura, Angela María; Rey, Juan José; Arbelaéz, María Patricia
We describe the changes that have been presented in the tendencies of mortality and hospital discharges by tuberculosis (TB) between 1985-1999, period before and during the implementation of the Health Sector Reform (HSR) in Colombia. For it, we carried out an exploratory descriptive study with analysis of time series of hospital discharges and mortality rates of TB in Colombia. It was found that although starting from 1991 the Series approach stabilized, their tendencies showed a significant descent diminishing both in 30% between 1985 and 1990. The steady trend registered from 1991 to 1999, could be explained by deterioration of the primary care during this period, also due to other complex social processes occurred in Colombia during this decade, which barred the continuing the descent trend in hospital discharges and mortality due to TB previously registered. Due to the study design limitations we cannot establish causal relationships between these trends and the health sector reform in the country; we recommend the improvement the health sector performance about public health problems such as TB in order to avoid unnecessary hospitalizations and deaths due to causes responsive to health sector interventions. PMID:15495579
Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur
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. PMID:17917199
In both Switzerland and Germany, necessary reforms in vocational education have been taking place for the past few years. By taking a closer look at the commerce sectors of both countries and their reforms, one can better compare their systems of apprenticeship. While the necessity for change in the commercial sector was similar in both countries,…
Monahan, Amy B.
There is significant interest in reforming retirement plans for public school employees, particularly in light of current market conditions. This paper presents an overview of the various types of state regulation of public pension plans that affect possibilities for reform. Several states have legal protections that effectively prevent a state…
The Healthcare Leadership Council (HLC) was formed in 1990 by 50 CEOs of hospitals, hospital systems, pharmaceutical companies, medical device manufacturers, Insurers and medical professionals. HLC is a coalition to develop the necessary consensus to realistically influence health care reforms. HLC urges that the "U.S. public policy goal should be to seek the best mechanism for balancing quality, access and affordability." As for access for the poor, the HLC would standardize eligibility for Medicaid at the federal poverty level, establishing a minimum basic benefit and payment plan with funding to come from specific taxes. For the employed uncovered, HLC would extend the exemption from state mandates to small employers; enact appropriate market reforms and provide income-related subsidies for those near the poverty line and for small employers; encourage employer-provided coverage for all employees on a voluntary basis.... HLC also backs state subsidized uninsurable risk pools for people whose conditions would make premiums too expensive. As for affordability of health care, HLC says consumers should become involved in cost-effective health care plans, appropriate employee cost sharing, lifestyle incentives/penalties, etc. Also, legislation should be overridden that inhibits innovation, creativity (state-mandated benefits, restrictions on selective contracting, CON requirements...), and medical malpractice tort reform measures also should be enacted. What follows is an in-depth interview with HLC Chairman G. Robert O'Brien, president of CIGNA Employee Benefits Companies. PMID:10109943
... SECURITY Federal Emergency Management Agency Public Meetings of National Flood Insurance Program (NFIP) Reform Effort AGENCY: Federal Emergency Management Agency, DHS. ACTION: Announcement of public meetings... Effort. In performing its mission, the Federal Emergency Management Agency (FEMA) believes it...
Hy, Ronald John
Public sector spending on health care clearly has a positive economic impact on local communities. Not only does such spending provide residents with better health care, but it is widely recognized as an investment that returns continual dividends in the form of better jobs, higher incomes, and additional state and local tax revenues. The results of a static input/output model shows that public sector spending on health care of approximately $46 billion (in 2009 dollars) in the state of Texas yields over 588,000 jobs, $74.2 billion in total output, $26.3 billion in personal income, $22 billion in employee compensation, and $1.8 billion in state and local taxes; it clearly has a considerable positive economic impact on local economies and their quest for economic development. PMID:22106548
Anuskiewicz, T.; Johnston, J.; Zimmerman, R. R.
Current activities of the program to accelerate specific applications of space related technology in major public sector problem areas are summarized for the period 1 June 1971 through 30 November 1971. An overview of NASA technology, technology applications, and supporting activities are presented. Specific technology applications in biomedicine are reported including cancer detection, treatment and research; cardiovascular diseases, diagnosis, and treatment; medical instrumentation; kidney function disorders, treatment, and research; and rehabilitation medicine.
Gómez, Elsa Gómez
Gender equity is increasingly being acknowledged as an essential aspect of sustainable development and more specifically, of health development. The Pan American Health Organization's Program for Women, Health, and Development has been piloting for a year now a project known as Equidad de género en las políticas de reforma del sector de salud, whose objective is to promote gender equity in the health sector reform efforts in the Region. The first stage of the project is being conducted in Chile and Peru, along with some activities throughout the Region. The core of the project is the production and use of information as a tool for introducing changes geared toward achieving greater gender equity in health, particularly in connection with malefemale disparities that are unnecessary, avoidable, and unfair in health status, access to health care, and participation in decision-making within the health system. We expect that in three years the project will have brought about changes in the production of information and knowledge, advocacy, and information dissemination, as well as in the development, appropriation, and identification of intersectoral mechanisms that will make it possible for key figures in government and civil society to work together in setting and surveying policy on gender equity in health. PMID:12162842
This study seeks an explanation for the neglect of state building in Russia. The major hypothesis is that dependence on external rent leads to the weakness of the state. Three intervening variables---transaction costs, bargaining power of the state, and discount rates---are posited to explain variance on the dependent variable, the weakness of the state. Based on the exploration of three dimensions of energy sector reform, the dissertation argues that in the short run resource rents may be the only reliable and adequate source of finance for the Russian government. The division of resource rents among the many claimants (state vs. business, state vs. society, Moscow vs. regions, and Russia vs. foreign companies), it submits, will pose a stringent test of the viability of democratic governance in Russia. The dissertation concludes that some evidence indicates that Russia has in fact met the characteristics of the rentier state. The greater reliance on a large resource sector for revenue has led to high transaction costs of tax collection, weak bargaining power of the state, and high discount rates of government officials in Russia.
Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs
China's healthcare system is experiencing significant growth from expanded government-backed insurance, greater public-sector spending on hospitals, and the introduction of private insurance and for-profit clinics. An incremental reform process has sought to develop market incentives for medical innovation and liberalize physician compensation and hospital finance while continuing to keep basic care affordable to a large population that pays for many components of care out-of-pocket. Additional changes presently under consideration by policymakers are likely to further restructure insurance and the delivery of care and will alter competitive dynamics in major healthcare industries, notably pharmaceuticals, medical devices, and diagnostic testing. This article describes the institutional history of China's healthcare system and identifies dilemmas emerging as the country negotiates divisions between public and private in healthcare. Building on this analysis, the article considers opportunities for public-private partnerships and greater systems integration to reconcile otherwise incommensurable approaches to rewarding innovation and improving access. The article concludes with observations on the public function of health insurance and its significance to further development of China's healthcare system. PMID:24052932
Indiana Univ., Bloomington. Midwest Center for Public Sector Labor Relations.
The purpose of this guide is to answer common questions about public sector labor relations with special emphasis on how this sector differs from the private sector. A beginning section offers general information defining and explaining public sector labor relations. A segment on labor relations law details legislation and the function of…
De Paepe, Pierre; Echeverría Tapia, Ramiro; Aguilar Santacruz, Edison; Unger, Jean-Pierre
Health sector reform was implemented in many Latin American countries in the 1980s and 1990s, leading to reduced public expenditure on health, limitations on public provision for disease control, and a minimum package of services, with concomitant growth of the private sector. At first sight, Ecuador appeared to follow a different pattern: no formal reform was implemented, despite many plans to reform the Ministry of Health and social health insurance. The authors conducted an in-depth review and analysis of published and gray literature on the Ecuadorian health sector from 1990 onward. They found that although neoliberal reform of the health sector was not openly implemented, many of its typical elements are present: severe reduction of public budgets, "universal" health insurance with limited coverage for targeted groups, and contracting out to private providers. The health sector remains segmented and fragmented, explaining the population's poor health status. The leftist Correa government has prepared an excellent long-term plan to unite services of the Ministry of Health and social security, but implementation is extremely slow. In conclusion, the health sector in Ecuador suffered a "silent" neoliberal reform. President Correa's progressive government intends to reverse this, increasing public budgets for health, but hesitates to introduce needed radical changes. PMID:22611652
Wang, Jia; Xie, Yu
Situated in China’s market transition, this study examines the relationship between economic sector and a worker’s happiness in post-reform urban China. Using datasets from the Chinese General Social Surveys 2003, 2006 and 2008, we find that workers in the state sector enjoy a subjective premium in well-being – reporting significantly higher levels of happiness than their counterparts in the private sector. We also find that during a period when a large wave of workers moved from the state sector to the private sector, those remaining in the state sector reported being significantly happier than did former state sector workers who had moved, whether the move was voluntary or involuntary. We attribute the higher level of reported happiness in the state sector than in the private sector to the disparity by sector in the provision of social welfare benefits. Those who made voluntary state-to-private moves experienced a trade-off in enjoying higher payoffs while losing job security, whereas involuntary mobiles experienced downward mobility and suffered a long-term psychological penalty. PMID:26188448
Wang, Jia; Xie, Yu
Situated in China's market transition, this study examines the relationship between economic sector and a worker's happiness in post-reform urban China. Using datasets from the Chinese General Social Surveys 2003, 2006 and 2008, we find that workers in the state sector enjoy a subjective premium in well-being - reporting significantly higher levels of happiness than their counterparts in the private sector. We also find that during a period when a large wave of workers moved from the state sector to the private sector, those remaining in the state sector reported being significantly happier than did former state sector workers who had moved, whether the move was voluntary or involuntary. We attribute the higher level of reported happiness in the state sector than in the private sector to the disparity by sector in the provision of social welfare benefits. Those who made voluntary state-to-private moves experienced a trade-off in enjoying higher payoffs while losing job security, whereas involuntary mobiles experienced downward mobility and suffered a long-term psychological penalty. PMID:26188448
Walker, Richard M.; Boyne, George A.
We present the first empirical assessment of the U.K. Labour government's program of public management reform. This reform program is based on rational planning, devolution and delegation, flexibility and incentives, and enhanced choice. Measures of these variables are tested against external and internal indicators of organizational performance.…
Mukhtar, Mohammed Ibn
Public management and administration today is about crafting, structuring and instituting. Structuration is a very integral part of all organisations. Unlike the gradualist approach, structural reform transforms the dominant system touching on main elements. Structural reform had largely come and gone without necessarily touching on some public…
Berry, Barnett; And Others
The Chattanooga (Tennessee) public schools are building a national reputation for the work they are doing to improve the city's schools. The Edna McConnell Clark Foundation, which has promised substantial grants for the reform of urban middle school education in Chattanooga, asked the Southern Education Foundation, through its Focused Reporting…
Hope, Kempe Ronald, Sr.
The purpose of this article is to provide an assessment and analysis of public sector performance contracting as a performance management tool in Kenya. It aims to demonstrate that performance contracting remains a viable and important tool for improving public sector performance as a key element of the on-going public sector transformation…
A growing body of research supports the idea that large scale school reform efforts often fail to create sustained change within the public school sector. Proponents of school reform argue that implementing school reform, effectively and with fidelity, can work to ensure the success of reform initiatives in public education. When implementing deep…
This report reviews the activities, strategies, successes, and problems of diverse school reform efforts across a 14-state sample of community organizations. In 1999 and 2000, interviewers visited over 40 organizations and conducted telephone interviews with dozens of other organizations involved in education reform. They met with directors,…
Nordgren, R. D.
School reform in the past several decades has taken a "modernist" bent in that it has focused on quantitatively based accountability systems modeled after business (Ravitch, 2013; Tienken & Orlich, 2013). The author uses a model devised by a Finnish scholar to demonstrate that 1) these reforms are indeed modernist, and 2) the private…
Bray, Judy; Medler, Alex
Denver is currently in the national education spotlight, largely because of its willingness to try a unique combination of major education reforms not seen in other large urban school districts. While many observers hold these reforms in high regard, a steep road lies ahead. Current student results are unacceptable by all measures. The time is…
Addonizio, Michael F.
Discusses state efforts to link education reform with educational adequacy. Describes four approaches for investigating this linkage: statistical modeling, empirical observation, professional judgment, and whole-school design. Investigates educational adequacy in Michigan's school-finance reform efforts by examining urban school districts. Finds…
Reville, S. Paul, Ed.
In the last decade, the Boston Public Schools has undergone critical reforms that have been of intense interest to school leaders and policymakers throughout the country. Under the leadership of superintendent Thomas Payzant, the Boston schools implemented extensive reform strategies that yielded notable results. Fittingly, at the end of Payzant's…
This paper reviews New York City Mayor Michael Bloomberg's education reform agenda, "Children first", in the light of organizational theory. I argue that this reform agenda reflects both coercive and mimetic isomorphism, as Bloomberg uses mayoral control to apply business concepts and practices to New York City's public school system. Through…
Vergara I, Marcos
Currently, there is no discussion on the need to improve and strengthen the institutional health care modality of FONASA (MAI), the health care system used by the public services net and by most of the population, despite the widely known and long lasting problems such as waiting lists, hospital debt with suppliers, lack of specialists and increasing services purchase transference to the private sector, etc. In a dichotomous sectorial context, such as the one of healths social security in Chile (the state on one side and the market on the other), points of view are polarized and stances tend to seek refuge within themselves. As a consequence, to protect the public solution is commonly associated with protecting the status quo, creating an environment that is reluctant to change. The author proposes a solution based on three basic core ideas, which, if proven effective, can strengthen each other if combined properly. These are: network financing management, governance of health care services in MAI and investments and human resources in networked self-managed institutions. The proposal of these core ideas was done introducing a reality testing that minimizes the politic complexity of their implementation. PMID:25860366
Kober, Katharina; Van Damme, Wim
Background The lack of human resources for health (HRH) is increasingly being recognized as a major bottleneck to scaling up antiretroviral treatment (ART), particularly in sub-Saharan Africa, whose societies and health systems are hardest hit by HIV/AIDS. In this case study of Swaziland, we describe the current HRH situation in the public sector. We identify major factors that contribute to the crisis, describe policy initiatives to tackle it and base on these a number of projections for the future. Finally, we suggest some areas for further research that may contribute to tackling the HRH crisis in Swaziland. Methods We visited Swaziland twice within 18 months in order to capture the HRH situation as well as the responses to it in 2004 and in 2005. Using semi-structured interviews with key informants and group interviews, we obtained qualitative and quantitative data on the HRH situation in the public and mission health sectors. We complemented this with an analysis of primary documents and a review of the available relevant reports and studies. Results The public health sector in Swaziland faces a serious shortage of health workers: 44% of posts for physicians, 19% of posts for nurses and 17% of nursing assistant posts were unfilled in 2004. We identified emigration and attrition due to HIV/AIDS as major factors depleting the health workforce. The annual training output of only 80 new nurses is not sufficient to compensate for these losses, and based on the situation in 2004 we estimated that the nursing workforce in the public sector would have been reduced by more than 40% by 2010. In 2005 we found that new initiatives by the Swazi government, such as the scale-up of ART, the introduction of retention measures to decrease emigration and the influx of foreign nurses could have the potential to improve the situation. A combination of such measures, together with the planned increase in the training capacity of the country's nursing schools, could even reverse
Kaproń, Danuta; Stephan, Werner
The involvement of the public in educational reform processes in modern democratic societies primarily serves the purpose of politically legitimizing the reform agenda. This study examines the rationales implicitly or explicitly submitted to the public to explain why educational reforms in the two countries should be endorsed. Although differences in the political culture caution against a hasty comparison of the two case studies, a number of politico-economic similarities allow for a valid juxtaposition. In Poland the context of socio-political and economic renewal prompted the reformers to emphasize the human-capital model which heightened public awareness and participation in the debate surrounding the reform. Public involvement in Saskatchewan was negatively affected for mainly two reasons. First, the government evidently manipulated public input by various means and thereby appears to have predetermined the outcome. Second, the rationale for the reform, based on a free-market model, tightened the linkage between the needs of the labour market and the mandate of the schools. As a result, public interest and participation was greatly diminished.
Mahmood, Qamar; Muntaner, Carles
Universal access to healthcare has assumed renewed importance in global health discourse, along with a focus on strengthening health systems. These developments are taking place in the backdrop of concerted efforts to advocate moving away from vertical, disease-based approaches to tackling health problems. While this approach to addressing public health problems is a step in the right direction, there is still insufficient emphasis on understanding the socio-political context of health systems. Reforms to strengthen health systems and achieve universal access to healthcare should be cognizant of the importance of the socio-political context, especially state-society relations. That context determines the nature and trajectory of reforms promoting universality or any pro-equity change. Brazil and Venezuela in recent years have made progress in developing healthcare systems that aim to achieve universal access. These achievements are noteworthy given that, historically, both countries had a long tradition of healthcare systems which were highly privatized and geared towards access to healthcare for a small segment of the population while the majority was excluded. These achievements are also remarkable since they took place in an era of neoliberalism when many states, even those with universally-based healthcare systems, were moving in the opposite direction. We analyze the socio-political context in each of these countries and look specifically at how the changing state-society relations resulted in health being constitutionally recognized as a social right. We describe the challenges that each faced in developing and implementing healthcare systems embracing universality. Our contention is that achieving the principle of universality in healthcare systems is less of a technical matter and more a political project. It involves opposition from the socially conservative elements in the society. Navigation to achieve this goal requires a political strategy that
Bhatia, Jagdish; Cleland, John
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. PMID:15459165
Tsigilis, Nikolaos; Zachopoulou, Evridiki; Grammatikopoulos, Vasilios
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…
For more than a decade, competence development has been a key concept of modern management in both the private and the public sector, but to some extent its meaning and practice have been different in the two sectors. In the public sector in particular, competence development has been closely related to a number of other buzzwords characterizing…
In 1992, Congress enacted the HOPE VI program to overhaul the nation's public housing policy. The reform legislation was prompted by a report commissioned by Congress that deemed two-thirds of all public housing "severely distressed." Since the landmark public housing policy was enacted in 1992, the Department of Housing and Urban Development…
Singh, Michael; Chen, Xiafang; Harreveld, Bobby
This working paper "investigates" the role of Vocational Education and Training in Schools (VETiS) in providing leaders with a driver for reforming Senior L/earning (Years 10, 11 and 12). Using a "case study methodology", this paper explores the collaboration and cooperation across different borders and sectors among leaders in the reform to…
Hutchinson, Marie; Jackson, Debra
Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing. PMID:25131347
Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M
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. PMID:23161587
Drezner, Jeffrey Alan
Understanding why government officials behave in certain ways under particular circumstances is an important theme in political science. This research explores the design of policies and incentives targeted at public sector officials, in particular the use of market based policy tools in a non-market environment, and the influence of that organizational environment on the effectiveness of the policy. The research examines the case of Department of Defense (DoD) facility energy management. DoD energy policy includes a provision for the retention of savings generated by conservation activities: two-thirds of the savings is retained at the installation generating the savings, half to used for further investment in energy conservation, and half to be used for general morale, welfare, and recreation activities. This policy creates a financial incentive for installation energy managers to establish higher quality and more active conservation programs. A formal written survey of installation energy managers within DoD was conducted, providing data to test hypotheses regarding policy effectiveness and factors affecting policy implementation. Additionally, two detailed implementation case studies were conducted in order to gain further insights. Results suggest that policy design needs to account for the environment within which the policy will be implemented, particularly organizational culture and standard operating procedures. The retention of savings policy failed to achieve its intended outcome---retention of savings for re-investment in energy conservation---because the role required of the financial management community was outside its normal mode of operation and interests and the budget process for allocating resources did not include a mechanism for retention of savings. The policy design did not adequately address these start-up barriers to implementation. This analysis has shown that in order for retention of savings, or similar policies based on market
Otieno, Wycliffe; Levy, Daniel
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…
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…
Hogan, Michael F.
BACKGROUND: In the United States, there is an uneasy division of responsibility for financing mental health care. For most illnesses, employer-sponsored health insurance and the large federal health insurance programs (Medicare, Medicaid) cover the costs of care. However, most employer-sponsored plans and Medicare provide only limited coverage for treatment of mental illness. A possible cause and result of this limited coverage in mental health is that states, and in some cases local (county) governments, finance a separate system of mental health care. This separate "public mental health system" provides a "safety net" of care for indigent individuals needing mental health care. However, there are potential negative consequences of maintaining separate systems. Continuity of treatment between systems may be impaired, and costs may be higher due to duplicate administrative costs. Maintaining a separate system managed by government may exacerbate the stigma associated with mental illness treatment. Most significantly, since eligibility for care may be linked to poverty status, and since having a serious mental illness may preclude regaining private coverage, maintaining a separate system may contribute to the poverty rate among persons with mental illnesses. AIMS OF THE PAPER: These potential problems have not been widely considered, perhaps because other problems and controversies in mental health care have captured our attention. In particular, controversies over deinstitutionalization in mental health have dominated the policy debate, especially when linked to related problems. These have included conflicts over authority and financial responsibility among federal, state and local governments, sensationalized media coverage of incidents involving people with mental illness, problems with siting community facilities, concern about mental illness among prisoners and the like. However, with the substantial reform of public mental health care in some states and
Voon, Lok Lew Yan
This talk will document my and associated colleagues' impact on physics pedagogy at the two universities I have been employed at from my initiation at the New Faculty Workshop as an assistant professor in 1998 to being currently a full professor and chair. The present reforms involving our introductory physics courses are connected to our science education program.
Apelt, Linda; Lingard, Bob
The rhetoric of current blueprints for (Australian) school reform must be scrutinized to ensure a power redistribution furthering improved outcomes for more students, particularly the least advantaged. A desirable social justice outcome might be achieved through blending equality aspects ensured by the old centralized system with the progressive…
Kottkamp, Robert B.; Silverberg, Ruth P.
The purpose of this study is to capture "insider" perspectives of professors in the forefront of transforming university leadership preparation programs. From interviews, we constructed first person narratives and developed "story threads" demonstrating related sequences of their thought and action in reform work. After developing themes based on…
Evers, Williamson M., Ed.; Izumi, Lance T., Ed.; Riley, Pamela A., Ed.
This book presents a collection of recent articles on the problems in today's schools, why school and students are underperforming, exploring a range of topics and explaining why some reforms in education are destined to fail while others have been proven to work. The first section, "Teaching Approaches," presents articles on progressive…
Background: India’s health sector witnessed some major policy changes in 1990s that aimed at making health services more accessible to the population. Methods: In this paper, I tried to present some preliminary results of the significant changes that occurred between 1995/6 and 2004, especially in relation to the question of access to healthcare for the poor and rural population using data from 52nd (1995–6) and 60th round (2004) of National Sample Survey Organization on ‘morbidity and healthcare’. Results: The analysis suggests that overall utilization of healthcare services have declined and the odds of not seeking care due to financial inability has further increased among the poor and rural population during the period of reforms. Results of the multivariate logit regression model indicate that the non-poor, middle and above educated people were having greater likelihood of using services from private health care provider. Conclusion: Interestingly, poor and rural residents were more likely to have used healthcare from public facilities in 2004 than in 1995–6, suggesting that the shift from private to public sector is encouraging, provided they receive good quality health care services at public facilities and do not face catastrophic health expenditures. PMID:24757689
Ghanadan, Rebecca Hansing
Since the 1990s, power sector reforms have become paramount in energy policy, catalyzing a debate in Africa about market-based service provision and the effects of reforms on access. My research seeks to move beyond the conceptual divide by grounding attention not in abstract 'market forces' but rather in how development institutions shape energy services and actually practice policy on the ground. Using the case of Tanzania, a country known for having instituted some of the most extensive reforms and a 'success story' in Africa, I find that reforms are creating large burdens and barriers for access and use of services, including: increasing costs, enforcement pressures, and measures to impose 'market' discipline. However, I also find that many of the most significant outcomes are not found in direct 'market' changes, but rather how reforms are selective, partial, and shaped by the wider needs and claims of the institutions driving reforms, so that questions of how reforms are implemented, how they are measured, and who tells the story become as important as the policies themselves. Using a multiple-arenas framework, including (i) a household and community level study of urban energy conditions, (ii) a study of service and management conditions at the national electric utility, (iii) an examination of the international policy process, and (iv) a study of the history of electricity services across colonial, post-independence, and reform periods, I show that African energy reforms are a technical and political project connecting energy to international investments, donor aid programs, and elite interests within national governments. Energy reforms also involve fundamental service changes that are reorganizing how the costs and benefits of energy systems are distributed, allocated, and managed. The effects of reform extend beyond formal services to have wide-reaching repercussions within natural resources, and uneven social dynamics on the ground. These features point
The author of this paper investigates the relevance of Waldorf education for public urban school reform. Based on analysis of survey data from over 500 graduates of private U.S. Waldorf schools, review of documents from the Gates Foundation, and staff-interview and student-achievement data from four public Waldorf-methods schools, she develops…
... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Public Input on Reform of the Housing Finance System AGENCIES: Office of the Undersecretary for Domestic Finance, Department of the Treasury; Office of the Assistant... Development (HUD) seek public input on establishing a more stable and sound housing finance system....
Boston Public Schools, MA.
The Boston (Massachusetts) Public Schools present a comprehensive plan designed to bring all students to an acceptable level of mastery to meet state requirements or their own new higher standards. For the first time in decades, all the elements of school reform are in place, with public and administrative support. The primary goal of the Boston…
Torabi, Mohammad R.; Crowe, James W.
This study investigated national public opinion on school health education and the implications for health-care reform initiatives. Telephone surveys of 1,005 adults nationwide indicated that the public at large believes in the importance of health education to reduce health problems among children, considering it the responsibility of parents and…
Roy, Anish Kumar
To date the public sector role in facilitating the transition to a sustainable energy future has been envisaged mainly from a regulatory perspective. In such a role, the public sector provides the push factors---enforcing regulations and providing incentives---to correct market imperfections that impede energy transitions. An alternative and complementary role of the public sector that is now gaining increasing attention is that of catalyzing energy transitions through public sector energy management initiatives. This dissertation offers a conceptual framework to rationalize such a role for the public sector by combining recent theories of sustainable energy transition and public management. In particular, the framework identifies innovative public management strategies (such as performance contracting and procurement) for effectively implementing sustainable energy projects in government facilities. The dissertation evaluates a model of sustainable public sector energy management for promoting energy efficiency in Malaysia. The public sector in Malaysia can be a major player in leading and catalyzing energy efficiency efforts as it is not only the largest and one of the most influential energy consumers, but it also plays a central role in setting national development strategy. The dissertation makes several recommendations on how a public sector energy management strategy can be implemented in Malaysia. The US Federal Energy Management Program (FEMP) is used as a practical model. The analysis, however, shows that in applying the FEMP model to the Malaysian context, there are a number of limitations that will have to be taken into consideration to enable a public sector energy management strategy to be effectively implemented. Overall the analysis of this dissertation contributes to a rethinking of the public sector role in sustainable energy development that can strengthen the sector's credibility both in terms of governance and institutional performance. In
Courtney, M; Yacopetti, J; James, C; Walsh, A
During the past decade, economic and political forces have caused radical transformations in health care systems resulting in changed circumstances within which nursing executives must function. This paper provides an understanding of nursing executives' roles and responsibilities and the impact changes in the health industry have had on their careers. One hundred and forty-seven (52%) of the 281 nursing executives employed in the Queensland Public Health Sector completed a postal self-administered survey. The findings of this study demonstrate their role has expanded to include not only nursing administration, but also responsibility for financial, human resources, strategic and resource management, staff development and quality improvement. The impact of these role changes has affected the health and well-being of nursing executives, with nearly half reporting increased stress, frustration and irritation. Their workload has increased and some reported deterioration in their health, specifically, exhaustion, fatigue and insomnia. Respondents reported they now have less time to spend with families and friends, which has had a negative impact on family relationships. Overall, nursing executives were satisfied with their current position, the work itself and their relationships with their co-workers, but dissatisfied with organisational aspects, especially the quality of mentorship and opportunities for promotion. PMID:11496477
Zhang, Ju-Yang; Long, Ru-Yin; Yan, Hai; Yang, Qing; Yang, Bo
Purpose: Since the beginning of the new health care reform in 2009, the state has illustrated the top design and health care improvement strategy of "encouraging social capital to participate in the reform of public hospitals", in accordance with the program's general objective. All areas have been explored on this matter and the results obtained are very interesting, not to mention the acquisition of significant experience. At present, the existing business models in China are mainly the following: Rebuild-Operate-Transfer (ROT), franchise business model, Build-Own-Operate-Transfer (BOOT) model, mixed ownership model and business insurance model. This paper introduces a variety of alternative models, and provides a simple analysis of the advantages and disadvantages. Moreover, for the reform of public hospitals, the government shares should go into franchise mode or mixed ownership, and all property rights should be transferred to the government to ensure the conservation and proliferation of state-owned assets. PMID:27273961
Din, Siraj ud; Khan, Bakhtiar; Rehman, Rashid; Bibi, Zainab
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…
Neal, Richard G.
A supplement to an earlier-published volume on bargaining tactics, this document presents specific tactics that can be used in the course of public sector collective bargaining to further management's pre-established negotiating strategies. All the tactics suggested are drawn from the author's personal experience as a public sector labor…
Rasheed, Muhammad Imran; Humayon, Asad Afzal; Awan, Usama; Ahmed, Affan ud Din
Purpose: The purpose of this paper is to explore/investigate various issues of teachers ' motivation in public sector Higher Educational Institutions of Pakistan. Design/methodology/approach: This is an exploratory research where surveys have been conducted in the well known public sector Universities of Pakistan; primary data have been collected…
The paper compares private and public sector developments relating to radon mitigation in the U.S. In response to elevated radon levels in many U.S. houses, the Federal and State governments and the private sector have undertaken many varied mitigation and public information effo...
The monograph deals with disparities between public and private sector employment conditions and practices which affect the recruitment and retention of personnel. The emphasis is on state agencies because the disparities are most evident at that level of public sector employment...
In 2000, South Africa implemented a levy-grant policy (Skills Development Levies Act, 1999) to give an incentive for workplace training across private and public sector workplaces alike, but the impact of the levy-grant scheme in the public sector was restricted by financial and management processes unique to that environment. This article shows…
Stanton, Pauline; Bartram, Timothy; Harbridge, Raymond
This study investigates the impact on human resource management (HRM) practices in the public health sector in Victoria, Australia of two different government policy environments. First, it explores the Liberal Coalition Government's decentralisation of public health sector management, from 1992-1999 and second, the Labor Government's…
McPake, Barbara; Yepes, Francisco Jose; Lake, Sally; Sanchez, Luz Helena
Many countries are experimenting with public hospital reform - both increasing the managerial autonomy with which hospitals conduct their affairs, and separating 'purchaser' and 'provider' sides of the health system, thus increasing the degree of market pressure brought to bear on hospitals. Evidence suggesting that such reform will improve hospital performance is weak. From a theoretical perspective, it is not clear why public hospitals should be expected to behave like firms and seek to maximize profits as this model requires. Empirically, there is very slight evidence that such reforms may improve efficiency, and reason to be concerned about their equity implications. In Colombia, an ambitious reform programme includes among its measures the attempt to universalize a segmented health system, the creation of a purchaser-provider split and the transformation of public hospitals into 'autonomous state entities'. By design, the Colombian reform programme avoids the forces that produce equity losses in other developing countries. This paper reports the results of a study that has tried to track hospital performance in other dimensions in the post-reform period in Bogotá. Trends in hospital inputs, production and productivity, quality and patient satisfaction are presented, and qualitative data based on interviews with hospital workers are analyzed. The evidence we have been able to collect is capable of providing only a partial response to the study question. There is some evidence of increased activity and productivity and sustained quality despite declining staffing levels. Qualitative data suggest that hospital workers have noticed considerable changes, which include greater responsiveness to patients but also a heavier administrative burden. It is difficult to attribute specific causality to all of the changes measured and this reflects the inherent difficulty of judging the effects of large-scale reform programmes as well as weaknesses and gaps in the data
Shan, Ming; Chan, Albert P C; Le, Yun; Hu, Yi
Response strategy is a key for preventing widespread corruption vulnerabilities in the public construction sector. Although several studies have been devoted to this area, the effectiveness of response strategies has seldom been evaluated in China. This study aims to fill this gap by investigating the effectiveness of response strategies for corruption vulnerabilities through a survey in the Chinese public construction sector. Survey data obtained from selected experts involved in the Chinese public construction sector were analyzed by factor analysis and partial least squares-structural equation modeling. Analysis results showed that four response strategies of leadership, rules and regulations, training, and sanctions, only achieved an acceptable level in preventing corruption vulnerabilities in the Chinese public construction sector. This study contributes to knowledge by improving the understanding of the effectiveness of response strategies for corruption vulnerabilities in the public construction sector of developing countries. PMID:24894336
McCollum, Rosalind; Chen, Lieping; ChenXiang, Tang; Liu, Xiaoyun; Starfield, Barbara; Jinhuan, Zheng; Tolhurst, Rachel
China has recently placed increased emphasis on the provision of primary healthcare services through health sector reform, in response to inequitably distributed health services. With increasing funding for community level facilities, now is an opportune time to assess the quality of primary care delivery and identify areas in need of further improvement. A mixed methodology approach was adopted for this study. Quantitative data were collected using the Primary Care Assessment Tool-Chinese version (C-PCAT), a questionnaire previously adapted for use in China to assess the quality of care at each health facility, based on clients' experiences. In addition, qualitative data were gathered through eight semi-structured interviews exploring perceptions of primary care with health directors and a policy maker to place this issue in the context of health sector reform. The study found that patients attending community health and sub-community health centres are more likely to report better experiences with primary care attributes than patients attending hospital facilities. Generally low scores for community orientation, family centredness and coordination in all types of health facility indicate an urgent need for improvement in these areas. Healthcare directors and policy makers perceived the need for greater coordination between levels of health providers, better financial reimbursement, more formal government contracts and recognition/higher status for staff at the community level and more appropriate undergraduate and postgraduate training. PMID:23576191
Background Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector. Methods This was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011. Results Overall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards. Conclusion Our study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change. PMID:23298253
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…
Thompson, Ron; Robinson, Denise
The unprecedented degree of attention given to the learning and skills sector in England by successive New Labour governments has led to a significant increase in what is expected of the teaching workforce. To help meet these expectations, a "step change" in the quality of initial teacher training for the sector is promised, alongside provisions…
Several African countries instituted education reforms in the 1980s and 1990s. Yet, there is only little evidence on the effectiveness of these programs. Additionally, most previous studies of the determinants of literacy and numeracy have considered the proficiency in only one language and, possibly, numeracy. This paper examines both of these…
Herriot-Hatfield, Jennie; Monahan, Amy; Rosenberg, Sarah; Tucker, Bill
Just 18 minutes before the midnight signing deadline on May 15, 2010, Minnesota state legislators breathed a sigh of relief. Their bipartisan pension reform legislation, which passed both chambers by large margins and aimed to help shore up a potentially failing pension system, had just escaped a veto threat. Under pressure from his Republican…
Agasisti, Tommaso; Dal Bianco, Antonio
In this article, we analyse the effects of teaching reforms in Italy. These were introduced in 1999, and changed the entire organization of university courses, where the Bachelor-Master (BA-MA) structure was adopted. The first step is to define the production process of higher education (HE). This process consists of several inputs (professors,…
Craglia, Massimo; Friis-Christensen, Anders; Ostländer, Nicole; Perego, Andrea
INSPIRE is a European Directive aiming to establish a EU-wide spatial data infrastructure to give cross-border access to information that can be used to support EU environmental policies, as well as other policies and activities having an impact on the environment. In order to ensure cross-border interoperability of data infrastructures operated by EU Member States, INSPIRE sets out a framework based on common specifications for metadata, data, network services, data and service sharing, monitoring and reporting. The implementation of INSPIRE has reached important milestones: the INSPIRE Geoportal was launched in 2011 providing a single access point for the discovery of INSPIRE data and services across EU Member States (currently, about 300K), while all the technical specifications for the interoperability of data across the 34 INSPIRE themes were adopted at the end of 2013. During this period a number of EU and international initiatives has been launched, concerning cross-domain interoperability and (Linked) Open Data. In particular, the EU Open Data Portal, launched in December 2012, made provisions to access government and scientific data from EU institutions and bodies, and the EU ISA Programme (Interoperability Solutions for European Public Administrations) promotes cross-sector interoperability by sharing and re-using EU-wide and national standards and components. Moreover, the Research Data Alliance (RDA), an initiative jointly funded by the European Commission, the US National Science Foundation and the Australian Research Council, was launched in March 2013 to promote scientific data sharing and interoperability. The Joint Research Centre of the European Commission (JRC), besides being the technical coordinator of the implementation of INSPIRE, is also actively involved in the initiatives promoting cross-sector re-use in INSPIRE, and sustainable approaches to address the evolution of technologies - in particular, how to support Linked Data in INSPIRE and
What role does a person's support for local educational control play in determining her attitude towards equity-minded school finance reform? This article reports estimations of binary and ordered probit models of two state public opinion polls and discusses newspaper coverage from the same two states to determine if and how local control has such…
This program guide on welfare reform raises basic questions about different beliefs that influence public policy about welfare and what the welfare system ought to achieve. Four policy approaches are offered as a framework for discussion: (1) cut welfare for the able; (2) use welfare as a tool to require recipients to become more responsible; (3)…
By opening the system to competition, popular school choice reforms seek to remake public education into a more consumer-oriented endeavor. While the underlying theory holds that competitive pressures will induce change and improvement in educational processes, research indicates that organizations often respond instead by developing promotional…
McBride, Genevieve G.
Analysis of the Wisconsin woman suffrage campaign of 1910-1920 suggests that public relations belonged not only to political or business practices, but was equally a process by which the masses achieved their own best interests in nineteenth and early twentieth century social reform movements. Woman suffragists were led by women, and the public…
Him, Miki Suzuki; Hoşgör, Ayşe Gündüz
In this article, we examine how socioeconomically disadvantaged women are affected by health sector reform and family planning policy changes in Turkey through a case study of Kurdish women's struggles for birth control. In Turkey, a family planning program became relatively marginalized in primary health care services as a result of health sector reform as well as a shift of population policy toward a moderately pronatal approach. We argue that an emerging health care system would leave disadvantaged women unable to benefit from contraceptives and would perpetuate reproductive health inequalities between women in the country. PMID:24134209
Selway, Joel Sawat
How do changes in electoral rules affect the nature of public policy outcomes? The current evidence supporting institutional theories that answer this question stems almost entirely from quantitative cross-country studies, the data of which contain very little within-unit variation. Indeed, while there are many country-level accounts of how changes in electoral rules affect such phenomena as the number of parties or voter turnout, there are few studies of how electoral reform affects public policy outcomes. This article contributes to this latter endeavor by providing a detailed analysis of electoral reform and the public policy process in Thailand through an examination of the 1997 electoral reforms. Specifically, the author examines four aspects of policy-making: policy formulation, policy platforms, policy content, and policy outcomes. The article finds that candidates in the pre-1997 era campaigned on broad, generic platforms; parties had no independent means of technical policy expertise; the government targeted health resources to narrow geographic areas; and health was underprovided in Thai society. Conversely, candidates in the post-1997 era relied more on a strong, detailed national health policy; parties created mechanisms to formulate health policy independently; the government allocated health resources broadly to the entire nation through the introduction of a universal health care system, and health outcomes improved. The author attributes these changes in the policy process to the 1997 electoral reform, which increased both constituency breadth (the proportion of the population to which politicians were accountable) and majoritarianism. PMID:21591306
Moresi-Izzo, Stefania; Bankauskaite, Vaida; Gericke, Christian A
In 1996, the Federal Law on Health Insurance (LAMal) was adopted in order to contain costs in Swiss health care. At the same time, the reform aimed to maintain or even improve solidarity and encourage institutional reform through new public management (NPM) and market mechanisms. More freedom in contractual conditions between insurers and providers and a clearer distinction of responsibilities between federal and regional (cantonal) authorities were stipulated to achieve efficiency, effectiveness, and transparency. The focus of this paper is an analysis of the effects of market reforms and NPM mechanisms introduced with the LAMal on the cost-containment, quality of care and equity objectives in the Swiss health care system. PMID:20540084
Rubinstein, Saul A.; McCarthy, John E.
For most of the past decade the policy debate over improving U.S. public education has centered on teacher quality. In this debate, teachers and their unions have often been seen as the problem, not part of the solution. Further, current discourse often assumes that conflicting interests between teacher unions and administration is inevitable.…
Piotti, B; Macome, E
It has been predicted that major introduction of information communication technology (ICT) for health care organisations (HCO) over the next 10 years will be used to achieve the universal coverage and improve the quality of health care delivered to people. Which is the best strategy on ICT transfer, adoption and adaptation for the local Mozambican HCO? This paper argues that a sociotechnical approach of ICT development can help policy makers and health managers to address the technology transfer in a better and more appropriate way to their social context and to the public health reforms in progress. The urgency of health care demands (e.g. AIDS epidemic) and the institutional changes implemented by the Government and the local Ministry of Health (MOH), open a dynamic process of re-organisation inside the health institutions in the next years. This process needs to be monitored and initiatives planned, which places pressure on the evolution of health information system (HIS). The increase in the use of ICT can be an ally for health managers. The emergence of the open source software (OSS) and the recent ICT market trends towards networking may also enable local HCO to better face and solve the long process of health care standardisation, which usually prepares and accompanies any introduction of ICT. On the other side, the "big bang" introduction of electronic packages, devices and software applications may be an obstacle framing and anchoring local HCO to external settings, "modern" and universal models. Thus, a uniform step-by-step implementation of hospital-based health information system is desirable. PMID:16807083
Reviews state labor legislation passed or debated in 1975 and early 1976. Also describes the impact of amending laws on the current labor picture and evident trends in public attitudes toward public employees. For availability, see EA 507 548. (Author)
Capshaw, N. Clark
Social cohesion, the "glue" that keeps a society together, is influenced by the various sectors or "pillars" of that society-educational institutions, social and religious institutions, business institutions, and government. In this article, the effect of the three branches of government (executive, legislative, and judicial) on social cohesion is…
Fox, D. M.
Standard interpretations of the history of public health in New York City in the twentieth century describe either the decline or the growth of the importance accorded to public health activities. To the contrary, public health has, paradoxically, both declined in salience and attracted increasing resources. This article describes the politics of public health in New York City since the 1920s. First it describes events in the history of public health in the context of events in the economy and in city, state, and national politics. Then it proposes three descriptive models for arraying the data about public health politics: accretion, reform, and crisis. Next it describes how the politics of AIDS in New York City in the 1980s was a consequence of the history that produced these three political styles. Finally, it argues that the three political styles are generalizable to the history of public health throughout the United States in the twentieth century. PMID:1814059
Guillou, Michèle; Carabantes Cárcamo, Jorge
A cooperation programme launched in 1999 by the Chilean Health Department and the French National College of Public Health (ENSP France) has now been running for four years. Its aim was to create and validate a national scheme for manager and executive training within the Chilean public hospital systems. Developed in partnership with the Public Health National College of Rio de Janeiro (Fondation Oswaldo Cruz) with whom ENSP France has teamed up for 10 years, this cooperation was designed by the Chilean partner as a contribution to the definition and implementation of a national policy on Human Resources which might follow the vast reform of the health system currently underway in the country. The scheme which gained international support is backed by a network of 5 universities (7 in 2004) associated with the Chilean Health Department, in a joint national development project for in-house management training for the management teams already in office. More than 100 manager and senior executives et 150 intermediate executives were thus trained between 2000 and 2003. The present scheme est presently being modified to meet new challenges arising from the need to support important changes occurring in the management of Chilean public hospitals, to give them more independence, while encouraging a network of all carers. The ENSP input concerns a line of transfer of competence in training and teaching engineering for all the Chilean partners involved. A module on know-how development support in 'remote control' open training engineering was added in 2002, resulting in the French ENSP concluding a collaboration agreement with the Université de Technologie de Compiègne (France). Moreover, support for implementing an accreditation scheme for management training for the Chilean health sector is under way, linking both French and Brazilian ENSP. Designed from the start on a regional South Cone/Brazil basis, a new expansion phase will be added to this international programme
Rosenberg, Sarah; Silva, Elena
Over the past decade, teachers have seen changes in both their conditions of employment--from pay to retirement benefits--and their practice. Far too often, these policies have been made by people who talk "about" teachers, rather than talking "to" them. Last fall, Education Sector surveyed a nationally representative random sample of more than…
Pere, Engjell; Minxhozi, Luljeta
In many countries, reforms in higher education have follow-on effects on social and economic development. This article relates mainly to economic and financial issues regarding the development of higher education. Starting from the notable increase in demand for higher education and the budgetary constraints on public education financing, we argue…
Hamid, Saima; Malik, Asmat Ullah; Kamran, Irum; Ramzan, Musarat
Background Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse. Methods A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients. Results All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system. Conclusion The study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for
Reform Judaism, the branch of Judaism most liberal in religious practice and most committed to adapting to the realities of modern America, has recently abandoned its opposition to Jewish day schools and has thereby signalled its acceptance of an alternative to public education. When the ancestors of these Reform Jews came to America in the middle…
Reed, James F.; Fox, M. J., Jr.
Reviews the legal rulings and statutes that have shaped public employee labor relations in Texas since the late 19th century. In the absence of one comprehensive labor/management act, Texas has many diverse laws and precedents that affect the public employee. Available from Baywood Publishing Company, Inc., 43 Central Drive, Farmingdale, NY 11735;…
Labor Management Services Administration (DOL), Washington, DC. Div. of Public Employee Labor Relations.
This guide summarizes the coverage of public employees by state labor relations laws. For each state, the guide describes legal provisions, current situation, and current legislative activity. The report also includes data on population, public employment, work stoppages, and state revenues and expenditures. Agencies useful in gathering and…
Health financing reform became a critical element of public sector reform in sub-Saharan Africa during the past decade. Within the framework of health sector reform, this article reviews the major constraints, goals, and strategies for health financing reform in sub-Saharan Africa. It identifies shrinking budgetary resources, increasing demand for health services, and rising health care costs as the primary factors driving the sub-region's health financing reform agenda. In light of these constraints, the article defines the major goals and the strategies for health care financing reform employed by many sub-Saharan African countries. PMID:12635996
Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh
Background & objectives: Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Methods: Data from National Sample Survey 60th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Results: Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Interpretation & conclusions: Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public
In the summer of 1867 Zurich, Switzerland, was struck by a severe Cholera outbreak. Recent research suggests that the Cholera epidemic had such an influence on the municipal policy makers that they pushed through a major reform of the public health system, namely of water supply and sewerage. This paper adopts a theoretical conception of crisis and social change to evaluate the plausibility of this hypothesis. The basic idea is that structural change can be usually understood as the consequence of a major social crisis. Exactly this was the case in Zurich during the 1860s. After a decade of economic stability and progress, a severe crisis simultaneously stuck Zurich's agriculture, textile industry and railway companies. The so called Democratic Movement threatened the existing political system; the old political establishment feared a political revolution. On top of all this, Cholera struck Zurich, precipitating a crisis in the public health system. Suddenly, old concepts and institutions were felt to be outdated. The democrats put through political reforms, the economic downswing ended and a large program to reshape the urban environment was initiated. It can be concluded that the Cholera epidemic alone did not cause the public health reform. But together with other crisis phenomena it played a major role in weakening the stability of the old system, and thus contributed to the society's ability to put in place new political, economic, and social structures. PMID:9092134
Adesina, Adebiyi; Wirtz, Veronika J; Dratler, Sandra
Since antiretroviral (ARV) medicines represent one of the most costly components of therapy for HIV in middle-income countries, ensuring their efficient procurement is highly relevant. In 2008, Mexico created a national commission for the negotiation of ARV prices to achieve price reductions for their public HIV treatment programmes. The objective of this study is to assess the immediate impact of the creation of the Mexican Commission for Price Negotiation on ARV prices and expenditures. A longitudinal retrospective analysis of procurement prices, volumes and type of the most commonly prescribed ARVs procured by the two largest providers of HIV/AIDS care in Mexico between 2004 and 2009 was carried out. These analyses were combined with 26 semi-structured key informant interviews to identify changes in the procurement process. Prices for ARVs dropped by an average of 38% after the first round of negotiations, indicating that the Commission was successful in price negotiations. However, when compared with other upper-middle-income countries, Mexico continues to pay an average of six times more for ARVs. The Commission's negotiations were successful in achieving lower ARV prices. However, price reduction in upper-middle-income countries suggests that the price decrease in Mexico cannot be entirely attributed to the Commission's first round of negotiations. In addition, key informants identified inefficiencies in the forecasting and procurement processes possibly affecting the efficiency of the negotiation process. A comprehensive approach to improving efficiency in the purchasing and delivery of ARVs is necessary, including a better clarification in the roles and responsibilities of the Commission, improving supply data collection and integration in forecasting and procurement, and the creation of a support system to monitor and provide feedback on patient ARV use. PMID:22375026
Fronstin, Paul; Helman, Ruth
PUBLIC SUPPORT FOR HEALTH REFORM: Findings from the 2009 Health Confidence Survey--the 12th annual HCS--indicate that Americans have already formed strong opinions regarding various aspects of health reform, even before details have been released regarding various key factors. These issues include health insurance market reform, the availability of a public plan option, mandates on employers and individuals, subsidized coverage for the low-income population, changes to the tax treatment of job-based health benefits, and regulatory oversight of health care. These opinions may change as details surface, especially as they concern financing options. In the absence of such details, the 2009 HCS finds generally strong support for the concepts of health reform options that are currently on the table. U.S. HEALTH SYSTEM GETS POOR MARKS, BUT SO DOES A MAJOR OVERHAUL: A majority rate the nation's health care system as fair (30 percent) or poor (29 percent). Only a small minority rate it excellent (6 percent) or very good (10 percent). While 14 percent of Americans think the health care system needs a major overhaul, 51 percent agree with the statement "there are some good things about our health care system, but major changes are needed." NATIONAL HEALTH PLAN ELEMENTS RATED HIGHLY: Between 68 percent and 88 percent of Americans either strongly or somewhat support health reform ideas such as national health plans, a public plan option, guaranteed issue, expansion of Medicare and Medicaid, and employer and individual mandates. MIXED REACTION TO HEALTH BENEFITS TAX CAP: Reaction to capping the current tax exclusion of employment-based health benefits is mixed. Nearly one-half of Americans (47 percent) would switch to a lower-cost plan if the tax exclusion were capped, 38 percent would stay on their current plan and pay the additional taxes, and 9 percent don't know. CONTINUED FAITH IN EMPLOYMENT-BASED BENEFITS, BUT DOUBTS ON AFFORDABILITY: Individuals with employment
OECD Publishing (NJ1), 2006
Public bodies hold a range of information and content ranging from demographic, economic and meteorological data to art works, historical documents and books. Given the availability of information and communication technologies (ICTs) public sector information can play an important role in producing innovative value-added services and goods.…
Connolly, John; Reid, Garth; Mooney, Allan
It is necessary for public managers to be able to evaluate programmes in the context of complexity. This article offers key learning and reflections based on the experience of facilitating the evaluation of complexity with a range of public sector partners in Scotland. There have been several articles that consider evaluating complexity and…
Performance measurement in the public sector is largely based on objective metrics, which may be subject to gaming behaviour. This paper investigates a novel subjective performance evaluation system where independent inspectors visit schools at very short notice, publicly disclose their findings and sanction schools rated fail. First, I…
... AGENCY Oil and Natural Gas Sector--Notice of Public Meeting AGENCY: Environmental Protection Agency (EPA... opportunity for public involvement during EPA's review of air regulations affecting the oil and natural gas industry. The review in progress covers oil and natural gas exploration and production, as well as...
Al-Shehab, Ali Jasem
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…
Public-sector scientists have a mandate to independently evaluate agricultural products available to American farmers on the open market, whereas the companies that sell the products are concerned about protecting their intellectual property. As a consequence of the latter concern, public scientist...
Education Commission of the States, Denver, CO.
The relationship between the public and independent sector of higher education in Florida is examined in this conference publication. The problems and issues involved in formulating state policy with respect to postsecondary education in Florida are examined. An overview of policy positions of other states is presented as well as an assessment of…
A study of the effect of organizational politics on 303 Israeli public employees found that public sector workers are more likely to react to organizational politics with negligent behavior than quitting. Women, highly educated employees, and those with higher incomes showed fewer intentions of neglect. (Contains 66 references.) (SK)
Thomas, David E.
This executive position paper proposes recommendations for designing reform models between public and private sectors dedicated to improving school reform work in low performing urban high schools. It reviews scholarly research about for-profit educational management organizations, high reliability organizations, American high school reform, and…
Alikhasi, Narges; Khadivi, Reza; Kheyri, Maryam
Background: Improving the utilization rate of antenatal care is a critical strategy for achieving the reproductive health goals in Iran. The aim of this study was to assess the utilization rate of antenatal care (ANC) by women after health sector reform (HSR) interventions in rural areas of Islamic Republic of Iran (IR Iran). Materials and Methods: This is a retrospective cross-sectional study. The data were gathered by cluster sampling from 400 motherhood records of mothers whose last pregnancies had been terminated in the first 3 months of 2013. Data were collected from 21 rural health centers of Isfahan district during the year 2013. The utilization rate of ANC by mothers was assessed by the number of visits they had, the time of the first ANC visit, the occurrence of pregnancy- or delivery-related complications, and the number of postpartum visits. Results: The mean time of the first ANC was 9 ± 5.23th week of gestational age. For 69.3% of pregnant women, the first ANC was before the 12th week. Overall, the frequency of ANC visits ranged from 2 to 21, with the average of 10.6 ± 3.23 visits. 93.8% of the utilized ANC visits were adequate. 99.8% of the deliveries took place in the hospital. 99% of mothers had at least one visit in the postpartum period. 4% of the mothers had suffered from pregnancy-related complications. Conclusion: It seems that IR Iran has achieved to one of the important objectives by its reform in health care access, that is, more ANC for pregnant women. PMID:25558259
Kezar, Andrianna; Tierney, William G.
Recently, the Center for Higher Education Policy Analysis at the University of Southern California conducted a national study of public higher education governing board performance. 130 board members, presidents, coordinating board officials, governors, legislators, and education department staff were interviewed about ways to improve performance…
Commons, Harriet V.
The Government Accounting Standards Board's Insurance Issues Project has issued an invitation to comment on two issues: (1) whether governmental risk pools should follow the same accounting principles as commercial insurance companies and (2) financial statement disclosures required of entities with public accountability (MLF)
Deregulation and liberalization of health services take several forms in Europe: public-private partnerships; contracting out of services; and corporatization of health care institutions. The impact on health workers includes changes in terms and conditions of employment, breakup of collective bargaining agreements, and often more stressful working conditions. The author examines four types of trade union responses to deregulation. National health trade union action has used campaigning, awareness raising, and judicial review. Health workers' unions in alliance with other trade unions have taken part in wider campaigns against privatization and in promoting public services. Health workers' unions joining with social movements have become involved in wider alliances that link with broader public policy issues such as poverty reduction and urban/regional regeneration. European-wide action, seen through the work of the European Federation of Public Service Unions, has concentrated on the development of an alternative health policy, and the promotion of social dialogue at a European level. Trade unions must adopt a range of approaches to challenge the effects of deregulation. Increasingly, trade union members need to be aware of how to take action at both the national and European levels. PMID:15346679
Fornia, William B
Public pension plans will continue to search for cost-sharing retiree health care solutions and may shift to a defined contribution emphasis. Fiduciary responsibility will be highlighted in view of controversial plan changes, government budgetary constraints, scrutinized investment return assumptions, potential labor shortages and increased shareholder activism. PMID:12800307