Tom Christensen; Per Laegreid; Inger Marie Stigen
This article addresses the development of new performance management systems related to public sector reforms. One such system is Management by Objectives and Results (MBOR), based on an official OECD model. Such a system tries to establish unambiguous goals, objectivity, and incentive elements into often traditionally trust-based systems embedded in a complex political-administrative context. To analyze such performance management systems
K. B. Antwi; F. Analoui
Purpose – This paper seeks to explore and understand the public sector reform (PSR) as it affects local governments in Ghana within the context of challenges facing human resource capacity building and development policies. Design\\/methodology\\/approach – Adopting an exploratory case study design, the research triangulated both secondary and primary sources of data. Primary data generated from self-completing questionnaire and interview
Adrian Ritz; Franziska Voegtli
Public-sector reform initiatives as part of development cooperation challenge many agricultural support services in developing countries of Central Asia. This article analyses the application of the results-based payment system in the Kyrgyz Rural Advisory Service (RAS) and identifies key determinants that are likely to influence its effective adaptation. The article is based on a literature review of public-sector reforms in
José A. Pagán; Jorge Valero Gil; José A. Tijerina Guajardo
. Over the last decade, the public sector in Mexico experienced substantial fiscal reform, divestiture of public enterprises,\\u000a and the elimination of many regulations affecting pay and employment. This study analyzes the changes in the public\\/private\\u000a sector differences in wages during the 1987–1997 period. The results from analyzing microdata from the Encuesta Nacional de\\u000a Empleo Urbano show that relative public
Christiana Stoddard; Peter Kuhn
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 teachers have risen steadily since 1983 by about
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…
Mary Ann Feldheim
Downsizing in the public sector is examined in this article using the cutback management movement of the 1970s and the reinventing government reform of the 1990s. In these movements, reduction-in-force techniques, cutback management, privatization, and contracting out have reduced the public sector workforce and the level of commitment to the ethic of public service. The betrayal of employee trust in
Kahn, David, Ed.
This book on implementing Montessori education in the public sector begins with a historical and social overview that reveals the usefulness of Montessori pedagogy as a means of national public school reform. The second chapter discusses equipment needed for Montessori schools, the scope and sequence of curriculum used, and minimal expectations…
The privatization process that took place in the telecom sector in Sénégal in 1995-96 was the response of the government to the increased competition expected to result from the development of the information technology. By anticipating the potential shock from large- scale data processing firms, the government sought to keep its national company alive, with its staff and other stake-holders.
Linda Colley; Willy McCourt; Jennifer Waterhouse
Public employment is a dynamic field of study, buffeted by the ever-changing and reforming public sector environment and by external events such as changing demographics and the global financial crisis. This first article to the special edition on contemporary public sector human resources provides a broad overview of recent developments, starting with the nature of public sector reforms and proceeding
Christiana Stoddard; Peter Kuhn
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 teachers have risen steadily since 1983 by about
Christiana Stoddard; Peter J. Kuhn
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 teachers have risen steadily since 1983 by about
This paper reports an in-depth and longitudinal case study on the new public management (NPM) reforms introduced in Portuguese public hospitals throughout the 2000s. The objectives of the investigation were twofold: firstly, it sought to analyse the role of accounting technologies and market-based mechanisms in the NPM reforms introduced in the sector when compared with other cases of NPM implementation;
ISSN 1745-9648 Electricity Sector Reform in Greece by Ekaterini Iliadou Lawyer - Legal Department of the electricity market reform in Greece which started in 2001 and is still developing slowly. This is related to the persisting dominance of the incumbent company and the specificities of the electricity sector of Greece
James Guthrie; Linda English
Performance measurement and programme evaluation have been promoted as a central mechanism of recent Australian public sector (APS) reform. Outlines recent reforms in the APS and identifies links between evaluation and performance information. Identifies the major issue of credibility, when performance information is produced internally and not verified externally. A lack of performance systems and standards can create difficulties for
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…
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
, foreign direct investment, and the financial sector. Unfortunately, those reforms lost momentum by the early 2000s. Thus, Part III analyses what happened, namely, backsliding on tariff cuts, persistent tariff escalations, and difficulties in the banking...
Examines the financial sector reform experience of Bangladesh. Finds that, while there have been some improvements in competition and efficiency, loan defaults still remain a significant problem. Also finds urban bias in loan allocation and shift of resources away from the rural sector. The main obstruction in the area of loan recovery is political interference. Provides a principal-agent explanation of
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…
The World Bank's Economic Development Institute has recently developed Health Reform.online to provide distance education opportunities for those interested in "health sector reform, health economics or sustainable financing." The site will house educational modules based on EDI's Health Sector Reform and Sustainable Financing training program. The first module, "Introduction to the concepts and analytical tools of health sector reform and financing," includes lessons, case studies, interactive exercises, suggested readings, an extensive glossary, and a course outline. Future EDI training opportunities will be announced at the site. A Library section allows browsing and searching of abstracts or the full-text of over 500,000 pages of World Bank health documents on health projects in developing countries. Note, to view the full-text documents, users will need to download the Prizm plug-in, available at the site. EDI plans to add links to regional partner institute Websites and courses, in the future.
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…
Bali is the first tourist destination in Indonesia. Unfortunately, the urban public transport network in Bali is poor. Therefore, traffic congestion has existed in many areas, especially in tourist destination objects and city centre. Public transport reform is, therefore, very important to increase the use of public transport mode and to maintain the sustainability. Traffic surveys were carried out in
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 particular site casts an eye on the question of transparency in governmental transactions through interviews with leaders from a broad range of sectors, along with allowing space for individual feedback. The "Points of View" section is a good place to start, as it includes commentary from government officials from Bolivia, Guatemala, and Tanzania about the question of public sector transparency. Other sections on the site address such thorny questions as "What tools help sustain public sector transparency?" and "What practices promote public-private partnerships?" Those visual learners coming to visit the site may appreciate the gallery of charts that offer indicators of levels of governance and transparency for more than 209 countries.
Catherine Paden; Benjamin I. Page
If democratically elected public officials respond to the policy preferences of ordinary citizens, one might expect them to make frequent, favorable references to public opinion as revealed by polls and surveys. An analysis of the 1995 congressional debates leading up to the passage of the Personal Responsibility and Work Opportunity Reconciliation Act (welfare reform), however, generally corroborates the findings of
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…
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…
Jansen, Arild; Løvdal, Einar
This study examines the reorganisation of the administration of admission to higher education in Norway, which has also included the development of a nationwide, ICT-based case handling system. This reform process was initiated out of the need to provide politicians with information for control and regulatory purposes, and the reform resulted in a centralised management information system. This system, however, has evolved into a coordinated but also partly locally delegated decision-making instrument which processes most of the applications for admission to higher education in Norway.
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
Pinhanez, Monica F. (Monica Fornitani)
This dissertation shows how administrative reforms of the State Tax Administration Bureaus (STABs) in Brazil between 1997 and 2005 contributed to strengthening public sector bureaucracies and institutions at the sub-national ...
Liaropoulos, L L; Kaitelidou, D
The 1983 health reform in Greece was a major political event in the social policy agenda. The main objective of the reform was the institution of a National Health System and the expansion of the health sector, improved equity, and the assumption of full responsibility for health services delivery by the state. An assessment of the results 10 years after full implementation of the reform shows that despite the expansion of the public sector, the public-private mix in financing and delivery has changed in favour of the private sector, making the Greek health system the most 'privatised' among the EU countries. The main reasons why the health reform failed to meet its objectives was the restrictive enforcement of full-time and exclusive hospital employment for doctors, the virtual ban on private hospital expansion, the much faster introduction and diffusion of new health technology by the private sector, and poor management, planning and control in the public sector. A new health reform voted into law in the summer of 1997 shows promise of redressing some of the shortcomings of the 1983 reform. PMID:10345933
Government policy measures adopted by many developing countries to reform the public sector enterprise performances can be classified into two broad categories in terms of decision criteria taken into consideration. The first category of reform primarily focuses on distancing the government from ownership change and control issues of these enterprises. Partial privatization or divestment falls in this category of change
Purpose – The purpose of this paper is to consider the impact of a major initiative (the National Competition Policy) and pieces of legislation (the Local Government Act and the Local Government Finance Standards) on the internal practices of a large Australian local authority. Design\\/methodology\\/approach – A theoretical framework is developed using new public management (NPM) and neo-institutional theory literatures
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…
Santi Gopal Maji; Soma Dey
The process of globalization and liberalization has strongly influenced the Indian banking sector. The ongoing reforms in the banking sector, with their thrust on transparency, efficiency and profitability, have forced the Indian banking sector to adopt suitable strategies with focus on productivity, profitability, competitiveness, and sustainability. Keeping a decade of reforms in the financial sector in the background, this study
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
ERAN VIGODA-GADOT; AVIV SHOHAM; NITZA SCHWABSKY; AYALLA RUVIO
This article1 deals with the fuzzy concept of organizational innovation in public sector domains. While it is not the first attempt to bring organizational innovation into the realm of public administration, the article provides a broader understanding of innovation in modern bureaucracies and points to some empirical efforts that may accel- erate post-public managerial reforms. This understanding builds on a
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
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
Edinburgh, University of
Institute of Public Sector Accounting Research I·P·S·A·R In Government, Public Services and Charities http://www.business-school.ed.ac.uk/research/centres/public-sector-accounting-research CALL FOR PAPERS for a RESEARCH WORKSHOP and a special issue of FINANCIAL ACCOUNTABILITY & MANAGEMENT "MODERNISING
Introducing reforms for the State Owned Enterprises (SOEs) has been an integral part of the reform process initiated in India since 1990s. While reforming, the concerns about ownership, competition and regulation, which have a direct bearing on the issue of the relative performance of publicly owned and privately owned firms have been adequately looked into. This paper focuses on the
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…
Relyea, Harold C.
Discusses recent legal, policy, and technological challenges to the GPO printing system, reviews the reform bill designed to address these problems, and tracks its progress through the legislative system. Highlights include the growth of electronic information; the erosion of supervisory authority of the Public Printer; constitutional challenges;…
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
Public Service Research Council, Vienna, VA.
It is the opinion of the authors of this position paper that collective bargaining in the public sector causes an increase in strikes and employee unrest, resulting in a diminution of public services. The authors assert that public employee collective bargaining means giving unions the power to control government through intimidation of the…
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
Harvey, Ken; Kalanj, Karolina; Stevanovi?, Ranko
The Croatian Pharmaceutical Sector Reform Project was one component of a larger Health Reform Project financed by the World Bank. The Croatian government was concerned that Croatia appeared to spend more money on medicinal drugs than most other countries in the region; that the price of drugs purchased in Croatia was higher than in some other countries, and that the prescribing habits of some Croatian physicians were perceived to be unnecessarily expensive. In addition, the Croatian Institute for Health Insurance (CIHI), which pays for most health care, had come under considerable financial pressure due to increasing health expenditure and a decreasing proportion of the population contributing to insurance. The Australian Health Insurance Commission won the contract for the pharmaceutical reform project. Australian experts were matched with Croatian experts in order to share knowledge, learn from each other, and provide the best advice. The project had two main components. The first addressed supply side issues and provided advice about savings that could be made by incorporating pharmacoeconomic principles into the selection and purchase of drugs on the Croatian positive list. The second component addressed demand side issues and provided advice aimed at evaluating and improving the quality and effectiveness of drug prescribing by Croatian physicians. This paper describes the second project component. We quantitatively and qualitatively evaluated the prescribing practice of Croatian physicians and ascertain how these might be improved. Croatian general practitioners are required to enter an International Classification of Diseases, 10th Revision (ICD10) diagnostic code on their prescription in order to indicate the clinical problem being treated. Quantitative research involved sorting CIHI prescription data for 2002 into ICD10 diagnostic categories and comparing the drugs prescribed for particular conditions with the recommendations in local and international best-practice guidelines. The results showed a number of areas where the prescribing of Croatian general practitioners and specialists could be improved, such as the use of antibiotics in upper respiratory tract infections and the treatment of hypertension. Qualitative research involved a series of workshops with local pharmacological experts and general practitioners during which the collected prescribing data was discussed, local factors which influenced prescribing were explored, and suggestions for improvement were collated. Many general practitioners felt pressured by increasingly assertive consumers, relentless pharmaceutical promotion, and strident government (CIHI) demands to restrain escalating health care costs. In addition, there was a lack of information about what constituted cost-effective treatment appropriate to the Croatian economic situation. There was support for the production of concise Croatian therapeutic guidelines that provided a limited number of best-practice treatment options for common conditions. A pilot set of such guidelines was devised and incorporated into a clinical software trialed in a Primary Health Care Information Technology Project in Koprivnica. This initiative received support from the general practitioners involved. It was recommended that a unit for the quality use of medicines should be set up to sustain the production of therapeutic guidelines and coordinate this activity with related initiatives. In addition, a quality assurance system (including performance indicators linked to financial incentives) was recommended that would encourage general practitioners to practice in accord with guidelines. We understand that the Croatian government has accepted a number of these recommendations and, in particular, performance indicators (and financial incentives) are written into new contracts for Croatian general practitioners in 2004. PMID:15495290
Mark A. Emmert; Walled A. Taher
This article reports on an empirical study of the job characteristics of public sector professionals and the impact of these characteristics on motivation, job satisfaction, and work involvement. We collected data from a random sample of professional and blue-collar workers in state government. The findings are: 1) though public sector professionals job characteristics are consistent with the normative data from
The divide between the private and public sector is one of the underlying assumptions of economic policy making, political debates and economic reforms; so much so, that we take for granted its predictions from a theoretical as well as empirical point of view. This paper is an attempt to confront these predictions with Ecuadorian data using a wide range of
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…
After 1989 our country strongly experienced the public administration reform necessity. One of public administrations reform’s objectives was to attract the citizens in planning and checking activities developed in the public sector and to create \\
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…
Lim, Teck-Onn; Goh, Adrian; Lim, Yam-Ngo; Mohamad Zaher, Zaki Morad; Suleiman, Abu Bakar
Between 1990 and 2005, dialysis treatment rates in Malaysia increased more than eightfold. Dialysis treatment reached a level comparable to rates in developed countries. This remarkable transformation was brought about in large part by the Malaysian government's large-scale purchase of dialysis services from the highly competitive private sector. This paper traces a series of public- and private-sector reforms that dramatically increased access to dialysis for patients with kidney failure from 13 per million people in the population in 1990 to 119 per million in 2005. Not all developing countries have had uniformly positive experiences with private-sector participation in health care. However, our data suggest that strong participation by the private sector in Malaysia has helped make for a stronger health care system as well as healthier patients. Yet the policy decisions that enabled the private sector to participate fully in providing dialysis have not been repeated with other medical services. PMID:21134922
Relative to both the rest of the criminal justice sector and to the British public sector as a whole, the police service has managed to maintain many of its traditional features and to survive the most radical dimensions of public-sector reforms inflicted on other areas of the public sector. This paper examines the track record of attempts to develop reform
Benjamin I. Page
Public opinion is relevant to entitlement reform because it bears upon issues of political feasibility. Proposals that go against the strongly held views of ordinary citizens are not likely to be politically feasible. In addition, we may consider public opinion especially well-informed, deliberative opinion relevant to what policy makers ought to do in a democracy. The available data
This paper examines the welfare effects of the reduction of the highest tariffs and the uniform change of all tariffs in a small open economy with public production. Using the restricted GNP and expenditure functions, the author shows that such tariff reforms can improve the welfare of the economy if the public production is initially abundant. A change in the
Since 1980 many developed countries have planned and implemented health sector reforms of different scales and ambitions. Norway has been no exception, and the main political aspirations have been to increase efficiency and improve consumer choice and responsiveness. The major financial reform was the introduction of an activity based financing based on diagnostic related groups (DRG). Other central reforms include
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 care costs proportionally. Instead, productivity will rise in particular in under-utilized private health care institutions. The results of this study also show that private-for-profit health care facilities are not only the luxurious providers catering exclusively for the rich but also play an important role in the service provision for the poorer population. The study findings also demonstrated a high degree of cost variability across private providers, suggesting differences in quality and efficiencies. PMID:21619567
The southern Mediterranean region faces one of the most important water crises in the world. The combination of aridity, foreign dependency, climate change, misallocation of the resources and escalating human demand make water supply a primary issue for health, economy and poverty reduction. In this context, institutional reform of the water supply sector is of great interest. Thus, the aim
21st Century Policy Review, 1992
This interview with Percy E. Pollard, Jr., Director of the Cultural and Human Services Program of International Business Machines, discusses new requirements for basic skills and competencies for American workers and considers the role of the private sector in the reforms needed for education and employment training. Women and minorities can take…
Felix Rigoli; Gilles Dussault
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
Núria Homedes; Antonio Ugalde
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.
External and internal exigencies (the Asian financial crisis, WTO membership for China; a foreign investment and growth slowdown for Viet Nam) are forcing governments to tackle with new resolve the twin challenges of state enterprise restructuring and financial sector reform. Without stronger banks, further financial opening bears high risks, but without more profitable state enterprises healtheir banks are likely to
STEM education reform A public research university imperative! University of Florida A significant and growing portion of future U.S. jobs will require proficiency in the STEM fields from majors and workers their intended STEM majors, shortchanging the national human resource capacity in these vital areas. Many other
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…
Derya ?en; Alankar Bandyopadhyay
This paper will examine current discussions in Turkey centered around the likely decentralization of its educational system as part of ongoing reform efforts in public administration. Ironically, both proponents and opponents of the education decentralization problematize issues related to resource allocation and discrepancies in educational quality and access under the current centralized system. Proponents argue that greater autonomy at the
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…
Thompson, R; Witter, S
Since the collapse of the Soviet Union increasing evidence is emerging of informal payments by patients for health care services that are officially free. There is little information, however, on the characteristics of these payments and the effect that they have on health care reform initiatives. This paper examines these issues and concludes that the endemic and complex nature of such payments suggests that a range of policy tools are necessary to address the negative features of informal payments in those countries undergoing transition. PMID:11184652
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 to those in economies of transition. The dissertation provides a guide for policy makers in the energy sector for implementing power sector reform. At first the dissertation offers a general overview of different models of power sector organization, regulatory frameworks and market arrangements, and the potential impact of reform on social welfare. This knowledge is then applied for analysis of power sector reform in the Republic of Georgia. Social welfare analysis (SWA) is a major analytical tool used in the research for assessing the potential impacts of different power sector organization models on various stakeholders. Through the research it was identified that power industry arrangements in different countries have their particularities; however, after some level of simplification, power sector organization models can fit into one of three broad categories: (1) Government control and regulation of generation and retail segments of the power industry. (2) Full scale competition in the generation segment and retail choice. (3) Partial government control of the generation segment and limited retail choice. For SWA of different power market arrangement scenarios, electricity supply and demand curves had to be derived; for this purpose electricity demand forecasting and power supply evaluation methodologies were developed. This dissertation combines SWA, accepted demand forecasting methods and established power supply evaluation techniques to assess power sector performance under specified policy scenarios relevant to the circumstances of economies in transition such as the Republic of Georgia. Detailed analyses are performed for understanding possible outcomes with the introduction of different reform models. In addition, specific options for incorporating sustainable energy alternatives in the energy planning process are identified and assessed in economic, environmental and social terms. Special attention is given to market-based instruments for promoting sustainable energy options (e.g., renewable portfolio standards, energy conservation and energy efficien
Theresa A. Pardo; Anthony M. Cresswell; Fiona Thompson; Jing Zhang
The success of information system development involving multi-organizational collaboration can depend heavily on effective\\u000a knowledge sharing across boundaries. This paper reports on a comparative examination of knowledge sharing in two separate\\u000a networks of public sector organizations participating in information technology innovation projects in New York State. As\\u000a is typical of innovations resulting from recent government reforms, the knowledge sharing in
Professional accounting standards have been applied to the public sector in Australia as part of the process of adopting accrual accounting. However, the reason given for their application to the public sector is questionable. The modes of operation of governments and of the business sector are very different, and accounting standards must be tailored to suit the specific information needs
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 that encourage positive responses among health workers b) the role of context has been underestimated and it is necessary to address broader systemic problems before initiating reform processes, c) reform programs need to incorporate active implementation research systems to learn the contextual dynamics and responses as well as have inbuilt program capacity for corrective measures d) health workers are key stakeholders in any reform process and should participate at all stages and e) some effects of reforms on the health workforce operate indirectly through levels of satisfaction voiced by communities utilising the services. PMID:17270042
Many new ideas arise at the borders of systems. Academics and educators engage in research and reform of the education system itself, but much that is innovative in today's schools originates outside the classroom, in a burgeoning set of programs and partnerships with the voluntary or community sector, and in the relationships being established by…
Karen Eggleston; Winnie Yip
We develop a model of public-private hospital competition under regulated prices, recognizing that hospitals are multi-service firms and that equilibria depend on the interactions of patients, hospital administrators, and physicians. We then use data from China to calibrate a simulation model of the impact of China's recent payment and organizational reforms on cost, quality and access. Both the analytic and
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…
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
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.
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…
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…
Gilbert, Frédéric; Denis, Jean-Louis; Lamothe, Lise; Beaulieu, Marie-Dominique; D'amour, Danielle; Goudreau, Johanne
Purpose - Governments everywhere are implementing reform to improve primary care. However, the existence of a high degree of professional autonomy makes large-scale change difficult to achieve. The purpose of this paper is to elucidate the change dynamics and the involvement of professionals in a primary healthcare reform initiative carried out in the Canadian province of Quebec. Design/methodology/approach - An empirical approach was used to investigate change processes from the inception of a public policy to the execution of changes in professional practices. The data were analysed from a multi-level, combined contextualist-processual perspective. Results are based on a longitudinal multiple-case study of five family medicine groups, which was informed by over 100 interviews, questionnaires, and documentary analysis. Findings - The results illustrate the multiple processes observed with the introduction of planned large-scale change in primary care services. The analysis of change content revealed that similar post-change states concealed variations between groups in the scale of their respective changes. The analysis also demonstrated more precisely how change evolved through the introduction of "intermediate change" and how cycles of prescribed and emergent mechanisms distinctively drove change process and change content, from the emergence of the public policy to the change in primary care service delivery. Research limitations/implications - This research was conducted among a limited number of early policy adopters. However, given the international interest in turning to the medical profession to improve primary care, the results offer avenues for both policy development and implementation. Practical implications - The findings offer practical insights for those studying and managing large-scale transformations. They provide a better understanding of how deliberate reforms coexist with professional autonomy through an intertwining of change content and processes. Originality/value - This research is one of few studies to examine a primary care reform from emergence to implementation using a longitudinal multi-level design. PMID:25735555
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
Liu Chang; Sun Gang
The public sector plays an important function of providing public goods and public services, maintaining public order. The public sector human resources as the executer of duties and the critical factor in public sector. Whether can take the effective management of human resources not only determine the efficiency and service quality of public sector, but also impact on the economic
Michael Hubbard; Marisol Smith
The research investigated the extent to which 'new public management' style reforms (in which the state confines itself to contracting, guiding, facilitating and financing in providing public services, rather than delivering them itself through civil service organizations) are successful in the institutional context of developing countries. Studies of reform of public services to agricultural marketing were conducted in Ghana, India,
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…
Fox, J C
Currently, individuals concerned about the cost and quality of health care, and the necessity of major system reform, are grappling with the concepts of managed competition, managed cooperation, sponsors, and health insurance purchasing cooperatives. Managed competition, broadly defined, is a purchasing strategy designed to obtain maximum value for consumers and employers as they acquire health care. Managed competition occurs at the level of integrated financial and delivery plans, not at the individual provider level. The goal of managed competition is to divide the providers in each community into competing economic units to motivate them to develop efficient delivery systems (Enthoven, 1993). Efficient health care delivery systems have not resulted from the fee-for-service and remote third-party reimbursement practices that currently dominate the health care system. However, more efficient delivery systems have emerged from managed care. Some of the best known models of managed care that have demonstrated cost effectiveness include Kaiser Permanente, Group Health Cooperative of Puget Sound, and Washington Group Health. The rapidly escalating consumption of US economic resources in the name of health care has led to the current pressure for health care reform. Although the public discussion about health care reform centers around the high cost of health care, we are, in truth, in the midst of both a crisis of medical care and an emergence of an era of health care for the nation's people. PMID:8410762
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 which has been sustained beyond the end of the funding. The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, and media work to mobilize community engagement. PMID:20576104
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
Alexander Schellong; Johann Wolfgang Goethe
Customer Relationship Management has been well discussed as a holistic concept for the private sector to start, maintain and optimize relationships to make customers more loyal\\/profitable - in sum to improve the relationship with the consumers. Many companies have invested into the customer driven CRM concept but research indicates varying outcomes. Recent publications, mainly driven by the private sector rather
_Public Policy for the Private Sector_ is a quarterly journal published by the World Bank's Finance, Private Sector, and Infrastructure Network (FPSI). Recently, new documents concerning Finance, Water, and Post-Privatization Performance have been added to this ongoing collection of policy and case study notes.
...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 for public sector employers. (a) Section...
...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 for public sector employers. (a) Section...
...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 for public sector employers. (a) Section...
Yingyi Qian; Chenggang Xu
China's thirteen years of reforms (1979-1991) have achieved an average GNP annual growth rate of 8.6%. What makes China's reforms from those of Eastern Europe and the Soviet Union is the sustained entry and expansion of the non-state sector. We argue that the organization structure of the economy matters. Unlike their unitary hierarchical structure based on the functional or specialization
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
Reports on an assessment that examined the role of school and public libraries in educational reform. Results for school libraries are reported related to student use, staffing, collections, equipment/technology, Internet access/use, needs, and involvement in educational reform efforts. Cooperation between schools and public libraries is also…
Kenneth A. Klase
This article evaluates the merits of utilizing human resource accounting (HRA) concepts to account for human resource development (HRD) in the public sector. It describes the development of the economic theory of human capital and the increasing recognition of human resources as human assets of public organizations to be managed and accounted for in a manner similar to capital assets.
For over 10 years states and counties have been adding commercially developed managed care products to community-based systems of care. These programs have dramatically altered the landscape in many public systems across the country. Results have varied from modest success to major failure with some managed behavioral healthcare organizations no longer viewing public contracts as desirable commodities. This article examines
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
van den Belt, Marjan; Kenyan, Jennifer R; Krueger, Elizabeth; Maynard, Alison; Roy, Matthew Galen; Raphael, Ian
In today's climate of government outsourcing and multiple stakeholder involvement in public sector management and service delivery, it is more important than ever to rethink and redesign the structure of how policy decisions are made, implemented, monitored, and adapted to new realities. The traditional command-and-control approach is now less effective because an increasing amount of responsibility to deliver public goods and services falls on networks of nongovernment agencies. Even though public administrators are seeking new decision-making models in an increasingly more complex environment, the public sector currently only sparsely utilizes Mediated Modeling (MM). There is growing evidence, however, that by employing MM and similar tools, public interest networks can be better equipped to deal with their long-term viability while maintaining the short-term needs of their clients. However, it may require a shift in organizational culture within and between organizations to achieve the desired results. This paper explores the successes and barriers to implementing MM and similar tools in the public sector and offers insights into utilizing them through a review of case studies and interdisciplinary literature. We aim to raise a broader interest in MM and similar tools among public sector administrators at various administrative levels. We focus primarily, but not exclusively, on those cases operating at the interface of ecology and socio-economic systems. PMID:20146770
Sveinung Jørgensen; Lars Jacob Tynes Pedersen
This article explores how the scope of solutions to complex problems is determined by the way in which the problem is formulated. We inquire into this by means of a theory-driven case study of the reform in the Norwegian drug rehabilitation sector and the Tyrili facility. We analyze divergent approaches to drug rehabilitation by means of a problem formulation framework,
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.
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.…
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
Wilkerson (Tom) and Associates, Ltd., Louisville, KY.
This report describes the attitudes of parents, the general public, school principals, and teachers across Kentucky about the implementation of school reforms based on the Kentucky Education Reform Act of 1990 (KERA). Data were gathered from random telephone surveys in the eight geographic regions of the state for each targeted audience based on…
McMahon, Mary; Limerick, Brigid; Cranston, Neil; Andersen, Cheryl
Purpose: This paper aims to document women's reflections on their careers over a ten-year period to provide quantitative baseline data on which to frame follow-up in-depth interviews. The participants work in the public service in Queensland (Australia) and had been recommended for, and participated in, women in management (WIM) courses conducted…
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
Ditterich, Rafael Gomes; Moysés, Simone Tetu; Moysés, Samuel Jorge
Results-based management is a cornerstone of reform in public administration, including the health field, and has become the basis for other innovations such as the institutionalization of management contracts and the use of professional incentives. This review article aims to introduce and discuss the use of such management contracts in the public health sector. Management by results has developed means and tools that highlight the importance of shared responsibility and mutual commitment between workers and management-level directors. Thus, preset goals are negotiated among all the stakeholders and are evaluated periodically in order to grant professional incentives. It is necessary to improve the mechanisms for control and observation, to more precisely determine the healthcare and management indicators and their patterns, to train stakeholders in designing the plan, and to improve the use of professional incentives in order to effectively increase accountability vis-à-vis the desired results. PMID:22488308
Meier, Benjamin Mason; Gebbie, Kristine M.
Given the public health importance of law modernization, we undertook a comparative analysis of policy efforts in 4 states (Alaska, South Carolina, Wisconsin, and Nebraska) that have considered public health law reform based on the Turning Point Model State Public Health Act. Through national legislative tracking and state case studies, we investigated how the Turning Point Act's model legal language has been considered for incorporation into state law and analyzed key facilitating and inhibiting factors for public health law reform. Our findings provide the practice community with a research base to facilitate further law reform and inform future scholarship on the role of law as a determinant of the public's health. PMID:19150900
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
Welford, W.H. (Olwine, Connelly, Chase, O'Donnell and Weyher, Washington, DC (United States)); Elston, P.J. (Long Lake Energy Corp., New York, NY (United States))
This article examines the reasons that it is likely that the 102nd Congress will pass legislation that will reform the Public Utilities Holding Company Act of 1935. The impetus provided by the Persian Gulf War, public opinion, the National Energy Plan and the National Independent Energy Producers (NIEP) is examined. Several proposals of the NIEP to guard against market abuses in the reforms are presented.
Adnett, Nick; Bougheas, Spiros; Davies, Peter
Reforms in many countries have attempted to increase the degree of competition in school markets. Analyzes school market outcomes utilizing a simple model of the type of local market created in England and Wales. Finds, for example, that the combination of quasi-market reforms do not appear to have produced incentives for all schools to increase…
Spritzer, Allan D., Comp.
Concern over the problems of labor-management relations in the public sector has generated considerable interest and concern in recent years among faculty and students as well as government employers and employees throughout the nation. Thus the Manpower and Industrial Relations Institute of the University of Alabama decided to issue a series of…
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…
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…
It is widely recognized that organizations, both in the public and private sectors, are subject to a wide range of changes in their external environment which often necessitate changes either in organizational structure or in management practice. The range of factors which can have these effects are many and varied. They can include changes in the international business environment, technical
Although there is substantial empirical evidence supporting the important role of leadership in organizational contexts, there is limited empirical evidence that focuses on the distinction between how employees feel about senior leaders and what they think about senior leaders. This is particularly true in the public-sector environment. In this paper, a model is tested that identifies key consequences of affectively
This course covers material essential to the education of M.G.A. students. Regardless of a student's specific interests or areas of specialization, the skills emphasized in this course are a prerequisite to effective administration of programs in the public, private, and not for profit sectors of the economy. The goals are for each student to understand the bases for the economic
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…
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.
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 health?s 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
Lewis B. Dzimbiri
In his 18-page paper entitled 'The Challenges of Governance, Public Sector Reform and Public Administration in Africa: Some Research Issues', Guy Mhone made central to public sector reforms the need to promote procedural rationality in the operation of the public sector and instrumental rationality in terms of economic, social and political outcomes. The present paper contributes to the debate on
Although a significant component of Cold War domestic security, counter-subversion has not received the same attention as counterespionage in recent historical writing. This article examines one aspect of the history of counter-subversion, specifically an internal attempt by the Canadian Security Service to reform itself in the face of the social change of the 1960s. ‘Key Sectors’ attempted to modernize the
Trippestad, Tom Are
This article presents a critical rhetorical analysis of the governing and reform ideology of the Norwegian school system of the 1990s. It uses Karl Popper's "The Open Society and its Enemies" as a critical resource in the reading of the reforms, and discusses some of the consequences of the regime's models of leadership and public management for…
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.
Victor Molinari; David A. Chiriboga; Lawrence Schonfeld; William E. Haley; John A. Schinka; Kathy Hyer; Larry W. Dupree
There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF\\/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care settings. Addressing the bio-psycho-social needs of frail, poor, and minority
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…
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…
Ronald J. Stupak; Jerry E. Moore
This article examines some of the questions that have been raised by many scholars, consultants, and managers regarding the relevance of organization development (OD) to public sector organizations: Some of the questions addressed include: To what extent is OD--as a strategy for planning and implementing change--relevant to public sector management? What are the salient differences between public and private sector
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, while higher levels of government must improve efforts to support local adaptation and provide the capacity through which local adaptation can succeed. PMID:22712716
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…
Vo Xuan Han; Roger Baumgarte
This study assesses the post-reform business environment in Viet Nam as seen from a Vietnamese perspective. A survey was conducted in the two largest cities, Hanoi and Ho Chi Minh City to study how Vietnamese entrepreneurs and owners evaluate the post-reform business environment. The findings were mixed. For instance, while the evidence supports the common thesis concerning the specific weaknesses
Schemmer, Ruth Ann, 1960
THE STATE AND HEALTH CARE REFORM: THE NATIONAL HEALTH INSURANCE AND PUBLIC HEALTH ACT OF 1949 A Thesis by RUTH ANN SCHEMMER Submitted to the Office of Graduate Studies of Texas A&M University in partial fulfillment of the requirements... for the degree of MASTER OF SCIENCE December 1994 Major subject: Sociology THE STATE AND HEALTH CARE REFORM: THE NATIONAL HEALTH INSURANCE AND PUBLIC HEALTH ACT OF 1949 A Thesis by RUTH ANN SCHEMMER Submitted to Texas A&M University in partial...
van Lerberghe, W; Ammar, W; el Rashidi, R; Awar, M; Sales, A; Mechbal, A
This paper describes how, against a background of growing financial crisis, pressure for reform is building up in the Lebanese health care system. It describes the various agendas and influences that played a role. The Ministry of Health, backed by some international organizations, has started taking the lead in a reform that addresses both the way care is delivered and the way it is financed. The paper describes the interventions made to prepare reform. The experience in Lebanon shows that this preparation is a process of muddling through, experimentation and alliance building, rather than the marketing of an overall coherent blueprint. PMID:10176266
Abstract The current Labour Government has embarked on radical public sector reform in England. A so-called ‘Modernisation Agenda’ has been developed that is encapsulated in the NHS Plan—a document that details a long-term vision for health care. This plan involves a five-fold strategy: investment through greater public funding; quality assurance; improving access; service integration and inter-professional working; and providing a public health focus. The principles of Labour's vision have been broadly supported. However, achieving its aims appears reliant on two key factors. First, appropriate resources are required to create capacity, particularly management capacity, to enable new functions to develop. Second, promoting access and service integration requires the development of significant co-ordination, collaboration and networking between agencies and individuals. This is particularly important for health and social care professionals. Their historically separate professions suggest that a significant period of change management is required to allow new roles and partnerships to evolve. In an attempt to secure delivery of its goals, however, the Government has placed the emphasis on further organisational restructuring. In doing so, the Government may have missed the key challenges faced in delivering its NHS Plan. As this paper argues, cultural and behavioural change is probably a far more appropriate and important requirement for success than a centrally directed approach that emphasises the rearrangement of structural furniture. PMID:16896369
Chung-An Chen; Barry Bozeman
Conventional wisdom of ‘sector matters’ suggests that those working in the government are more risk averse than those employed by business enterprises. However, whether public sector workers tend to be more risk averse than non-profit sector workers is unknown. Our paper examines whether the levels of organizational risk aversion as perceived by managers differ between public and non-profit organizations and
Charles R. Fenner Jr; Jan Selmer
Although public sector expatriates are becoming increasingly common, research on them is very limited. There is reason to believe that the situation for expatriates from the public sector may be different than for those from the private sector. This study investigated US Department of Defense administrators assigned to US embassies worldwide. Results showed that self-efficacy, role clarity and role discretion
of the application of new public management styles to Ireland. Particular attention is paid to the public service "Politics, Economy and Society: Irish Develop- mentalism, 1958-2008", held at University College Dublin interests are in Irish and comparative political economy. Her recent publications include "The Politics
Qualitative tools are potentially powerful to gain understandings of the voluntary sector’s (VS) engagement with public service delivery. This is because of the strengths associated with qualitative methods to gain specific information on an area as diverse as the VS and the ability to carry out comparative analyses. Despite this, research on the VS is dominated by work that uses
Scott, Hugh J.
Three leadership imperatives for school board members in school reform are presented in this paper. The imperatives are linked to specific challenges confronting the public school system, which include collective bargaining, student testing, and cultural diversity. Each is discussed and related to a legislative school board action that determines…
Webb, Norman L.
This paper describes the Study of Systemic Reform in Milwaukee Public Schools (MPS), an embedded research project that crossed the lines between objectivity and subjectivity, technical assistance and evaluation, and qualitative and quantitative research. The project created a collaboration between researchers at the Wisconsin Center for Education…
Food Price Subsidies and Nutrition: Evidence from State Reforms to India's Public Distribution food price subsidies affect household nutrition using a dramatic expansion of the availability. These results differ from recent studies suggesting that food subsidies have little effect on nutrition
Smoley, Eugene, Jr.
This document discusses the desirability of creating a synergistic business/education relationship. The most pressing problems of urban education and education reform are not conceptual or analytic, but managerial. Dysfunctional public education will affect business in the future because the products of the education system will enter the work…
National Center on Performance Incentives, 2008
In "Market-Based Pay Reform for Public School Teachers"--a paper presented at the National Center on Performance Incentives research to policy conference in February--Michael Podgursky, professor of economics at the University of Missouri, examines the effects and unintended consequences of the current compensation system for teachers in the U.S.…
This paper draws on the experience of China to show that improved enterprise performance can be achieved without privatization. Export expansion is used as an indicator of increased economic efficiency. China has reformed its traditional state?owned enterprises by the use of management contract systems, expanding enterprise autonomy and increasing retained profits. Township and village enterprises, which are public enterprises under
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…
Doyle, Denis P.
Examines the private sector's historic role in human capital investment, emphasizing its contemporary interest in public education and the workforce. Private sector philanthropy is currently an issue of survival to public education. An important private sector role is to act as a political catalyst to push through essential educational reform. (SM)
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 the trend of a diminishing health workforce. Conclusion Emigration and attrition due to HIV/AIDS are undermining the health workforce in the public sector of Swaziland. Short-term and long-term measures for overcoming this HRH crisis have been initiated by the Swazi government and must be further supported and increased. Scaling up antiretroviral treatment (ART) and making it accessible and acceptable for the health workforce is of paramount importance for halting the attrition due to HIV/AIDS. To this end, we also recommend exploring ways to make ART delivery less labour-intensive. The production of nurses and nursing assistants must be urgently increased. Although the migration of HRH is a global issue requiring solutions at various levels, innovative in-country strategies for retaining staff must be further explored in order to stem as much as possible the emigration from Swaziland. PMID:16737544
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
Purpose – This paper seeks to explore sources of political and administrative challenges which arise from an absence of alignment of supply chains linking the activities of public agencies. Design\\/methodology\\/approach – The performance measurement challenges created by an apparent absence of alignment within public sector supply chains are explored from a conceptual perspective, through the supply chain and public sector
Public policy students were surveyed four times from 1998- 2000 (n=126, 104, 95, 92). Results reveal that many begin with uncertain goals and ambivalence about public sector work. Interest declined and the curriculum did little to promote the public sector. Many anticipated fluid careers and chose positions that offer growth more commonly…
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…
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…
Luke Haggarty; Penelope Brook; Ana Maria Zuluaga
The case in Mexico City offered an opportunity to observe the advantages, and disadvantages of gradualist reform. Unfortunately, the authors find that the long-term nature of an incremental approach does not match well with the generally shorter-term horizons of elected politicians. Difficult decisions in implementation are left to later years, which pushes potentially unpopular actions onto the shoulders of future
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 in 2004 (as regards principles and methods) through a Chilean/French cooperation towards Paraguay. PMID:14963889
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 addition, it links theory with practice by offering a strategy that can effectively address critical issues arising from the energy-development-policy nexus of the sustainable energy development debate.
Schauffler, H; Wilkerson, J
OBJECTIVES: This study examined the activities and influence of public health interest groups and coalitions on the national health care reform debates in the 103rd Congress. METHODS: Congressional staff and representatives of public health interest groups, coalitions, and government health agencies were interviewed. Content analysis of eight leading national health care reform bills was performed. RESULTS: The public health community coalesced around public health in health care reform; nearly all the major interest groups and government health agencies joined two or more public health or prevention coalitions, and half joined three or more. The most effective influence on health care reform legislation was early, sustained personal contact with Congress members and their staffs, accompanied by succinct written materials summarizing key points. Media campaigns and grassroots mobilization were less effective. Seven of the eight leading health care reform bills included one or more of the priorities supported by public health advocates. CONCLUSIONS: The public health community played an important role in increasing awareness and support for public health programs in the health care reform bills of the 103rd Congress. PMID:9240098
Ana Maria Zuluaga; Luke Haggarty; Penelope Brook
August 2001In the early 1990s Mexico City?s Federal District (the D.F.) initiated a series of service contracts with four operators in the private sector?each to be implemented in three stages over ten years. The idea was to introduce competitive pressures and to find out if a ?gradualist? approach would reduce social and political opposition to private sector involvement and would
Carlos Serrano Cinca; Cecilio Mar Molinero; Alexandre Bossi Queiroz
This paper discusses the identification and measurement of intangible assets in the public sector. A discussion of intellectual capital theory identifies and classifies a number of intangible assets of relevance to the public sector. Multidimensional scaling and related multivariate techniques are proposed for their detection and quantification. The methodology is illustrated with a case study: the provision of council services
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…
In the past two decades, the public sector both in Australia and overseas has undergone a period of intense change. The focus has been on efficiency, effectiveness and value for money of public sector operations. The methods by which governments account and report on their operations has received scrutiny. While Treasuries and Departments of Finance in each Australian jurisdiction have
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...
Kammen, Daniel M.
Agricultural Biotechnology and Globalization: The Role of Public and Private Sector Research Greg biotechnology sector as it works to sustain innovations and further propagate its benefits into the new century institutional mechanisms for public and private partnership that can help agricultural biotechnology fulfill its
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
Market-oriented health care reforms have been implemented in the tax-financed Swedish health care system from 1990 to 2013. The first phase of these reforms was the introduction of new public management systems, where public health centers and public hospitals were to act as private firms in an internal health care market. A second phase saw an increase of tax-financed private for-profit providers. A third phase can now be envisaged with increased private financing of essential health services. The main evidence-based effects of these markets and profit-driven reforms can be summarized as follows: efficiency is typically reduced but rarely increased; profit and tax evasion are a drain on resources for health care; geographical and social inequities are widened while the number of tax-financed providers increases; patients with major multi-health problems are often given lower priority than patients with minor health problems; opportunities to control the quality of care are reduced; tax-financed private for-profit providers facilitate increased private financing; and market forces and commercial interests undermine the power of democratic institutions. Policy options to promote further development of a nonprofit health care system are highlighted. PMID:25618987
Consultation of the DfE's Green Paper, "Support and Aspiration: A New Approach to Special Educational Needs," provoked considerable debate among public and private sector professionals, parents and young people over the planned special educational needs reform. Since then, publication of the Children and Families Bill in 2013…
Carpenter, Dick M., II
This document describes the flaws in an October 2007 Wisconsin Policy Research Institute (WPRI) report on public school choice and parental involvement, "Fixing the Milwaukee Public Schools: The Limits of Parent-Driven Reform." Because the report claims that public school choice and parental involvement have little effect on student performance in…
Zhong, Lijin; Mol, Arthur P. J.; Fu, Tao
During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China’s water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China.
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…
Emil Inauen; Katja Rost; Bruno S. Frey; Fabian Homberg; Margit Osterloh
To overcome agency problems, public sector reforms started to introduce businesslike incentive structures to motivate public officials. By neglecting internal behavioral incentives, however, these reforms often do not reach their stated goals. This research analyzes the governance structure of Benedictine monasteries to gain new insights into solving agency problems in public institutions. A comparison is useful because members of both
Mark Hart; Helena Lenihan
This paper aims to contribute to the debate about the role of the public sector in stimulating greater use of private sector equity for business start-up and growth in two ways. First, to examine the extent to which the provision of public sector equity finance enables individual firms to raise additional funds in the private sector market place. Second, to
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
Public libraries both in South Africa and internationally are under financial pressure owing, in large part, to a decline in public (or government) funding. One of the responses to the situation is, and has been, for the public library sector to consider alternative sources of funding to supplement that received from government. This article provides an overview of alternative funding
Meier, Benjamin Mason; Kayser, Georgia Lyn; Kestenbaum, Jocelyn Getgen; Amjad, Urooj Quezon; Dalcanale, Fernanda; Bartram, Jamie
The development of a human right to water and sanitation under international law has created an imperative to implement human rights in water and sanitation policy. Through forty-three interviews with informants in international institutions, national governments, and non-governmental organizations, this research examines interpretations of this new human right in global governance, national policy, and local practice. Exploring obstacles to the implementation of rights-based water and sanitation policy, the authors analyze the limitations of translating international human rights into local water and sanitation practice, concluding that system operators, utilities, and management boards remain largely unaffected by the changing public policy landscape for human rights realization. To understand the relevance of human rights standards to water and sanitation practitioners, this article frames a research agenda to ensure that human rights aspirations lead to public policy reforms and public health outcomes. PMID:24381084
The Halifax Explosion provided the opportunity for an "experiment in public health" that was meant not only to restore but also to improve the city and its population in the process. The restructuring that occurred during the restoration was influenced by pre-existing ideals and prejudices which were reflected in the goals of the newly formed committees in charge of the reconstruction. The primary emphasis on improvement as well as control was the result of existing regional concerns regarding the emigration of the province's most "desirable" stock, in the form of healthy, educated young men and women, to central Canada and the eastern United States. Public health reforms reflected the eugenic goal of improving the overall quality of the population through education, surveillance, and inspection, resorting finally to institutionalizing people who public health officials determined were genuinely deficient. PMID:24909020
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 the use of global persistent identifiers. It is evident that government and scientific data infrastructures are currently facing a number of issues that have already been addressed in INSPIRE. Sharing experiences and competencies will avoid re-inventing the wheel, and help promoting the cross-domain adoption of consistent solutions. Actually, one of the lessons learnt from INSPIRE and the initiatives in which JRC is involved, is that government and research data are not two separate worlds. Government data are commonly used as a basis to create scientific data, and vice-versa. Consequently, it is fundamental to adopt a consistent approach to address interoperability and data management issues shared by both government and scientific data. The presentation illustrates some of the lessons learnt during the implementation of INSPIRE and in work on data and service interoperability coordinated with European and international initiatives. We describe a number of critical interoperability issues and barriers affecting both scientific and government data, concerning, e.g., data terminologies, quality and licensing, and propose how these problems could be effectively addressed by a closer collaboration of the government and scientific communities, and the sharing of experiences and practices.
Penn-Kekana, Loveday; Blaauw, Duane; Schneider, Helen
Poor practice by health care workers has been identified as contributing to high levels of maternal mortality in South Africa. The country is undergoing substantial structural and financial reforms, yet the impact of these on health care workers performance and practice has not been studied. This study, which consisted of an ethnography of two labour wards (one rural and one urban), aimed to look at the factors that shaped everyday practice of midwives working in district hospitals in South Africa during the implementation of a public sector reform to improve financial management. The study found that the Public Financing Management Act, that aimed to improve the efficiency and accountability of public finance management, had the unintended consequence of causing the quality of maternal health services to deteriorate in the hospital wards studied. The article supports the need for increased dialogue between those working in the sexual and reproductive health and health systems policy arenas, and the importance of giving a voice to front-line health workers who implement systems changes. However, it cautions that there are no simple answers to how health systems should be organized in order to better provide sexual and reproductive health services, and suggests instead that more attention in the debate needs to be paid to the challenges of policy implementation and the socio-political context and process issues which affect the success or failure of the implementation. PMID:15452017
Yanagisawa, S; Mey, V; Wakai, S
This study compared health-seeking behaviour between poor and better-off people after health sector reform in Cambodia. The survey was conducted in the Prek Dach Health Centre coverage area, which is located in South-east Cambodia. The study population consisted of 257 housewives of reproductive age, selected at random. Data were collected through household surveys with a structured questionnaire. Data collected included socio-demographic information on the housewives, as well as episodes of illness of family members within 30 days prior to the survey. Two indicators, the floor area of living space and a rating scale on asset ownership, were used to identify poor and very poor people. When a family member became ill, subjects most often used home remedies as a first step, followed by self-medication. Subsequently, people used self-medication or the private health sector. Very poor people used the health centre more often than better-off people as a first step. For the second step, use of the health centre was also high among the poor compared with better-off people, although the difference was not statistically significant. Keeping the treatment fees low and abolishing informal fees maintained the affordability of health-centre services for the poor. However, this benefit diminished quickly with distance from the health centre. The significant difference between poor and better-off people disappeared for villages situated more than 2 km from the health centre. Thus, the health centre in the studied area was shown to be effective in providing primary health care to the economically disadvantaged, but only within a limited geographic area. PMID:14643624
Silva, Elena; Headden, Susan
Providence, Rhode Island, is one of those gritty eastern mill towns that wears its centuries-old history on its sleeve. Like many American cities, Providence is home to a struggling public school system with chronically low-performing schools. They include Roger Williams Middle, where last year only 17 percent of eighth-graders scored at or above…
We describe in detail seven distinct areas in both public and private sectors in which a real-time computer-aided dispatch system is applicable to the allocation of scarce resources. Characteristics of a real-time ...
Zoe Radnor; Paul Walley
This article considers whether public sector organizations regard Lean merely as a set of tools and techniques without considering either the underlying conditions and principles or regard Lean as a philosophy. The authors analyse a series of case studies of Lean in the public sector around four themes—process-based view, focus on value, elimination of waste and employee-driven change—before considering the
Manuel Sánchez Pérez; Juan Carlos Gázquez Abad; Gema María Marín Carrillo; Raquel Sánchez Fernández
Purpose – This paper seeks to examine the relationship between service quality and behavioural purchase intentions in the public-sector transport industry in Spain. Design\\/methodology\\/approach – The study first identifies five distinctive research streams in service quality. An empirical analysis is then carried out in which the SERVPERF scale is adapted to the study of service quality in the public-sector transport
Sari, N; Langenbrunner, J C
What do consumers pay for pharmaceuticals in a transition economy, and who is hit hardest? Kazakhstan is in the midst of emerging from a Soviet Union state to a market economy. It has seen a significant dip in Gross Domestic Product and available revenues for health as a result. New sources of revenues, such as out-of-pocket payments, both formal and informal, have become widespread. In this paper we use the results of a 1996 Living Standards survey jointly sponsored by the World Bank and the Kazakhstan Government to examine patterns of prescribed pharmaceutical spending. We use a two-part regression model that is utilized to adjust for the skewness of non-spenders and heavy utilizers. Results suggest that upper-income groups spend more in absolute terms, but low-income groups pay a higher share of their income for pharmaceuticals. Pharmaceutical expenditure is positively related to poor health status, chronic illness and rural area residence. Our estimates suggest that on average people in rural areas spend 16% more than people in urban areas. The analysis shows that certain types of illnesses impose significant out-of-pocket burden for consumers - gynaecologic as well as intestinal and cardiac. The findings can be used for developing and designing a new 10-year World Bank-financed programme for restructuring the health sector. They also suggest the need for prioritizing rural care, as well as covering pharmaceuticals for specific types of care interventions and certain demographic groups. PMID:11739368
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 sector OOP expenditure. PMID:23041735
Perks, Carol; Toole, Michael J.; Phouthonsy, Khamla
The Lao People's Democratic Republic (Lao PDR) is classified by the World Bank as a low-income country under stress. Development partners have sought to utilize effective aid instruments to help countries classified in this way achieve the Millennium Development Goals; these aid instruments include sector-wide approaches (SWAps) that support decentralized district health systems and seek to avoid fragmentation and duplication. In Asia and the Pacific, only Bangladesh, Papua New Guinea and the Solomon Islands have adopted SWAps. Since 1991, a comprehensive primary health care programme in the remote Sayaboury Province of Lao PDR has focused on strengthening district health management, improving access to health facilities and responding to the most common causes of mortality and morbidity among women and children. Between 1996 and 2003, health-facility utilization tripled, and the proportion of households that have access to a facility increased to 92% compared with only 61% nationally. By 2003, infant and child mortality rates were less than one-third of the national rates. The maternal mortality ratio decreased by 50% despite comprehensive emergency obstetric care not being available in most district hospitals. These trends were achieved with an investment of approximately 4 million US dollars over 12 years (equivalent to US 1.00 US dollars per person per year). However, this project did not overcome weaknesses in some national disease-control programmes, especially the expanded programme on immunization, that require strong central management. In Lao PDR, which is not yet committed to using SWAps, tools developed in Sayaboury could help other district health offices assume greater planning responsibilities in the recently decentralized system. Development partners should balance their support for centrally managed disease-specific programmes with assistance to horizontally integrated primary health care at the district level. PMID:16501731
Cheema, Jehanzeb R.
The education system in Qatar comprises of both private schools, which receive money through student fees, and public schools, which are fully government-funded. In the mid-2000s, Qatar started its transition towards an independent school model with the aim of eventually converting all public schools into government-supported independent schools. The idea was to give public schools more autonomy in terms of hiring decisions, adoption of curriculum and textbooks, and budget spending, enabling them to emulate some of the private schools' strategies for turning out successful students. This study examines evidence from the 2006-2012 administrations of the Program for International Student Assessment (PISA) in Qatar in order to evaluate whether or not recent educational reform efforts in this country have succeeded in bridging the literacy divide between private and public schools. The results, presented in a number of detailed tables and discussed in the last part of the article, indicate that there is a significant difference in key literacy skills between the two types of schools. Private schools were found to outperform their public counterparts in areas such as mathematics, reading and science, both before and after controlling for important student-level differences, and this gap has evidently persisted from 2006 to 2012.
Norma M. Riccucci
A priority in American domestic policy over the past few years has been to win the battle against drug use in our society. The frenzy surrounding this country's war on drugs, however, inevitably begs the question, Is the government, either as an employer or regulator of private sector employment, within legal and constitutional bounds when it requires employees to undergo
Bachman, Charles A.
While private sector organizations have implemented enterprise resource planning (ERP) systems since the mid 1990s, ERP implementations within the public sector lagged by several years. This research conducted a mixed method, comparative assessment of post "go-live" ERP implementations between public and private sector organization. Based on a…
Pat Walsh; Jane Bryson; Zsuzsanna Lonti
This study uses Dyer and Shafer's organizational agility framework to analyze and compare the contribution of human resource strategies and practices to organizational capability in twelve private sector and three public sector organizations. Similarities are found in public and private sector HR practices and priorities, particularly with regard to some aspects of work design, performance management and remuneration, and communication.
Tan Woei Luen; Suliman Al-Hawamdeh
Many organizations in the private or public sectors in Singapore have started to realize the importance of knowledge management in streamlining their operations. This realization stems from the fact that Singapore, as a small country with no natural resources, has to rely on human capital and its people in positioning itself for the new economy. Many organizations in the public
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…
Shuqin Chen; Nianping Li; Jun Guan
The purpose of this research is to find a statistical methodology to investigate the national energy consumption in the public buildings sector in China, in order to look into the actuality of the national energy consumption of public buildings and to provide abundant data for building energy efficiency work. The frame of a national statistical system of energy consumption for
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…
Pokharel, Mohan P.; Hult, Karen M.
Purpose: The purpose of this paper is to explore the learning dynamics in the local level public organizations due to a policy intervention in collaboration with university. This study aims to identify the existence of four different types of organizational learning in different localities and to explain their implications to public sector…
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.…
Guimarães, Cristian Fabiano; da Silva, Rosane Azevedo Neves
This paper presents a theoretical review of how the public health concept has been perceived in health practices, based on the problematic field introduced in Italian and Brazilian health reforms, in order to understand the construction of public health and the meanings that this term acquires in the health arena. The main goal is to understand how public health appears in the context of health movements in Italy and Brazil, as well as its movement of variation. In this sense, an attempt is made to identify elements that contribute to the composition of a genealogy of public health. From the investigation of public health practices, the tensions produced by this concept are analyzed, giving visibility to those practices that demonstrate the public health experience as a force in the world of health. PMID:25760131
Arild Wæraas; Haldor Byrkjeflot
This article discusses five problems that most public organizations will face when adopting a popular, yet largely unexplored management concept: reputation management. The inherently political nature of public organizations constrains their reputation management strategies. Furthermore, they have trouble connecting with their stakeholders on an emotional level, standing out as unique and differentiated organizations, communicating as coherent bodies, and maintaining excellent
Antonis Adam; Manthos Delis; Pantelis Kammas
In this paper we seek a robust methodology for the measurement of the relative public sector efficiency of 19 OECD countries\\u000a over the period 1980–2000. We estimate relative efficiency scores for five disaggregated accounts of public spending as well\\u000a as for aggregate public spending. Then, we use a semi-parametric econometric method to isolate the impact of government inefficiency\\u000a from the
Haynie, Jeffrey J; Hartman, Sandra J; Lundberg, Olof
Vocational choice theory asserts that an individual's career choice will be based on that person's anticipated satisfaction from working in a particular field and that the person's personality will determine which field will be most satisfying. This study measured personalities and job satisfaction among public health workers to determine if public health work is satisfying to individuals with particular personality types. The study was performed on 47 public health workers in the Southeastern region of Louisiana. These workers were given a questionnaire consisting of the Big 5 personality profile, the Job Descriptive Index, several open-ended questions, and a demographic survey. The findings indicate that emotional stability is a personality characteristic associated with satisfaction from public health work. Possible reasons for this finding and its implications are discussed. PMID:17938592
Ross, Michele L.; Brudney, Jeffrey L.
Smaller government and community service initiatives mean public administrators must increase citizen volunteer involvement. They should adopt successful techniques from volunteer administrators for recruiting, selecting, motivating, training, and developing volunteers. (SK)
Lunt, Neil; Exworthy, Mark; Hanefeld, Johanna; Smith, Richard D
Many public health systems in high- and middle-income countries are under increasing financial pressures as a result of ageing populations, a rise in chronic and non-communicable diseases and shrinking public resources. At the same time the rise in patient mobility and concomitant market in medical tourism provides opportunities for additional income. This is especially the case where public sector hospitals have a reputation as global centres of excellence. Yet, this requires public sector entrepreneurship which, given the unique features of the public sector, means a change to professional culture. This paper examines how and under what conditions public sector entrepreneurship develops, drawing on the example of international patients in the UK NHS. It reports on a subset of data from a wider study of UK medical tourism, and explores inward flows and NHS responses through the lens of public entrepreneurship. Interviews in the English NHS were conducted with managers of Foundation Trusts with interest in international patient work. Data is from seven Foundation Trusts, based on indepth, semi-structured interviews with a range of NHS managers, and three other key stakeholders (n = 16). Interviews were analysed using a framework on entrepreneurship developed from academic literature. Empirical findings showed that Trust managers were actively pursuing a strategy of expanding international patient activity. Respondents emphasised that this was in the context of the current financial climate for the NHS. International patients were seen as a possible route to ameliorating pressure on stretched NHS resources. The analysis of interviews revealed that public entrepreneurial behaviour requires an organisational managerial or political context in order to develop, such as currently in the UK. Public sector workers engaged in this process develop entrepreneurship - melding political, commercial and stakeholder insights - as a coping mechanism to health system constraints. PMID:24833318
Olson, Kathryn M.
This essay argues that teaching rhetorical leadership, particularly the skill of inherency analysis, is crucial to preparing effective citizen leaders. Using the example of education reforms for children with disabilities, it illustrates the practical value for those interested in public concerns of understanding and using analysis of the…
Describes the impact of social and political reforms in Russia during the 1860s on the role of the Imperial Public Library. The discussion covers the changes in library organization and operations that reflected a willingness to adapt to changing social conditions, and the resulting perception of the library as a vital tool for progress. (80…
Yuri NATCHETOI; Viktor KAUFMAN; Konstantin BEZNOSOV
Development of mobile software applications for use in specific domains such as Public Security must conform to stringent security requirements. While mobile devices have many known limitations, assuring complex fine-grained security policies poses an additional challenge to quality mobile services and raises usability concerns. We address these challenges by means of a novel approach to authentication and gradual multi-factor authorization
This article addresses the offshoring of clinical trials to middle- and low-income countries, and the complicated ways in which they have become integral to public health and quality of care in these contexts. I focus on the operations of United States-based contract research organizations (CROs), which make up a specialized global industry focusing on the recruitment of human subjects and
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…
Jackson, Janese Marie
Given the perils of today's dynamic and resource-constrained environment, intellectual capital has become a source of competitive advantage for public sector organizations. Composed of three elements--organizational knowledge, innovative capability, and organizational commitment--intellectual capital is an asset that cannot simply be bought or…
Moscote, R.A. (World Bank, Washington, DC (United States). LAC Technical Dept.)
This article discusses the changes in energy policy of most countries in the Latin American and the Caribbean region. The topics of the article include the new legal and regulatory frameworks being developed, investment, privatized power producers, government regulation, power distribution, power transmission, access to transmission lines, pricing regulations, and increasing capacity of the power systems.
Golden, John M
While society debates whether and how to use public funds to support work on human embryonic stem cells (hESCs), many scientific groups and businesses debate a different question - the extent to which patents that cover such stem cells should be permitted to limit or to tax their research. The Wisconsin Alumni Research Foundation (WARF), a non-profit foundation that manages intellectual property generated by researchers at the University of Wisconsin at Madison, owns three patents that have been at the heart of the latter controversy The story of WARF's patents and the controversy they have fostered highlights not only continuing tensions between proprietary and nonproprietary approaches to developing science and technology, but also an at least partly reassuring capacity of public and private sectors to deal with those tensions in a way that can render them substantially manageable, and frequently more manageable as a technology matures. More particularly, the cumulative story of WARF's patents features three leitmotifs that suggest how an attentive and engaged public sector might commonly succeed in working with public and private sector actors to achieve workable balances between proprietary rights and more general social interests: (1) right holders' decisions to pursue less than full rights assertion or enforcement; (2) the ability of government and other public sector actors to help bring about such decisions through co-option or pressure; and (3) the frequent availability or development of technological alternatives that limit research bottlenecks. PMID:20579254
Martin, David P.
IT governance has become an important topic as both public and private organizations struggle to meet the challenge of aligning complex IT systems with operational needs. Without effective IT governance, organizations fail to gain strategic benefits that come by the proper strategic alignment of IT resources with the larger organizational mission.…
Patrick, Walter K; Cadman, Edwin C
Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research and designer drugs have dramatically changed medical practice. Creatively, educational institutions have adopted the use of: (1) New educational and communication technologies: internet and health informatics; (2) Problem based learning approaches; Integrated Practice and Theory Curricula; Research and Problem Solving methodologies and (3) Partnership and networking of institutions to synergise new trends (e.g. core competencies). Less desirably, changes are inadequate in key areas, e.g., Health Economics, Poverty and Health Development, Disaster Management & Bioterrorism and Ethics. Institutions have begun to adjust and develop new programs of study to meet challenges of emerging diseases, design methodologies to better understand complex social and economic determinants of disease, assess the effects of violence and address cost containment strategies in health. Besides redesigning instruction, professional schools need to conduct research to assess the impact of health reform. Such studies will serve as sentinels for the public's health, and provide key indicators for improvements in training, service provision and policy. PMID:12597516
Pamela Whitten; Mark Notman; Charles Maynard; Rebecca Henry; Robert Glandon
Effective population-based and patient-centered public health care is highly dependent on timely and reliable health-related information. The continuous growth and availability of health-related information brought about by the emergence of a new digital communications environment offers a range of opportunities that facilitate access to useful health information for the public health sector–for providers as well as patients. Such advancements, however,
The manual provides practical assistance to public transit agencies in California in contracting for goods and services with the private sector. It also assists private firms seeking to provide goods and services to public transit agencies. The manual provides an overview of each of the processes involved in procurement from preparation of procurement documents to contract management and evaluation. It also provides detailed, practical guidance on each of these processes.
This paper provides an empirical investigation of the agency relationship between the public sector and small firms targeted for assistance by examining micro and macro data for a cross section of eligible women business enterprises (WBEs). Using hedonic sales and employment indices we find that 2% of firm sales is lost to negative gender externality. We show that under asymmetric
Kubala, James Joseph
A quantitative and qualitative study examined three leadership strategies found in performance-based management (human resource, scientific management and political strategies used in public sector management); a framework by which performance measurement (PM) supports leadership strategies; and how the strategies impact PM. It examined leadership…
Susan A. MacManus
The costs and benefits of government purchases of goods and services from businesses are examined from the perspective of both public and private sector officials. Generally, governments see more benefits than costs, often because of fiscal stress. Businesses, especially newer, smaller firms are more likely to see more costs than benefits. The article concludes with ten projections for changes in
At first glance, public-sector labor unions are just one of many types of organizations that participate in the political process. However, these unions differ significantly from other interest groups made up of individual citizens or non-labor organizations. Because their members' interests are tied to government policy, these unions are more…
Van Wie McGrory, Laura; Coleman, Philip; Fridley, David; Harris,Jeffrey; Villasenor Franco, Edgar
The evolution of government purchasing initiatives in Mexicoand China, part of the PEPS (Promoting an Energy-efficient Public Sector)program, demonstrates the need for flexibility in designingenergy-efficiency strategies in the public sector. Several years ofpursuing a top-down (federally led) strategy in Mexico produced fewresults, and it was not until the program was restructured in 2004 tofocus on municipal-level purchasing that the program gained momentum.Today, a new partnership with the Mexican federal government is leadingto an intergovernmental initiative with strong support at the federallevel. By contrast, the PEPS purchasing initiative in China wassuccessfully initiated and led at the central government level withstrategic support from international experts. The very different successtrajectories in these two countries provide valuable lessons fordesigning country-specific public sector energy-efficiency initiatives.Enabling conditions for any successful public sector purchasinginitiative include the existence of mandatory energy-efficiencyperformance standards, an effective energy-efficiency endorsementlabeling program, an immediate need for energy conservation, a simplepilot phase (focusing on a limited number of strategically chosenproducts), and specialized technical assistance. Top-down purchasingprograms are likely to be more successful where there is high-levelpolitical endorsement and a national procurement law in place, supportedby a network of trained purchasers. Bottom-up (municipally led)purchasing programs require that municipalities have the authority to settheir own purchasing policies, and also benefit from existing networks ofcities, supported by motivated municipal leaders and trained purchasingofficials.
Lynne Gerke; Gail Ridley
This paper details research undertaken to evaluate the potential to use the Control Objectives for Information and Related Technologies (COBIT) framework as the basis for Information Technology (IT) audits in a state public sector audit office from Australia. The research outlined here used a survey methodology to determine the high level control objectives from COBIT considered to be the most
Leslie, Laurel K.; Lambros, Katina M.; Aarons, Gregory A.; Haine, Rachel A.; Hough, Richard L.
This study investigates rates and predictors of school-based services (SBSs) for 390 youth meeting criteria for Attention Deficit Hyperactivity Disorder and served in the San Diego public sectors. Only 60% of youth had received an Attention Deficit Hyperactivity Disorder diagnosis; these youth were younger, male, Caucasian (versus Latino), and…
Richard T. Cober; Douglas J. Brown; Alana J. Blumental; Dennis Doverspike; Paul E. Levy
Organizational use of Internet recruiting has dramatically increased in the last five years. However, there has been little research to guide the development of organizational employment Web pages. This paper first outlines the reasons why public sector organizations should consider focusing more energy on developing their own employment Web sites to supplement other recruiting activities. We then present a model
Bearden, Lisa J.
A study compared the differences among public and private sector rehabilitation professionals with respect to their attitudes toward aging, fear of aging, and involvement with older clients. Demographic variables of age, sex, race, and educational status were also examined. The study sample included 325 full-time, nonclerical employees of…
The results of this research has highlighted the fact that most public sector bodies in Portugal do not have any formal specification for training requirements, nor do they have training programmes or detailed training evaluation systems. Furthermore, there is no interaction in these areas between the training body and the Departmental Customer or…
Margaret F. Reid; Myria W. Allen; Cynthia K. Riemenschneider; Deborah J. Armstrong
To improve our understanding of individual motivations to remain employed in governmental agencies this study focuses on a specific segment of a state government agency workforce. Information technology (IT) employees possess skills that transfer easily to other sectors, which make them an important group when examining factors that influence the affective commitment and job satisfaction of individuals working in public
Dongwoon Han; Heejin Lee
The public health sector in South Korea introduced district health information systems (DHIS) in health centres in the early 1990s. DHIS aimed to help health centres to provide comprehensive health care services and to achieve effective and efficient management of their works. District health information systems are still being implemented in health centres. Information generated and collected through the systems
Stangl, Dalene K.; Tweed, Dan L.; Farmer, Betsy; Langmeyer, David; Stelle, Lynn; Behar, Lenore B.; Gagliardi, Julia; Burns, Barbara J.
This paper presents contributions at a symposium about Carolina Alternatives (CA), a North Carolina program that blends capitated financing with public sector managed care for mental health and substance abuse services for children and youth eligible for Medicaid. The symposium focused on stakeholders' perspectives and on expenditure patterns of…
The success of individual firms can illustrate lessons learned from economy-wide research on how public policy and private company policy affect the development of the services sector. This review of some 14 case studies of large international services firms shows that three factors are common to their success: (1) Many successful services companies examined owe their existence and success to
Susan Forde; Kerrie Foxwell; Michael Meadows
This article explores the role of community or `public arena' journalism in offering alternative frameworks for making sense of the world through the lens of local communities and their various networks. Our particular focus is on new research into Australia's unique community broadcasting sector, based on nationwide telephone surveys and focus group discussions involving a broad range of community journalists,
Levine, Marsha, Ed.
The American Enterprise Institute and the National Institute of Education commissioned six authors to prepare papers examining the barriers and incentives to private-sector involvement in public schools. These authors include representatives from two corporations, a former school superintendent and academic, a state policy analyst and attorney,…
Sharif, Raed M.
Although there appears to be a broad recognition of the key role that Public Sector Information (PSI) can play in the development of societies, there are still significant gaps in our understanding of how PSI is actually being utilized and of its wider societal value, especially in developing countries. The overarching goal of this dissertation…
This article explores the core themes and issues of private residential service delivery for children and youth in Ontario, with a specific focus on staffed group care within this sector. Such exploration highlights the juxtaposition of the public rights of children with the private world of service provision. Based on twenty interviews with…
Sekhon, Jasjeet S.
Public R&D Investments and Private-sector Patenting: Evidence from NIH Funding Rules Pierre Azoulay Institutes of Health (NIH) on the rate of patent production by pharmaceutical and biotechnology firms. Our of idiosyncratic rigidities in the rules that govern peer review within NIH to generate exogenous variation
This study uses a Cox proportional hazards model to estimate ther elationship between state-level collective bargaining policies and union growth in the public sector. The proportional hazards analysisis performed with data on approximately eight hundred municipal police departments. The timing of unionization in these departments clearly indicates that unionization rarely precedes the enactment of a statute. Where bargaining laws have
Currently, a dyadic and hierarchical vision dominates in the literature on leadership as it does in the public sector (Gronn, 2002; Hiller and Vance, 2006). The transactional and transformational perspectives present leaders in relation with their subordinates or their supporters. Yet, that is a truncated vision of the reality because it disregards the situation and the other leaders present (Gronn,
Yannis Markovits; Ann J. Davis; Doris Fay; Rolf van Dick
Employees in the public and private sectors experience different working conditions and employment relationships. Therefore, it can be assumed that their attitudes toward their job and organizations, and relationships between them, are different. The existing literature has identified the relationship between organizational commitment and job satisfaction as interesting in this context. The present field study examines the satisfaction–commitment link with
This paper provides a broad review of the public sector accounting research in recent years, including that undertaken in the US. An analysis of this research reveals a methodological distinction between research undertaken in the US (using predominately functionalist methodologies, accompanied by positivistic quantitative research methods) and that undertaken in the rest of the world (using interpretive and radical\\/alternative methodologies,
This article argues that psychological factors determine the content of people’s work motivations but that social factors determine their relative importance. The author identified six universal human needs and corresponding rewards, orientations to work, organizational control methods, and types of involvement. The author used data from a public sector organization to illustrate these orientations. He used Randall Collins’s ritual interaction
Jewson, Nick; Felstead, Alan; Green, Francis
This article examines what has happened to training in public sector organisations in the UK in a period of austerity. It draws on individual-level data collected over the period 2000-2012 and establishment-level data collected from employer surveys carried out between 2005 and 2012. To understand these data further, 75 qualitative interviews with…
Hamlin, Robert G.; Patel, Taran
Purpose: This paper aims to report the results of a replication study of perceived managerial and leadership effectiveness within a Romanian public sector hospital, and to discuss the extent to which they are similar to and different from findings from equivalent studies carried out in two British NHS Trust hospitals. Design/methodology/approach:…
Peter Sibanda; Taruona Muchena; Farai Ncube
The research analyses employee engagement as a precursor to unlocking organisational performance in a public sector organisation in Zimbabwe. The organisation (herein referred to as Zim-PSO), which has been plagued by operational and people challenges, is essentially locked in underperformance, which, it is argued, could improve as employee engagement levels also improved. A sample of 50 subjects participated in the
Most performance indicator schemes in the public sector have been implemented on the assumption that they will yield benefits in terms of efficiency and equity. Less attention has been paid to the potential costs of such schemes. Drawing on experience from a range of sources, this paper identifies eight consequences of publishing performance data that are not necessarily intended, and
This November, California voters must decide two policy questions of great concern to public-sector unions. One is a tax hike to stave off further cuts to state spending (there are two versions on the ballot with a chance of passing). The other is a "paycheck protection" measure that would ban the practice of unions' deducting money from member…
Reshaping the states of Western Europe has direct implications for their respective public sectors. Broad convergent pressures have led to largely similar reform programmes. However, differences remain across Western Europe in the nature, style, timing and pace of the reforms. These differences may be explained by analysing the nature of the pressures, the size and scope of the traditional public
Lafferty, Michael B.
When it comes to public-sector pensions, writes lead author Michael B. Lafferty in this report, "A major public-policy (and public-finance) problem has been defined and measured, debated and deliberated, but not yet solved. Except where it has been." As recounted in "Halting a Runaway Train: Reforming Teacher Pensions for the 21st Century", these…
Sajid Mahmood; Muhammad Kazim Rahim Najjad; Nasir Ali; Naeem Yousuf; Yasir Hamid
OBJECTIVES: To identify the predictors of obesity among post graduate trainee doctors working in a tertiary care hospital of public sector at Karachi, Pakistan.METHODS: A cross sectional analytical study was conducted at one of the tertiary care hospitals of public sector in Karachi. Information was collected from 117 post graduate trainee doctors via pre-tested self administered questionnaire and standard tools
Paris-Sud XI, Université de
Earnings Differentials between the Public and Private Sectors in China: Exploring Changes for Urban Differentials between the Public and Private Sectors in China: Exploring Changes for Urban Local Residents for local residents in urban China between 2002 and 2007. We find that earnings gaps across ownership
Background Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. Methods The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. Conclusions The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system where church-run health facilities are vital in the provision of health care in rural areas and where patients tend to prefer these services. In order to ensure equity in distribution of qualified health workers in Tanzania, a national regulation and legislation of the pension schemes is required. PMID:22480347
Andersen, Mette Rye; Storm, Hans H
The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in Europe are at stake. PMID:24120502
Daniels, Norman; Flores, Walter; Pannarunothai, Supasit; Ndumbe, Peter N.; Bryant, John H.; Ngulube, T. J.; Wang, Yuankun
The Benchmarks of Fairness instrument is an evidence-based policy tool developed in generic form in 2000 for evaluating the effects of health-system reforms on equity, efficiency and accountability. By integrating measures of these effects on the central goal of fairness, the approach fills a gap that has hampered reform efforts for more than two decades. Over the past three years, projects in developing countries on three continents have adapted the generic version of these benchmarks for use at both national and subnational levels. Interdisciplinary teams of managers, providers, academics and advocates agree on the relevant criteria for assessing components of fairness and, depending on which aspects of reform they wish to evaluate, select appropriate indicators that rely on accessible information; they also agree on scoring rules for evaluating the diverse changes in the indicators. In contrast to a comprehensive index that aggregates all measured changes into a single evaluation or rank, the pattern of changes revealed by the benchmarks is used to inform policy deliberation aboutwhich aspects of the reforms have been successfully implemented, and it also allows for improvements to be made in the reforms. This approach permits useful evidence about reform to be gathered in settings where existing information is underused and where there is a weak information infrastructure. Brief descriptions of early results from Cameroon, Ecuador, Guatemala, Thailand and Zambia demonstrate that the method can produce results that are useful for policy and reveal the variety of purposes to which the approach can be put. Collaboration across sites can yield a catalogue of indicators that will facilitate further work. PMID:16175828
Daniels, Norman; Flores, Walter; Pannarunothai, Supasit; Ndumbe, Peter N; Bryant, John H; Ngulube, T J; Wang, Yuankun
The Benchmarks of Fairness instrument is an evidence-based policy tool developed in generic form in 2000 for evaluating the effects of health-system reforms on equity, efficiency and accountability. By integrating measures of these effects on the central goal of fairness, the approach fills a gap that has hampered reform efforts for more than two decades. Over the past three years, projects in developing countries on three continents have adapted the generic version of these benchmarks for use at both national and subnational levels. Interdisciplinary teams of managers, providers, academics and advocates agree on the relevant criteria for assessing components of fairness and, depending on which aspects of reform they wish to evaluate, select appropriate indicators that rely on accessible information; they also agree on scoring rules for evaluating the diverse changes in the indicators. In contrast to a comprehensive index that aggregates all measured changes into a single evaluation or rank, the pattern of changes revealed by the benchmarks is used to inform policy deliberation aboutwhich aspects of the reforms have been successfully implemented, and it also allows for improvements to be made in the reforms. This approach permits useful evidence about reform to be gathered in settings where existing information is underused and where there is a weak information infrastructure. Brief descriptions of early results from Cameroon, Ecuador, Guatemala, Thailand and Zambia demonstrate that the method can produce results that are useful for policy and reveal the variety of purposes to which the approach can be put. Collaboration across sites can yield a catalogue of indicators that will facilitate further work. PMID:16175828
Powell, G N
This study examined reactions of part-time MBA students (n = 199) and undergraduate business students (n = 220) to the affair involving U.S. President Bill Clinton and White House intern Monica Lewinsky prior to Clinton's impeachment by the House of Representatives. Consistent with research on attitudes toward workplace romance in the private sector, women believed that this affair occurring in the public sector represented a more serious problem for the nation and more than men were inclined to prefer that some type of action, e.g., resignation or impeachment, be taken. Implications of the results are discussed. PMID:11272740
Rachel Jenkins; Ahmed Heshmat; Nasser Loza; Inkeri Siekkonen; Eman Sorour
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
Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and
Emery M. Roe
What is evaluated as central government decentralization to improve rural development may also be local government reform for improved district development. The challenge in analyzing such efforts is not to be preoccupied with an always-present politics of decentralization. This article examines a local government reform in Zimbabwe that has been equated with central government decentralization: the Amalgamation of the countryside's
Mehrolhassani, Mohammad Hossein; Emami, Mozhgan
Background: Change theories provide an opportunity for organizational managers to plan, monitor and evaluate changes using a framework which enable them, among others, to show a fast response to environmental fluctuations and to predict the changing patterns of individuals and technology. The current study aimed to explore whether the change in the public accounting system of the Iranian health sector has followed Kurt Lewin’s change theory or not. Methods: This study which adopted a mixed methodology approach, qualitative and quantitative methods, was conducted in 2012. In the first phase of the study, 41 participants using purposive sampling and in the second phase, 32 affiliated units of Kerman University of Medical Sciences (KUMS) were selected as the study sample. Also, in phase one, we used face-to-face in-depth interviews (6 participants) and the quote method (35 participants) for data collection. We used a thematic framework analysis for analyzing data. In phase two, a questionnaire with a ten-point Likert scale was designed and then, data were analyzed using descriptive indicators, principal component and factorial analyses. Results: The results of phase one yielded a model consisting of four categories of superstructure, apparent infrastructure, hidden infrastructure and common factors. By linking all factors, totally, 12 components based on the quantitative results showed that the state of all components were not satisfactory at KUMS (5.06±2.16). Leadership and management; and technology components played the lowest and the greatest roles in implementing the accrual accounting system respectively. Conclusion: The results showed that the unfreezing stage did not occur well and the components were immature, mainly because the emphasis was placed on superstructure components rather than the components of hidden infrastructure. The study suggests that a road map should be developed in the financial system based on Kurt Lewin’s change theory and the model presented in this paper underpins the change management in any organizations. PMID:24596885
Background South Africa has large public and private sectors and there is a common perception that public sector hospitals are inefficient and ineffective while the privately owned and managed hospitals provide superior care and are more sustainable. The underlying assumption is that there is a potential gap in management capacity between the two sectors. This study aims to ascertain the skills and competency levels of hospital managers in South Africa and to determine whether there are any significant differences in competency levels between managers in the different sectors. Methods A survey using a self administered questionnaire was conducted among hospital managers in South Africa. Respondents were asked to rate their proficiency with seven key functions that they perform. These included delivery of health care, planning, organizing, leading, controlling, legal and ethical, and self-management. Ratings were based on a five point Likert scale ranging from very low skill level to very high skill level. Results The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. Conclusion The findings confirm our supposition that there is a lack of management capacity within the public sector in South Africa and that there is a significant gap between private and public sectors. It provides evidence that there is a great need for further development of managers, especially those in the public sector. The onus is therefore on administrators and those responsible for management education and training to identify managers in need of development and to make available training that is contextually relevant in terms of design and delivery. PMID:18257936
-In 2001, Colquitt developed an Organizational Justice Scale that intended to measure procedural, distributive, interpersonal, and informational justice. The dimensionality of the scale has been tested in subsequent studies with diverging results. Given the fact that contextual differences may account for more variation across research sites than individual differences, the deviating research findings may be due to context. This study examined the dimensionality of Colquitt's Organizational Justice Scale in a new context: the public health sector. The procedural and informational justice dimensions were highly correlated, but confirmatory factor analysis showed that a four-factor solution provided a better fit than a three-factor solution. All fit indices for the four-factor model were consistent with a good model. There was, however, evidence of a potential omitted factor, procedural-voice justice, which has also been found in a previous examination of the measure in the public sector. PMID:25871568
Paolo Liberati; Antonio Sciala
This paper investigates the impact of economic integration on the vertical structure of the public sector within a country.\\u000a To tackle this issue we set up a model of fiscal federalism, where economic integration is assumed to affect central government\\u000a tax revenues. The main findings are that when an increase of the impact of economic integration brings about a reduction
Mission-directed public-sector research facilities are experiencing increasingly severe budget environments while seeing expanding missions and responsibilities. In an effort to identify research leveraging methodologies an information search was conducted in conjunction with some efforts to find the proper links to systems engineering fundamentals. The result is an initial model for use in a preconcept/phase-1 engineering design organization, with a goal of improving the organizations performance.
John Akin; Paul Hutchinson; Koleman Strumpf
While many developing countries have devolved health care responsibilities to local governments in recent years, no study has examined whether decentralisation actually leads to greater health sector allocative efficiency. This paper approaches this question by modeling local government budgeting decisions under decentralisation. The model leads to conclusions not all favourable to decentralisation and produces several testable hypotheses concerning local government
Crick Lund; Sharon Kleintjes; Ritsuko Kakuma; Alan J. Flisher
Background There is growing recognition that mental health is an important public health issue in South Africa. Yet mental health services\\u000a remain chronically under-resourced. The aim of this study was to document levels of current public sector mental health service\\u000a provision in South Africa and compare services across provinces, in relation to current national policy and legislation.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A survey was conducted
Historically, the Israeli health care system has been considered a high-performance system, providing universal, affordable, high-quality care to all residents. However, a decline in the ratio of physicians to population that reached a modern low in 2006, an approximate ten-percentage-point decline in the share of publicly financed health care between 1995 and 2009, and legislative mandates that favored private insurance have altered Israel's health care system for the worse. Many Israelis now purchase private health insurance to supplement the state-sponsored universal care coverage, and they end up spending more out of pocket even for services covered by the entitlement. Additionally, many publicly paid physicians moonlight at private facilities to earn more money. In this article I recommend that Israel increase public funding for health care and adopt reforms to address the rising demand for privately funded care and the problem of publicly paid physicians who moonlight at private facilities. PMID:23569052
Theunissen, Marianne; Swanepoel, DeWet
The purpose of this study was to examine the current status of newborn/infant hearing screening programs in public sector hospitals in South Africa by means of a descriptive survey. Data was gathered using a self-administered postal questionnaire, which included questions on screening resources and protocols, follow-up, diagnostic, and information management procedures as well as timing of intervention. The questionnaire was sent to 86 speech therapy and audiology departments within public sector hospitals throughout South Africa and 44 questionnaires were returned. The findings indicated that 27% (n=12) of respondents were conducting some form of hearing screening. The most frequently reported reasons for the absence of a screening program were a lack of appropriate equipment and a shortage of staff. Institutions with active screening programs face many challenges and programs are mostly unsystematic. Reported findings make a valuable contribution to the field of early hearing detection and intervention by providing a baseline for the development and structuring of early hearing detection and intervention services as a priority in the public healthcare sector of South Africa. PMID:18781510
Rogers, John S.; Terriquez, Veronica
This article explores the potential role of low-wage service sector unions in engaging in equity-minded school reform. The members of many such unions are parents of children attending poorly resourced public schools. In seeking to address the interests of their members, labor unions can draw upon resources, organizing strategies, and political…
Rivera, William M.
This paper distinguishes two pathways in the various proposals for innovative reforms of public sector agricultural extension. The two "pathways" involve the participatory trends toward democratization and farmer association and, in contrast, the push toward capitalistic commercial attitudes toward agriculture as business. The introduction reviews…
Abstract The voluntary or third sector in England is now receiving more sustained attention from policy makers than ever before. This paper claims that this situation, particularly as given tangible expression through the development,of a Compactbetween,the Government,and representatives of the third sector, amounts to the mainstreaming of the third sector onto the public policy agenda. It seeks to explain why
Paris-Sud XI, Université de
Organizations (CSO) leads to the reproduction of the practices stemming from the company in these a priori non-profit organizations dealing with medical, sanitary and social sector A large number of non-profit organizations are witnessing an increase in the number of non-profit organizations involved in the public sector often
Dickson, David; Hargie, Owen; Wilson, Noel
Four large organizations, two each from the private and public sectors of the Northern Ireland economy, were selected for this study which, first, explored the effects of religion-based workforce difference on intergroup relationships, second, investigated the contribution of organizational sector to communicative differences, and third, gauged…
McDonald, Julie; Powell Davies, Gawaine; Jayasuriya, Rohan; Fort Harris, Mark
Ongoing care for chronic conditions is best provided by interprofessional teams. There are challenges in achieving this where teams cross organisational boundaries. This article explores the influence of organisational factors on collaboration between private and public sector primary and community health services involved in diabetes care. It involved a case study using qualitative methods. Forty-five participants from 20 organisations were purposively recruited. Data were collected through semi-structured interviews and from content analysis of documents. Thematic analysis was used employing a two-level coding system and cross case comparisons. The patterns of collaborative patient care were influenced by a combination of factors relating to the benefits and costs of collaboration and the influence of support mechanisms. Benefits lay in achieving common or complementary health or organisational goals. Costs were incurred in bridging differences in organisational size, structure, complexity and culture. Collaboration was easier between private sector organisations than between private and public sectors. Financial incentives were not sufficient to overcome organisational barriers. To achieve more coordinated primary and community health care structural changes are also needed to better align funding mechanisms, priorities and accountabilities of the different organisations. PMID:21554068
Public Agenda, 2012
This is a report on how community stakeholders, including parents, teachers, community leaders and advocates, think about current efforts by Chicago Public Schools (CPS) to "turn around" Chicago's lowest-performing schools, and their expectations for future school reform actions. It was prepared by Public Agenda, with support from…
In the aftermath of the Norwegian hospital reform of 2002, the private supply of specialized healthcare has increased substantially. This article analyses the likelihood of medical specialists working in the private sector. Sector choice is operationalized in two ways: first, as the likelihood of medical specialists working in the private sector at all (at least 1% of the total work hours), and second, as the likelihood of working full-time (90-100%) privately. The theoretical framework is embedded in work values theory and the results suggest that work values are important predictors of sector choice. All analyses are based on a postal questionnaire survey of medical specialists working in private contract practices and for-profit hospitals and a control group of specialists selected from the Norwegian Medical Association's member register. The analyses revealed that while autonomy values impact positively on the propensity for allocating any time at all to the private sector, professional values have a negative effect. Given that the medical specialist already works in the private sector, a high valuation of professional values and payment and benefit values increases the likelihood of having a dual sector job rather than a full-time private position. However, due to the cross-sectional structure of the data and limitations in the dataset, causality questions cannot be fully settled on the basis of the analyses. The relationship between work values and sector choice should, therefore, be regarded as associations rather than causality links. Finally, the likelihood of working in the private sector varies significantly at the municipality level, suggesting that medical specialist's location is important for sector choice. PMID:17161892
Ya Ping Wang
Housing provision in Chinese cities has experienced many changes since 1979 when the country embarked on major economic reform. During the late 1980s and the 1990s many publicly owned houses were sold to their existing tenants or other public sector employees. Large numbers of new houses were built by commercial property developers for the emerging urban housing market. As a
...the Wall Street Reform and Consumer Protection Act and the Rulemakings That...Dodd-Frank Wall Street Reform and Consumer Protection Act (``Dodd-Frank Act...Dodd-Frank Wall Street Reform and Consumer Protection Act (``Dodd-Frank...
Bonner, Cameron S.; Herschbach, Dennis R.; Rifkin, Norman
Improvements in education are occurring in Macedonia, but challenges remain with quality, equity, efficiency, and administration. This report presents to United States Agency for International Development (USAID)/Macedonia a way to move forward in assisting the education sector. It is the result of almost four plus weeks of study by a team of…
Krishnan A Devidoss
India is rapidly becoming one of the largest consumers of energy in the world. At the same time, India continues to be hindered by bureaucratic delays, an archaic tax system, security problems and prohibitive investment regulations that have made expansion and consolidation in the petroleum sector difficult. This Note explores underlying structural problems in India’s investment, tax, and regulatory climate
Background Tuberculosis (TB) is endemic in Pakistan which ranks fifth amongst the twenty two countries designated to be highly burdened by TB according to the World Health Organization. However, there is paucity of data regarding the knowledge of diagnosis of TB and its management amongst public and private practitioners. In this study, we endeavor to identify this gap in knowledge regarding the diagnosis and management of TB between public and private doctors and the factors affecting these knowledge scores in urban Pakistan. Methods This cross sectional survey was conducted between June and December 2011. Doctors from public hospitals, private hospitals and private clinics scattered in all eighteen towns of Karachi were included in the study. Qualified MBBS doctors working in any specialty were eligible to participate whereas doctors working in both the public and private sectors were excluded from the study. Vignette based clinical scenarios were given to assess the knowledge score regarding the diagnosis and management of TB. Results A total of 196 doctors participated in the study. There was a significant difference between private and public physicians in terms of age and years of practice (p-value <0.05). Significant differences in the proportion of knowledge scores were observed between the public and private doctors and National TB Control Program trained and untrained doctors in Karachi. Factors associated with inadequate knowledge scores were being female gender [OR: 2.76 (95% CI: 1.418-5.384)], private employment status [OR: 1.50 (95% CI: 1.258-2.439)], and not trained by NTP [OR: 2.98 (95% CI: 1.286-3.225)] on multivariate logistic regression analysis. Conclusion It is concluded that a knowledge gap exists between the public and private doctors in Karachi. Strengthening of currently implemented public private mix model along with improvement in the trainings of public and private practitioners is highly recommended to control TB in Pakistan. PMID:24156568
Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini
Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01). Age and education level of health care providers don’t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi. PMID:24479088
Background The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Methods Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N?=?165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€?=?MYR4). Results A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P?=?0.003). Higher costs were expended as disease severity increased (ANOVA, P?=?0.022) and for patients requiring surgeries (ANOVA, P?0.001). Providers generally spent most on consumables while patients spent most on transportation. Conclusions Cost of providing dental treatment for periodontitis patients at public sector specialist settings were substantial and comparable with some non-communicable diseases. These findings provide basis for identifying potential cost-reducing strategies, estimating economic burden of periodontitis management and performing economic evaluation of the specialist periodontal programme. PMID:24884465
The reform of the tarification according to activity is now in place with a "T2A" rate said to be 100%, ie the hospitals are paid based on the national tariffs for a stay in hospital. The reform will continue with a list of stays for which, each year, a single tariff between the public sector and the private sector is applied. This single tariff results from the "inter-sector tariff convergence" policy which is applied. PMID:22924191
Becker, Davida; Díaz-Olavarrieta, Claudia; Garcia, Sandra G.; Harper, Cynthia C.
Objective First trimester abortion was decriminalized in Mexico City in 2007. We studied client views of family planning services provided during abortion care at public facilities and acceptance of postabortion contraception. Methods We surveyed 402 clients seeking first trimester abortion care in Mexico City. We used logistic regression to test whether postabortion contraception varied by abortion visit characteristics or client sociodemographics. Results Most participants (81.6%) reported being offered contraception at their visit and 89.5% selected a contraceptive method postabortion, with 58.9% selecting the IUD. Surgical abortion clients were more likely to report being offered contraception than medical abortion clients (p<.001), as were clients attended by a female physician (p<.05). Clients at the general hospital were less likely to report being offered contraception (p<.001). Conclusion Public sector facilities in Mexico City are providing a generally high level of postabortion family planning care and uptake of postabortion contraception is high. PMID:23499047
Bluford, J W
While managed care is still a new concept in much of the country, it has been a reality in the Minneapolis-St. Paul area for more than three decades. Metropolitan Health Plan (MHP), a public-sector, county-owned health maintenance organization (HMO), was developed 10 years ago as a mechanism to ensure retention of the county hospital's historical patient base if the state of Minnesota were to mandate managed care for public-assistance patients (which occurred in 1985). Because MHP's chief provider organization was Hennepin County Medical Center, which has a long history of serving the poor, it had an advantage over its more established competitors. MHP's greater knowledge of the population and sensitivity to ethnic and cultural diversity has enabled it to develop programs and systems to streamline access to services, many of which are unique to MHP. PMID:7918887
Zumrah, Abdul Rahim
Purpose: This study aims to investigate the relationships among perceived organizational support (POS), transfer of training outcomes to the workplace and service quality in the context of public sector organizations in Malaysia. Design/methodology/approach: The data for this study have been collected from three sources, the employees of public…
May Ifeoma Nwoye
State owned enterprises have in recent years presented an acute set of institutional problems compared with their counterparts in the private sector problems. Most often they have large operating deficits and impose a heavy burden on the public budget. Although experience with public enterprises varies from country to country, in many developing countries, the responsibility for devising and implementing the
Background Countries in the Asia Pacific region have made great progress in the fight against malaria; several are rapidly approaching elimination. However, malaria control programmes operating in elimination settings face substantial challenges, particularly around mobile migrant populations, access to remote areas and the diversity of vectors with varying biting and breeding behaviours. These challenges can be addressed through subnational collaborations with commercial partners, such as mining or plantation companies, that can conduct or support malaria control activities to cover employees. Such partnerships can be a useful tool for accessing high-risk populations and supporting malaria elimination goals. Methods This observational qualitative case study employed semi-structured key informant interviews to describe partnerships between the Malaysian Malaria Control Programme (MCP), and private palm oil, rubber and acacia plantations in the state of Sabah. Semi-structured interview guides were used to examine resource commitments, incentives, challenges, and successes of the collaborations. Results Interviews with workers from private plantations and the state of Sabah MCP indicated that partnerships with the commercial sector had contributed to decreases in incidence at plantation sites since 1991. Several plantations contribute financial and human resources toward malaria control efforts and all plantations frequently communicate with the MCP to help monitor the malaria situation on-site. Management of partnerships between private corporations and government entities can be challenging, as prioritization of malaria control may change with annual profits or arrival of new management. Conclusions Partnering with the commercial sector has been an essential operational strategy to support malaria elimination in Sabah. The successes of these partnerships rely on a common understanding that elimination will be a mutually beneficial outcome for employers and the general public. Best practices included consistent communication, developing government-staffed subsector offices for malaria control on-site, engaging commercial plantations to provide financial and human resources for malaria control activities, and the development of new worker screening programmes. The successes and challenges associated with partnerships between the public and commercial sector can serve as an example for other malaria-eliminating countries with large plantation sectors, and may also be applied to other sectors that employ migrant workers or have commercial enterprises in hard to reach areas. PMID:24443824
Barriers to Private Sector Public School Collaboration. A Set of Exploratory Papers Commissioned by the National Institute of Education and the American Enterprise Institute for Public Policy Research.
American Enterprise Inst. for Public Policy Research, Washington, DC.
Six exploratory papers by different authors from both the corporate sector and the public school systems present several relevant perspectives on business/education collaboration. The first, by Dr. Marsha Levine (who also provides the introduction to the collection), suggests three analytic frameworks for planning and implementing public/private…
Ahmed Galal; Omar Razzaz
Some World Bank-supported efforts at land and real estate reform have too narrow a technical focus, at the expense of institutional reform. Some emphasize one set of reforms (such as mortgage finance) while ignoring others essential to those reforms (such as clear property rights and land registration). Some emphasize one sector (such as urban land) while ignoring its interaction with
Waitzkin, Howard; Yager, Joel; Santos, Richard
Relatively little research has clarified how executives of for-profit healthcare organisations frame their own motivations and behaviour, or how government officials frame their interactions with executives. Because managed care has provided an organisational structure for health services in many countries, we focused our study on executives and government officials who were administering public sector managed care services. Emphasising theoretically the economic versus non-economic motivations that guide economic behaviour, we extended a long-term research project on public sector Medicaid managed care (MMC) in the United States. Our method involved in-depth, structured interviews with chief executive officers of managed care organisations, as well as high-ranking officials of state government. Data analysis involved iterative interpretation of interview data. We found that the rate of profit, which proved relatively low in the MMC programme, occupied a limited place in executives' self-described motivations and in state officials' descriptions of corporation-government interactions. Non-economic motivations included a strong orientation toward corporate social responsibility and a creed in which market processes advanced human wellbeing. Such patterns contradict some of the given wisdom about how corporate executives and government officials construct their reality. PMID:21707659
Kolstad, Julie Riise; Lindkvist, Ida
Motivational crowding-out theory establishes that the effectiveness of financial incentive schemes, like pay-for-performance, crucially depends on the underlying social preferences of health workers. In this paper we study the extent to which heterogeneity in the strength and structure of social preferences is related to career choices by testing whether preferences vary systematically between Tanzanian health worker students who prefer to work in the private for-profit health sector and those who prefer to work in the public health sector. Despite its important policy implications, this issue has received little attention to date. By combining data from a questionnaire and an economic experiment, we find that students who prefer to work in the public health sector have stronger pro-social preferences than those who prefer to work in the private for-profit sector. PMID:22763126
conferences allow computer hackers to “collectively enact,hackers’ moral technical imaginaries begin with technical discussions of computers,hackers, the lifeworld of media reformers is largely a solitary practice in front of a computer,
Rispel, Laetitia C.; Angelides, George
Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ? R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year, a total of 5369 registered nurses could have been employed in lieu of nursing agency expenditure. Conclusions The study findings should inform workforce planning in South Africa. There is a need for uniform policies and improved management of commercial nursing agencies in the public health sector. PMID:25537936
The embezzlement and corruption scandal surrounding the director of a local Massachusetts housing authority in late 2011 spurred a heated public debate about governance and efficiency in the state-funded public housing ...
L'Abbé, M; Schermel, A; Minaker, L; Kelly, B; Lee, A; Vandevijvere, S; Twohig, P; Barquera, S; Friel, S; Hawkes, C; Kumanyika, S; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Rayner, M; Sacks, G; Sanders, D; Snowdon, W; Swinburn, B; Walker, C
This paper outlines a step-wise framework for monitoring foods and beverages provided or sold in publicly funded institutions. The focus is on foods in schools, but the framework can also be applied to foods provided or sold in other publicly funded institutions. Data collection and evaluation within this monitoring framework will consist of two components. In component I, information on existing food or nutrition policies and/or programmes within settings would be compiled. Currently, nutrition standards and voluntary guidelines associated with such policies/programmes vary widely globally. This paper, which provides a comprehensive review of such standards and guidelines, will facilitate institutional learnings for those jurisdictions that have not yet established them or are undergoing review of existing ones. In component II, the quality of foods provided or sold in public sector settings is evaluated relative to existing national or sub-national nutrition standards or voluntary guidelines. Where there are no (or only poor) standards or guidelines available, the nutritional quality of foods can be evaluated relative to standards of a similar jurisdiction or other appropriate standards. Measurement indicators are proposed (within 'minimal', 'expanded' and 'optimal' approaches) that can be used to monitor progress over time in meeting policy objectives, and facilitate comparisons between countries. PMID:24074214
Andrew Noblet; Stephen T. T. Teo; John McWilliams; John J. Rodwell
The wide-ranging changes that have occurred in the public sector over recent years have placed increasing demands on public-sector employees. A survey of employees within a relatively commercially-oriented public-sector organization in Australia was used to test a demand-oriented generic model of employee well-being and a variety of situation-specific variables. The presence of support at work and the amount of control
Julian V Roberts
Objective: One justification for a statutory ban on physical punishment is that passage of such legislation changes public attitudes towards the use of this form of parental discipline. The experience in Sweden is often cited as an example of legislation which changed public opinion. The aim of this brief article is to review the public opinion findings in Sweden in
Mukherjee, Sudeshna Basu; Ray, Anjali
Background: The present study was firstly aimed to find out the nature of stressful life events arising out of the innovative challenges in modernized organizations; and secondly, it tried to identify the relationship between innovative work behavior of managers and the levels of stress arising out of stressful events in modernized organizations (public and private) in West Bengal. Materials and Methods: Data was collected from a sample of 200 managers, by using 3 tools (General Information Schedule, Life Event Inventory and Innovative Work Behavior Scale) through a face-to-face interview. Responses were subjected to both quantitative and qualitative analyses. The data was statistically treated for ‘t’ and ANOVA. Results: Data highlighted the fact that the qualitative profile of stressful events in the lives of managers expressed specificity in terms of their organizational type (public- and private-sector modernized organizations), and levels of stress from stressful life events were significantly higher among the modernized private-sector managers than those among public-sector managers. The prevalence of innovative work behavior was moderately higher among managers of private-sector modernized organizations than their counterparts in public-sector organizations. The trends of innovative work behavior of the managers indicated much variability due to interaction of their level of perceived stressful challenges for innovation and the global forces of change that have unleashed dynamic, systematic and higher expectation level from them. PMID:21180486
Paris-Sud XI, Université de
1 Is the Consociational system reformable ? The current state of public life in Lebanon is neither groups and the majority of the Islamic fundamentalist movements, had already thrown in the sponge of the population by the political class and its loyalty towards a State whose authority would thus appear all
Muurinen, Charlotte; Laine, Matti; Pentti, Jaana; Virtanen, Marianna; Salo, Paula; Kivimäki, Mika; Vahtera, Jussi; Oksanen, Tuula
This prospective cohort study aimed to examine the associations of trust towards the supervisor (vertical trust) and trust towards co-workers (horizontal trust) with retirement intentions. The participants were 14 840 women and men working in the municipal sector in 2000-12 (Finnish Public Sector Study). Trust (vertical trust towards the supervisor and horizontal trust towards co-workers) and retirement intentions were assessed in repeated surveys. Multivariable multinomial logistic regression analyses were conducted to assess the association between baseline trust and retirement intentions at 3.7 years of follow-up. Demographic characteristics, health, psychological distress, health risk behaviors, personality factors, and psychosocial factors were included as covariates. Of the participants, 67.0% trusted their supervisor and 54.9% trusted their co-workers. Employees who trusted their supervisor (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.53-0.67) and employees who trusted their co-workers (odds ratio 0.62, 95% confidence interval 0.55-0.70) at baseline were less likely to have strong retirement intentions at follow-up compared to those who did not trust. These associations largely persisted after adjusting for all covariates and taking into account baseline retirement intentions. In conclusion, trust in the supervisor and co-workers predicted retirement intentions. These observational findings suggest that increasing trust in the workplace may contribute to lengthening working careers and preventing early retirement. PMID:25191745
Cawich, Shamir O; Harding, Hyacinth E; Crandon, Ivor W; McGaw, Clarence D; Barnett, Alan T; Tennant, Ingrid; Evans, Necia R; Martin, Allie C; Simpson, Lindberg K; Johnson, Peter
The barriers to health care delivery in developing nations are many: underfunding, limited support services, scarce resources, suboptimal health care worker attitudes, and deficient health care policies are some of the challenges. The literature contains little information about health care leadership in developing nations. This discursive paper examines the impact of leadership on the delivery of operating room (OR) services in public sector hospitals in Jamaica.Delivery of OR services in Jamaica is hindered by many unique cultural, financial, political, and environmental barriers. We identify six leadership goals adapted to this environment to achieve change. Effective leadership must adapt to the environment. Delivery of OR services in Jamaica may be improved by addressing leadership training, workplace safety, interpersonal communication, and work environment and by revising existing policies. Additionally, there should be regular practice audits and quality control surveys. PMID:24355903
Place, Jean Marie S; Billings, Deborah L; Blake, Christine E; Frongillo, Edward A; Mann, Joshua R; deCastro, Filipa
In this article we describe the knowledge frameworks that 61 physicians, nurses, social workers, and psychologists from five public-sector health care facilities in Mexico used to conceptualize postpartum depression. We also demonstrate how providers applied social and behavioral antecedents in their conceptualizations of postpartum depression. Using grounded theory, we identify two frameworks that providers used to conceptualize postpartum depression: biochemical and adjustment. We highlight an emerging model of the function of social and behavioral antecedents within the frameworks, as well as the representation of postpartum depression by symptoms of distress and the perception among providers that these symptoms affected responsibilities associated with motherhood. The results provide a foundation for future study of how providers' conceptualizations of postpartum depression might affect detection and treatment practices and might be useful in the development of training materials to enhance the quality of care for women who experience any form of distress in the postpartum period. PMID:25281238
Norma González González
In the context of the changes taking place in the health care sector, it is indispensable to make an analysis that considers the importance and the role of human resources since they play a determining role in mee- ting the targets and expectations derived from the reform and the accompanying decentralization in this sector. From a Sociology- and Public Administration-based
District of Columbia Public Schools: While Early Reform Efforts Tackle Critical Management Issues, a District-Wide Strategic Education Plan Would Help Guide Long-Term Efforts. Testimony before the Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia, Committee on Homeland Security and Governmental Affairs, U.S. Senate. GAO-08-549T
Ashby, Cornelia M.
In response to long-standing problems with student academic performance, the condition of school facilities, and the overall management of the D.C. public school system, the D.C. Council approved the Public Education Reform Amendment Act of 2007 (Reform Act). The Reform Act made major changes to the operations and governance of the D.C. public…
Salo, Paula; Ala-Mursula, Leena; Rod, Naja Hulvej; Tucker, Philip; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi
Objectives: Employee control over work times has been associated with favorable psychosocial and health-related outcomes, but the evidence regarding sleep quality remains inconclusive. We examined cross-sectional and prospective associations between work time control and sleep disturbances in a large working population, taking into account total hours worked. Methods: The data were from a full-panel longitudinal cohort study of Finnish public sector employees who responded to questions on work time control and sleep disturbances in years 2000-2001, 2004-2005, 2008-2009, and 2012. The analysis of cross-sectional associations was based on 129,286 person measurements from 68,089 participants (77% women) aged 17-73 years (mean 43.1). Data from 16,503 participants were used in the longitudinal analysis. Log-binomial regression analysis with the generalized estimating equations method was used. Results: Consistently in both cross-sectional and longitudinal models, less control over work time was associated with greater sleep disturbances in the total population and among those working normal 40-hour weeks. Among participants working more than 40 hours a week, work time that was both very high (cross-sectional prevalence ratio compared to intermediate work time control [PR] 1.32, 95% confidence interval [CI] 1.05-1.65) and very low (PR 1.23, 95% CI 1.08-1.39) was associated with sleep disturbances, after adjustment for potential confounding factors. Conclusions: These data suggest that having few opportunities to influence the duration and positioning of work time may increase the risk of sleep disturbances among employees. For persons working long hours, very high levels of control over working times were also associated with increased risk of sleep disturbances. Citation: Salo P, Ala-Mursula L, Rod NH, Tucker P, Pentti J, Kivimäki M, Vahtera J. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. SLEEP 2014;37(7):1217-1225. PMID:25061250
Background The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Methods Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Conclusions Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors. PMID:21619572
Robelen, Erik W.
Kicked off the week of April 10, 2006 with a big plug on "The Oprah Winfrey Show," a new campaign spearheaded by the Bill & Melinda Gates Foundation is aiming to drum up public action to address what its organizers see as a crisis in America's public high schools. The Stand Up campaign comes as high schools have emerged as a focus of public-policy…
IDRA Newsletter, 1998
This theme issue addresses school reform, focusing on accountability, attrition, public-supported private education, equitable education, and schoolwide reform. "School-Student Performance and Accountability" (Jose A. Cardenas) discusses what constitutes good performance in school; the shifting emphasis among the input, output, and process of…
Boskin, Michael J.
Providing pre-college teachers with an analysis of tax reform is the primary goal of this publication. The present tax system is both inefficient and inequitable. Three goals of tax reform proposals are detailed: (1) fairness--the dimensions of horizontal equity, or equal treatment of equals however defined, and vertical equity, reflecting the…
Lawrence O. Gostin; Peter D. Jacobson; Katherine L. Record; Lorian E. Hardcastle
The Patient Protection and Affordable Care Act is a major achievement in improving access to health care services. However, evidence indicates that the nation could achieve greater improvements in health outcomes, at a lower cost, by shifting its focus to public health. By focusing nearly exclusively on health care, policy makers have chronically starved public health of adequate and stable
Goldman, G. T.; Carlson, C.
To enact effective policies to address climate change, decision makers need both scientific and political support. One major barrier to U.S. climate policy enactment has been the opposition of private sector actors to proposed policies and to climate science itself. Increasingly, the public and investors are holding companies accountable for their actions around climate change—including political activies, affiliations with trade groups, and involvement with climate science. However, this accountability is inhibited by the prominent role that trade associations have played in climate policy debates in recent years. The opaque nature of such groups is problematic, as it inhibits the public from understanding who is obstructing progress on addressing climate change, and in some cases, impedes the public's climate literacy. Voluntary climate reporting can yield some information on companies' climate engagement and demonstrates the need for greater transparency in corporate political activities around climate change. We analyze CDP climate reporting data from 1,824 companies to assess the degree to which corporate actors disclosed their political influence on climate policies through their trade associations. Results demonstrate the limitations of voluntary reporting and the extent to which companies utilize their trade associations to influence climate change policy debates without being held accountable for these positions. Notably, many companies failed to acknowledge their board seat on trade groups with significant climate policy engagement. Of those that did acknowledge their board membership, some claimed not to agree with their trade associations' positions on climate change. These results raise questions about who trade groups are representing when they challenge the science or obstruct policies to address climate change. Recommendations for overcoming this barrier to informed decision making to address climate change will be discussed.
Kay Greasley; Paul Watson; Shilpa Patel
Purpose – This paper aims to examine the impact of organisational change on public sector employees utilising the implementation of the UK Government's “Back to work” programme (BTW) as a case study example. The paper seeks to explore the employee response to the changes they experience as a result of this new initiative. Design\\/methodology\\/approach – A qualitative approach was adopted
Vassilis Loumos; George Christonakis; Girgios Mpardis; Panagiota Tziova
Outsourcing in the Public sector has become common practice in the United States and is spreading rapidly in the European Union. When Information & Communication Technologies (ICT) are involved, outsourcing becomes rather complex. In such cases, a clear definition of the processes to be implemented and a quality assurance monitoring system are crucial factors for success. In addition, globalization, world
Branch, Gregory F.; Hanushek, Eric A.; Rivkin, Steven G.
Although much has been written about the importance of leadership in the determination of organizational success, there is little quantitative evidence due to the difficulty of separating the impact of leaders from other organizational components--particularly in the public sector. Schools provide an especially rich environment for studying the…
Branch, Gregory F.; Hanushek, Eric A.; Rivkin, Steven G.
Although much has been written about the importance of leadership in the determination of organizational success, there is little quantitative evidence due to the difficulty of separating the impact of leaders from other organizational components--particularly in the public sector. Schools provide an especially rich environment for studying the…
Amran Ahmed; Abdul Hamid; Sachiko Takahi
The main objective of this study is to explore the employee perception on the impact of ISO 9000 registration on Total Quality Management (TQM) practices of the public sector in Kota Kinabalu, Sabah. Thus, this study examined to what extent does the employee's perceptions of certified IS09000 department and non-certified ISO department affect on TQM practices namely, top management com
Brown, Mary Maureen; Brudney, Jeffrey L.
The effectiveness of information technology in promoting the learning organization in the public sector was examined using responses of 314 police officers. Three factors that threatened the capability of information technology to support knowledge workers in learning organizations were found: asymmetrical decision parameters, ill-structured…
Kinkead, J. Clint.; Katsinas, Stephen G.
This work brings forward the geographically-based classification scheme for the public Master's Colleges and Universities sector. Using the same methodology developed by Katsinas and Hardy (2005) to classify community colleges, this work classifies Master's Colleges and Universities. This work has four major findings and conclusions. First, a…
B. Christopher Frueh; Anouk L. Grubaugh; Karen J. Cusack; Jon D. Elhai
Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19%-43%), contributes a significant illness burden, and hinders mental health care. Yet few public-sector mental health agencies routinely provide
Grey, J. (editor); Newman, M.
The dynamics of aerospace technology transfer is discussed with reference to the agencies which facilitate the transfer to both the public and private sectors. Attention is given to NASA's Technology Utilization Program, and to specific applications of aerospace technology spinoff in the daily life of Americans.
Stephen T. T. Teo
This study examines the effectiveness of the strategic human resource management (HRM) function performed by the corporate human resource department of an Australian public-sector entity, before and after its corporatization. Multiple methods (including a survey of senior managers and semi-structured interviews) were used to collect the data. Despite an improvement in the overall level of strategic integration between HRM and
Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.
There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care…
David Elisha; Daphna Levinson; Alexander Grinshpoon
This article proposes a need-based model for determining staffing needs for regional or national public sector outpatient mental health services. It constitutes a spreadsheet method involving a sequence of calculations relating demographic variables, workers' productivity, anticipated demand, and standards pertaining to annual visits per client distributed among the core mental health professions. The authors demonstrate the application of the model
Hamlin, Robert G.; Sage, Lesley
This paper describes an empirical study of mentor and mentee behaviors deemed critical for developing healthy mentoring relationships and effective mentoring during the "start up" and "on going" stages of a formal mentoring scheme within a major UK public sector organization. Several identified behavioral categories (criteria) of mentoring…
In the previous two papers were examined the content and the source of architects' images of the users of public-sector housing schemes they had recently designed. In this concluding paper are made recommendations for change. Findings from interviews with occupiers show that existing procedures do not produce satisfactory schemes. It is suggested that architectural education and professional norms at present
Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.
The water sector is dependent on effective institutions and organisations, and, therefore, on strong competences at the individual level. In this paper we describe competence formation and competence needs in a case study of the Directorate General of Water Resources (DGWR) in the Ministry of Public Works in Indonesia. A framework is introduced for the water sector comprising three aggregate competences for technical issues, management, and governance, and a meta-competence for continuous learning and innovation. The four competences are further organised in a T-shaped competence profile. Though DGWR professionals have a firmly "technical" orientation, both surveys and interviews reveal a strong perceived requirement for other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. Further, a discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that can be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With low competence in these fields, it is difficult for professionals to communicate and collaborate effectively in a multidisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this is partially compensated by the attention to continuous learning and innovation. The exposure to a different culture and learning format is experienced as fundamentally formative.
Tsai, Wehn-Jyuan; Liu, Jin-Tan; Chou, Shin-Yi; Thornton, Robert
Between 1968 and 1973 the Taiwanese government undertook the most extensive expansion on record of the public junior high school system in Taiwan. This study analyzes the effects of the 1968 education reform and subsequent high school expansion on gender disparities in employment generally, as well in different sectors and classes of employment.…
The goal of this paper is to explore the effects of micro-budgeting decisions and show how they might support or hamper district reform strategies. The study draws on public and private sector resource allocation literature to identify key elements of resource allocation decisions. These elements are used to highlight different allocation…
Mridha, Malay Kanti; Anwar, Iqbal; Koblinsky, Marge
Achieving Millennium Development Goal 5 in Bangladesh calls for an appreciation of the evolution of maternal healthcare within the national health system to date plus a projection of future needs. This paper assesses the development of maternal health services and policies by reviewing policy and strategy documents since the independence in 1971, with primary focus on rural areas where three-fourths of the total population of Bangladesh reside. Projections of need for facilities and human resources are based on the recommended standards of the World Health Organization (WHO) in 1996 and 2005. Although maternal healthcare services are delivered from for-profit and not-for-profit (NGO) subsectors, this paper is focused on maternal healthcare delivery by public subsector. Maternal healthcare services in the public sector of Bangladesh have been guided by global policies (e.g., Health for All by the Year 2000), national policies (e.g., population and health policy), and plans (e.g., five- or three-yearly). The Ministry of Health and Family Welfare (MoHFW), through its two wings-Health Services and Family Planning-sets policies, develops implementation plans, and provides rural public-health services. Since 1971, the health infrastructure has developed though not in a uniform pattern and despite policy shifts over time. Under the Family Planning wing of the MoHFW, the number of Maternal and Child Welfare Centres has not increased but new services, such as caesarean-section surgery, have been integrated. The Health Services wing of the MoHFW has ensured that all district-level public-health facilities, e.g., district hospitals and medical colleges, can provide comprehensive essential obstetric care (EOC) and have targeted to upgrade 132 of 407 rural Upazila Health Complexes to also provide such services. In 2001, they initiated a programme to train the Government's community workers (Family Welfare Assistants and Female Health Assistants) to provide skilled birthing care in the home. However, these plans have been too meagre, and their implementation is too weak to fulfill expectations in terms of the MDG 5 indicator-increased use of skilled birth attendants, especially for poor rural women. The use of skilled birth attendants, institutional deliveries, and use of caesarean section remain low and are increasing only slowly. All these indicators are substantially lower for those in the lower three socioeconomic quintiles. A wide variation exists in the availability of comprehensive EOC facilities in the public sector among the six divisions of the country. Rajshahi division has more facilities than the WHO 1996 standard (1 comprehensive EOC for 500,000 people) whereas Chittagong and Sylhet divisions have only 64% of their need for comprehensive EOC facilities. The WHO 2005 recommendation (1 comprehensive EOC for 3500 births) suggests that there is a need for nearly five times the existing national number of comprehensive EOC facilities. Based on the WHO standard 2005, it is estimated that 9% of existing doctors and 40% of nurses/midwives were needed just for maternal healthcare in both comprehensive EOC and basic EOC facilities in 2007. While the inability to train and retain skilled professionals in rural areas is the major problem in implementation, the bifurcation of the MoHFW (Health Services and Family Planning wings) has led to duplication in management and staff for service-delivery, inefficiencies as a result of these duplications, and difficulties of coordination at all levels. The Government of Bangladesh needs to functionally integrate the Health Services and Family Planning wings, move towards a facility-based approach to delivery, ensure access to key maternal health services for women in the lower socioeconomic quintiles, consider infrastructure development based on the estimation of facilities using the WHO 1996 recommendation, and undertake a human resource-development plan based on the WHO 2005 recommendation. PMID:19489411
Dahab, Maysoon; Kielmann, Karina; Charalambous, Salome; Karstaedt, Alan S; Hamilton, Robin; La Grange, Lettie; Fielding, Katherine L; Churchyard, Gavin J; Grant, Alison D
Abstract We investigated reasons for clinical follow-up and treatment discontinuation among HIV-infected individuals receiving antiretroviral therapy (ART) in a public-sector clinic and in a workplace clinic in South Africa. Participants in a larger cohort study who had discontinued clinical care by the seventh month of treatment were traced using previously provided locator information. Those located were administered a semistructured questionnaire regarding reasons for discontinuing clinical follow-up. Participants who had discontinued antiretroviral therapy were invited to participate in further in-depth qualitative interviews. Fifty-one of 144 (35.4%) in the workplace cohort had discontinued clinical follow-up by the seventh month of treatment. The median age of those who discontinued follow-up was 46 years and median educational level was five years. By contrast, only 16.5% (44/267) of the public-sector cohort had discontinued follow-up. Among them the median age was 37.5 years and median education was 11 years. Qualitative interviews were conducted with 17 workplace participants and 10 public-sector participants. The main reasons for attrition in the workplace were uncertainty about own HIV status and above the value of ART, poor patient-provider relationships and workplace discrimination. In the public sector, these were moving away and having no money for clinic transport. In the workplace, efforts to minimize the time between testing and treatment initiation should be balanced with the need to provide adequate baseline counseling taking into account existing concepts about HIV and ART. In the public sector, earlier diagnosis and ART initiation may help to reduce early mortality, while links to government grants may reduce attrition. PMID:21214378
Susumu Shikano; Franz Urban Pappi
Many post-industrial societies are confronted with the necessity to carry out structural re- forms, such as those of their pension system, health care system etc. The complexity of opinion formation concerning these issues due to their technical nature often leads to an instability of public opinion. Whereas this technical nature can be overcome through sym- bolizing the issues as ideological
Aliff, John Vincent
Into the "quality of public schools" issue step politicians with quick fixes--"proven" business practices variously rejected by experts Peter Drucker (Management by Objectives) and W. E. Deming (Quality Management). These include the following. Determine product quality by inspection--hence, compare school quality by testing teachers and students.…
Walter K. Patrick; Edwin C. Cadman
Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research
Bridwell-Mitchell, E. N.
The research herein uses a mixed methods approach to examine how organizational phenomena at the macro level of analysis translate into phenomena at the micro level. Specifically, the research attempts to explain how cultural institutions may translate into individual attitudes and actions, such as public school teachers' decisions about using…
Gerard Caprio Jr; Izak Atiyas; James Hanson
The argument in favor of gradual - but sustained - financial reform is based on two factors. First, the development of borrower net worth will determine the health of the real and, ultimately, the financial sector. Thus, speeding up reforms when borrower net worth is subject to positive shocks - or slowing them when it is subject to negative shocks
Super, David A
The Patient Protection and Affordable Care Act (ACA) transformed U.S. public law in crucial ways extending far beyond health care. As important as were the doctrinal shifts wrought by National Federation of Independent Business v. Sebelius, the ACA's structural changes to public law likely will prove far more important should they become entrenched. The struggle over the ACA has triggered the kind of "constitutional moment" that has largely replaced Article V's formal amendment procedure since the Prohibition fiasco. The Court participates in this process, but the definitive and enduring character of these constitutional moments' outcomes springs from broad popular engagement. Despite the Court's ruling and the outcome of the 2012 elections, the battle over whether to implement or shelve the ACA will continue unabated, both federally and in the states, until We the People render a clear decision. Whether the ACA survives or fails will determine the basic principles that guide the development of federalism, social insurance, tax policy, and privatization for decades to come. In each of these areas, the New Deal bequeathed us a delicate accommodation between traditionalist social values and modernizing norms of economic efficiency and interest group liberalism. This balance has come under increasing stress, with individual laws rejecting tradition far more emphatically than the New Deal did. But absent broad popular engagement, no definitive new principles could be established. The ACA's entrenchment would elevate technocratic norms across public law, the first change of our fundamental law since the civil rights revolution. The ACA's failure would rejuvenate individualistic, moralistic, pre-New Deal norms and allow opponents to attempt a counterrevolution against technocracy. PMID:24834539
Taveira, Alvaro D; James, Craig A; Karsh, Ben -Tzion; Sainfort, François
The integration of quality management initiatives, particularly total quality management (TQM), and ergonomics has received increasing attention from scholars and practitioners. Above all, the question of how TQM programs relate to ergonomic aspects of organizational design and culture is at the center of this discussion. This study examines how elements of a "typical", Deming-inspired, TQM program in the public sector interact with the work environment. Elements of the TQM program were defined and measured using the Malcom Baldridge Award criteria. The specific elements examined were "Management Support of Quality", "Information and Analysis", "Human Resources", "Processes and Quality Results", and "Customer Focus and Satisfaction". The relationship between these TQM elements and the work environment were defined through five separate hypotheses. The work environment was described by the constructs "Supervisor Support", "Task Clarity", "Task Orientation", and "Innovation". Data were obtained through survey questionnaires administered to employees of four departments in a municipal government organization. Results supported three of the hypotheses, but produced some unanticipated outcomes with regard to the other two. Namely, "Management Support of Quality" was significantly related to "Supervisor Support", "Task Orientation", "Task Clarity" and "Innovation"; "Human Resources" was significantly related to "Supervisor Support"; "Processes and Quality Results" was significantly related to "Task Orientation" and "Innovation". Contrary to predicted "Information and Analysis" was negatively related to "Innovation", and "Customer Focus" was unrelated to any of the outcome variables. The relationships between these TQM elements and work environment dimensions are discussed. Implications for TQM and ergonomic practice are analyzed, and directions for future research proposed. PMID:12880738
The application of the value-added tax to public sector bodies, non-profit organizations and charitable organizations substantially departs from full taxation in most VAT regimes around the world. The problems with the mostly exempt regime for those organizations are reviewed. Options to modify or replace the regimes are reviewed and assessed from the perspective of developing and transitional economies. The Australian-New
Phillip H. Sandro
This article uses a modelling approach to project the effects of a public sector urban import-substitution program called Buy Chicago. The City of Chicago would redirect its non-local procurement back to Chicago firms to reach a 90 percent local-buying goal with the intention of creating jobs, revenue and economic growth. The employment generated from Buy Chicago was projected by a
Arsenijevic, Jelena; Pavlova, Milena; Groot, Wim
This paper focuses on the exemption mechanism that accompanies patient co-payments for outpatient and inpatient hospital care in Serbia. The objective was to investigate the level and dynamics of out-of-pocket payments for this type of services by exempted groups (older than 65?years, younger than 15?years, unemployed, disabled and individuals with low family income) compared with that by other groups. For this purpose, we use empirical household data collected in the Serbian Living Standards Measurement Study carried out in 2002, 2003 and 2007. These years correspond to the start of the recent reforms in the Serbian healthcare sector and 1 and 5?years after the start of the reform. Our results show that people who belong to exempted groups were paying for healthcare in 2002, 2003 and 2007. They report different types of out-of-pocket payments for outpatient and inpatient hospital care. Thus, despite the ambition of the Ministry of Health in Serbia to promote equity in healthcare as a leading aim of the reforms, the implementation of the exemption mechanism fails to protect the targeted groups. Future exemption mechanism should be pro-poor oriented but should also exempt those whose health status requires a frequent healthcare use. PMID:23788401
This article describes the regulatory and enterprise reform in the Chinese airline industry and its impact on the industry’s tremendous growth in recent years. It starts with a brief description of China’s general economic and industrial reform, followed by a detailed description of reforms in the air transport sector. It then examines the impact of the reform on the growth
Szesze, M.; Kahl, S.; Janney, D.
In the Montgomery County Public Schools (MCPS), the science curriculum is undergoing a comprehensive systemic review in an effort to revise the system's curriculum and the entire instructional program. As a part of this overall effort, MCPS has developed a framework for the astronomy curriculum that includes a rationale, essential indicators, and blueprints. The school system is partnering with the NASA Goddard Space Flight Center to involve professional astronomers/space scientists as content advisors to ensure science content accuracy and currency. Through this partnership, many NASA developed educational materials have been made available to the school system to assist with the instructional sequences. This new policy has resulted in the development of a clear and coherent astronomy curriculum for grades K-8. The blueprint is written in the form of a set of indicators which identify the exact skills and knowledge that need to be taught at each grade level so that students will meet and exceed state, national, and international standards. Each blueprint also includes the enduring understandings and essential questions that students should focus on for that specific unit of study, a proposed instructional sequence, and assessment and differentiation ideas. Using these blueprints, teachers will create curriculum guides that include model lessons, model assignments, concept maps, resources, assessment samples, and strategies for differentiating the curriculum to meet the needs of a wide range of learners. In addition, a 45 hour certification training course is being developed to train in service teachers in a wide range of space science disciplines from seasons to cosmology. The course is being developed and will be taught by a team composed of space scientists and master educational trainers. Pilot testing of the curriculum and the training course will begin in Fall 2002.
Vaccaro, Patrick L.
A review of court cases reveals that most jurisdictions are drifting toward the private sector presumption of arbitrability of grievances. With this drift comes the continual erosion of management prerogatives, authority, and power. (Author/IRT)
Gary H Jefferson; Thomas G Rawski
This paper begins by using a structure-conduct-performance perspective to show that partial reform improved the operation of China's state industries during the 1980s. The authors review the achievements of industries outside the state sector, emphasizing their links to the state sector. The paper focuses on key defects in the industrial system related to finance and ownership; shows how the accelerated
Nepal, Rabindra; Jamasb, Tooraj
This paper assesses the electricity sector reforms across small power systems while citing Nepal as an example. The on-going political instability and increasing electricity demand make power sector reform in Nepal and similar small systems a more...
K. Hemmes; L. M. Kamp; A. B. H. Vernay; G. de Werk
This paper explores the innovative concept of flexible poly-generation of hydrogen, power and heat using an internal reforming fuel cell. Flow sheet calculations show that total efficiency of the system in terms of hydrogen and power production can be increased significantly up to 90%. Furthermore by the coproduction of hydrogen, operation at double power density becomes feasible. The concept does
Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D; Helms, David
Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476
Gething, Peter W.; Kirui, Viola C.; Alegana, Victor A.; Okiro, Emelda A.; Noor, Abdisalan M.; Snow, Robert W.
Background As international efforts to increase the coverage of artemisinin-based combination therapy in public health sectors gather pace, concerns have been raised regarding their continued indiscriminate presumptive use for treating all childhood fevers. The availability of rapid-diagnostic tests to support practical and reliable parasitological diagnosis provides an opportunity to improve the rational treatment of febrile children across Africa. However, the cost effectiveness of diagnosis-based treatment polices will depend on the presumed numbers of fevers harbouring infection. Here we compute the number of fevers likely to present to public health facilities in Africa and the estimated number of these fevers likely to be infected with Plasmodium falciparum malaria parasites. Methods and Findings We assembled first administrative-unit level data on paediatric fever prevalence, treatment-seeking rates, and child populations. These data were combined in a geographical information system model that also incorporated an adjustment procedure for urban versus rural areas to produce spatially distributed estimates of fever burden amongst African children and the subset likely to present to public sector clinics. A second data assembly was used to estimate plausible ranges for the proportion of paediatric fevers seen at clinics positive for P. falciparum in different endemicity settings. We estimated that, of the 656 million fevers in African 0–4 y olds in 2007, 182 million (28%) were likely to have sought treatment in a public sector clinic of which 78 million (43%) were likely to have been infected with P. falciparum (range 60–103 million). Conclusions Spatial estimates of childhood fevers and care-seeking rates can be combined with a relational risk model of infection prevalence in the community to estimate the degree of parasitemia in those fevers reaching public health facilities. This quantification provides an important baseline comparison of malarial and nonmalarial fevers in different endemicity settings that can contribute to ongoing scientific and policy debates about optimum clinical and financial strategies for the introduction of new diagnostics. These models are made publicly available with the publication of this paper. Please see later in the article for the Editors' Summary PMID:20625548
This paper investigates similarities and differences between abortion clients of a public-sector clinic and a non-governmental organization (NGO) clinic in Nepal. In 2010, a survey of 1,172 women was conducted in two highly-attended abortion clinics in Kathmandu—one public-sector clinic and another operated by an NGO. Data on the sociodemographic characteristics of clients, their fertility preferences, and use of contraceptives were analyzed. Similarities and differences between the two groups of clients were examined by either chi-square or t-test. The clients of the two clinics were similar with respect to age (27.3±5.7 years), education (26.5% had no education), and number of living children (1.88±1.08). They differed with regard to contraceptive practice, the circumstances resulting in unintended pregnancy, and future fertility preferences. Just over 50% clients of the public and 35% clients of the NGO clinic reported use of contraceptives surrounding the time of unintended pregnancy. The groups also differed in the contraceptive methods used and in reasons for not using any method. The NGO clinic contributed principally to expanding the availability of and access to abortion services. PMID:24288952
Qin, Paige; Chernew, Michael
This paper examines the trade-off between wages and employer spending on health insurance for public sector workers, and the relationship between coverage and hours worked. Our primary approach compares trends in wages and hours for public employees with and without state/local government provided health insurance using individual-level micro-data from the 1992-2011 CPS. To adjust for differences between insured and uninsured public sector employees, we create a matched sample based on an employee's propensity to receive health insurance. We assess the relationship between state contribution to the health plan premium, state-level healthcare spending, and the wages and hours of state and local government employees. We find modest reductions in wages are associated with having employer-sponsored health insurance (ESHI), although this effect is not precisely measured. The reduction in wages associated with having ESHI is larger among non-unionized workers. Further, we find little evidence that provision of health insurance increases hours worked. PMID:25479888
Jan, Stephen; Bian, Ying; Jumpa, Manuel; Meng, Qingyue; Nyazema, Norman; Prakongsai, Phusit; Mills, Anne
This paper examines the policy options for the regulation of dual job holding by medical professionals in highly resource-constrained settings. Such activity is generally driven by a lack of resources in the public sector and low pay, and has been associated with the unauthorized use of public resources and corruption. It is also typically poorly regulated; regulations are either lacking, or when they exist, are vague or poorly implemented because of low regulatory capacity. This paper draws on the limited evidence available on this topic to assess a number of regulatory options in relation to the objectives of quality of care and access to services, as well as some of the policy constraints that can undermine implementation in resource-poor settings. The approach taken in highlighting these broader social objectives seeks to avoid the value judgements regarding dual working and some of its associated forms of behaviour that have tended to characterize previous analyses. Dual practice is viewed as a possible system solution to issues such as limited public sector resources (and incomes), low regulatory capacity and the interplay between market forces and human resources. This paper therefore offers some support for policies that allow for the official recognition of such activity and embrace a degree of professional self-regulation. In providing clearer policy guidance, future research in this area needs to adopt a more evaluative approach than that which has been used to date. PMID:16283054
Heinrich, Carolyn J.; Nisar, Hiren
School districts required under No Child Left Behind (NCLB) to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in services. If the market does not drive out ineffective providers, students may not gain through SES participation.…
Heinrich, Carolyn; Nisar, Hiren
School districts required under No Child Left Behind to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in service provision. If the market does not work to drive out ineffective providers, students will be less likely to gain…
Abdulaziz Al-Raisi; Saad Amin; Saad Tahir
The United Arab Emirates (UAE) is in the midst of tremendous economic development. With a rapidly changing economy, it is increasingly important for this expatriate dependent country to start equipping a modern native workforce with the skills required to enter the work place. UAE impressive economic diversification programs, including expanding commercial infrastructure, advancement in the banking sector, development in educational
Purpose – The paper draws from the ORC Putting it in Perspective Report, which annually presents the findings of employee research projects from a vast benchmarking database. This provides an insight into the key factors that influence employee engagement, with comparisons across different sectors. Design\\/methodology\\/approach – The paper describes some of the key findings from the 2007 Putting it in
Spencer J. Henson; Neal H. Hooker
Private sector responses to the challenge of managing food safety are explored. This paper clarifies the objectives of this special issue, introducing the key issues in each of the following articles. The degree and manner of regulatory compliance, an important element of any strategic food safety management decision, are discussed. Separate of the response to regulations, the incentives of firms
Ezenwaji, Emma E.; Anyadike, Raymond N. C.; Igu, Nnaemeka I.
Recent studies in water supply in Enugu urban area have observed that there is a persistent water supply shortage relative to demand. One of the strategies for achieving a good water supply under the circumstance is through efficient water allocation to consumers. The existing allocation system by the Enugu State Water Corporation is not achieving the desired goal, because it is not based on any scientific criteria. In this study, we have employed the linear programming modelling technique to optimise the allocation of 35,000,000 L of water produced daily by the State Water Corporation and supplied to the four sectors of the town. The result shows that the model allocated 27,470,000 L to the residential sector, 3,360,000 L to commercial, 3,120,000 L to industrial and 882,000 L to public institutions sectors leaving a balance of 168,000 L to be utilised in emergency situations. This allocation pattern departs sharply from the present management technique adopted by the corporation. It is then suggested that for urban water supply to be sustainable in the town, the corporation should rely on this technique for water supply.
Peter Simmons; Tom Watson
In 2004 the authors presented their initial findings of a national survey of evaluation practices amongst Australian public relations practitioners who were mostly Public Relations Institute of Australia members. They found a media relations-centric focus. There was an increase in research and evaluation activity, compared with Walker's study in 1993, but the focus remained on outputs, not outcomes of communication.
Fernandez, Sergio; Smith, Craig R.; Wenger, Jeffrey B.
We examine the effects of governments' use of alternative service provision on public employment using panel data from a nationally representative sample of local governments. We model the effects of alternative service provision on the size of the public workforce and hypothesize that alternative provision jointly impacts both full- and part-time…
Grissom, Jason A.; Keiser, Lael R.
Studies of race representation in public organizations illustrate the importance of bureaucrat race in determining client-level outcomes. Building "upward" from this research, this study examines how supervisor race impacts outcomes for street-level bureaucrats using data from a nationally representative sample of public schools. Employing…
Walker, Billy D.
Texas public school finance is undergoing reform in response to a state Supreme Court decision in Edgewood I.S.D. v. Kirby, that declared the school finance system in violation of the "efficient clause" of the state constitution. State aid has declined since 1984 due to state revenue constraints, reform mandates largely funded from local taxes,…
Examining work and community relations in one Texas school district, this study explores intensifying managerialism under performance accountability (PA) pressures. Reports, press releases, and media accounts are combined with ethnographic study from one elementary school to explore the enactment of school district reforms. Locating PA within a…
Barata, Martha Macedo de Lima; Kligerman, Débora Cynamon; Minayo-Gomez, Carlos
Discussing the need to implement an environmental management system in civil service entities, this paper offers a brief description of some management practices used by companies in various sectors that are endeavoring to establish the best possible relationships between business activities, environmental issues and human needs, today and in the future. Some economic arguments are presented, including the benefits obtained by private sector companies adopting eco-efficiency criteria that are in themselves sufficient to justify the implementation of an effective environmental management policy in government institutions. The relevance is also stressed of drawing up the Civil Service Environment Agenda (A3P), striving to introduce a new cultural approach that will mobilize civil servants in order to optimize resources, combating waste and encouraging better work environments. For this Agenda to be effective, civil servants and managers must obviously be fully engaged. PMID:17680067
Rothstein, Steven J; Bi, Yong-Mei; Coneva, Viktoriya; Han, Mei; Good, Allen
It has been 30 years since the first transformation of a gene into a plant species, and since that time a number of biotechnology products have been developed, with the most important being insect- and herbicide-resistant crops. The development of second-generation products, including nutrient use efficiency and tolerance to important environmental stressors such as drought, has, up to this time, been less successful. This is in part due to the inherent complexities of these traits and in part due to limitations in research infrastructure necessary for public sector researchers to test their best ideas. Here we discuss lessons from previous work in the generation of the first-generation traits, as well as work from our labs and others on identifying genes for nitrogen use efficiency. We then describe some of the issues that have impeded rapid progress in this area. Finally, we propose the type of public sector organization that we feel is necessary to make advances in important second-generation traits such as nitrogen use efficiency. PMID:24948680
B. H. MacGillivray; P. D. Hamilton; J. E. Strutt; S. J. T. Pollard
Financial pressures, regulatory reform, and sectoral restructuring are requiring water utilities to move from technically inclined, risk-averse management approaches toward more commercial, business-oriented practices. Risk analysis strategies and techniques traditionally applied to public health protection are now seeing broader application for asset management, assessing competition risks, and potential threats to the security of supplies. Water utility managers have to consider
Sood, Neeraj; Burger, Nicholas; Yoong, Joanne; Kopf, Dan; Spreng, Connor
Background Health systems in Sub-Saharan Africa (SSA) are in urgent need of improvement. The private health sector is a major provider of care in the region and it will remain a significant actor in the future. Any efforts by SSA governments to improve health systems performance therefore has to account for the private health sector. Regional and international actors increasingly recognize importance of effectively engaging with the private health sector, and initiatives to improve engagement are underway in several countries. However, there is little systematic analysis of private health providers' view and experience with engagement. Methodology/Principal Findings In this study we surveyed private health facilities in Kenya and Ghana to understand the extent to which and how governments interact and engage with these facilities. The results suggest that government engagement with private health facilities is quite limited. The primary focus of this engagement is “command-and-control” type regulations to improve the quality of care. There is little attention paid to building the capacity of health care businesses through either technical or financial assistance. The vast majority of these facilities also receive no government assistance in meeting public health and social goals. Finally, government engagement with private pharmacies is often neglected and clinics receive a disproportionate share of government assistance. Conclusions/Significance Overall, our findings suggest that there may be considerable untapped potential for greater engagement with private health facilities—particularly pharmacies. Improving engagement will likely help governments with limited resources to better take advantage of the private sector capacity to meet access and equity objectives and to accelerate the achievement of the Millennium Development Goals. PMID:22132092
ERAN VIGODA-GADOT; SAGIE MEIRI
This paper takes a socio-psychological approach to NPM and its value-based theory in public administration. We develop a model for the study of NPM values based on the idea of Person- Organization Fit (POF) and examine it empirically. Findings, based on a survey of 205 Israeli local governance personnel, revealed that the POF of several core NPM values (that is,
Dr. Prast suggests that policy options that rely on private companies to help secure energy supplies need to consider the conflicts and tensions that exist between these companies and the public agencies, especially Federal agencies, that regulate their activities. The US still needs a combination of private initiative and public control, but the naive approach of the 1960s should be replaced with an atmosphere of continuous assessment to make sure the companies are meeting public policy goals. A new kind of private/public arrangement may be needed to deal with the large reserves on Federal lands. This will require redefining present Federal roles in energy production to focus on frontier technology and eliminate a duplication of effort. Dr. Prast feels that improvements can be made in the effectiveness of the Federal bureaucracy by profiting from past errors, but that efforts to disband DOE are premature until a relationship of cooperation and confidence develops between private companies and regulators. 64 references. (DCK)
and managerialism into public services. Nowadays, there is a debate among scholars on the demise of the NPM model). Arguing for the demise of the NPM model in the 2000's, several scholars have formalized alternative models
Beauvallet, Godefroy; Boughzala, Younès; Assar, Saïd
Public procurement constitutes a significant portion of national PIB in all countries and electronic platforms for supporting public transactions are an important application of e-government. In France, new regulations since 2005 are pushing public and private actors to adopt electronic means for handling all steps of the purchase process in public organisations. Based on quantitative and qualitative surveys made between 2005 and 2008, this chapter presents the general topic of e-procurement and specifically discusses the problem of e-procurement adoption in public institutions in France. The conclusions of these investigations spanning a three years period, are that public e-procurement is constantly progressing, although difficulties related to insufficient technical skills and the complexity of the juridical context hinder seriously its full adoption. They also show that a digital and an organisational divide is appearing between big administrations which have the adequate resources and skills to fully adopt e-procurement, and small administration (i.e. local authorities) which are still reluctant or unable to conduct a purchase in a digital manner.
Hamid Davoudpour; Mohammad Sadegh Ahadi
Iran's demographic profile is sharply youth oriented and this upcoming generation's needs for employment and housing, coupled with low-energy efficiency vectors and consumption patterns, has created a constant rise in energy demand and greenhouse gas (GHGs) emissions in the residential sector. Improved energy efficiency as a national policy lynchpin for demand reduction and GHGs mitigation, has become commonplace. OPEC countries
Reviews curriculum reform being implemented at the Library School of Stuttgart for students planning to work in public libraries. Components of the new curriculum include core courses in library science, electives in special areas of librarianship, seminars in chosen subject disciplines, and field work in libraries and government agencies. (LRW)
Burns, Susan Freeman; Gardner, Catherine D.
A recent Google search for information regarding performance pay in education produced 6.1 million results. This number should come as no surprise given the current level of interest in incentives as a popular reform option in public education. Supporters believe pay-for-performance programs encourage less effective teachers to improve and will…
Clark, Janet; Otte, Michelle; Fair, Lynn
Aurora (Colorado) Public Schools responded to the Colorado State Model Content Standards for Reading and Writing and the accountability measures attached to the state assessments by implementing the Aurora Achievement Initiative in 2001. Originating from literature on best practices and large-scale school reform, the goal of the districtwide…
Discusses school reform efforts in England that were designed to make England's publicly funded schools as attractive as independent schools via government funding. Efforts include enhancing parental choice of schools by removing bureaucratic and administrative restrictions, establishing a national school inspection system to maintain quality, and…
de Miranda, John
Economic analysis of alcohol and drug treatment services usually focuses on understanding the private, profit-oriented, hospital-based setting. Professional publications of the alcoholism treatment field, as well as popular press and electronic media exposure, also focus heavily on the private system. Low cost, quality treatment services, however,…
Examined the moderating effect of sex on the contribution of specific job characteristics as sources of general job satisfaction. A survey of over 2,000 public employees showed only minimal sex differences. Supervision was more important to females. Females also tended to be more satisfied with their salaries. (JAC)
Democracy Movement BY MARTÍN CARCASSON & LEAH SPRAIN CENTER FOR PUBLIC DELIBERATION, COLORADO STATE democracy is an approach to politics in which citizens, not just experts or politicians, are deeply involved, and gridlock. Those involved with what some have called the "deliberative democracy" movement come to the work
Peter Taylor; Thanos Panagouleas; Shia Ping Kung
Public sports facilities in the England have long been subject to questioning in terms of justifying the subsidies that government provides for their operations. This questioning often relates to the types of customers who use these facilities, the logic being that subsidies are justified more when sufficient use is made by ‘disadvantaged' or socially excluded groups. This is particularly the
The capacity of public service staff in developing countries is crucial for achieving the Millennium Development Goals. Literature from developed countries shows that, working with higher education institutions (HEIs), industries have improved their human resource capacity through continuing professional development. This paper reports on research…
Stein, Bradley D.; Sorbero, Mark J.; Goswami, Upasna; Schuster, James; Leslie, Douglas L.
Objective: Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on…
Panagiotis Gkorezis; Eugenia Petridou
This paper examines the impact of five extrinsic rewards (financial incentives, promotion opportunities, organisational prestige, relations with supervisor and relations with peers) on employees' psychological empowerment. Further, the present study compares these effects and the level of psychological empowerment between public and private employees. The results demonstrated that extrinsic rewards differentially affected both samples. Financial incentives, promotion opportunities and organisational
There have been substantial changes in the labour market over the past few years and survey results indicate 60% of staff will leave public library service over the next decade. While this creates opportunities for library staff, limited training budgets and a focus on compliance and specific library skills training have led to a gap in the formal…
Research for Better Schools, Inc., Philadelphia, PA.
Approximately 2,700 books, pamphlets, and articles from all over the world published before October 1967, are listed in this annotated bibliography on public expenditure decision making. Emphasis is on the economic criteria of decision making derived through use of systematic and analytical methods. Entries are organized into 33 general…
Yin Hung Joan Leung
\\u000a In an information and knowledge-based economy, an educated populace is an important asset for a country to sustain technological\\u000a advances and economic growth. Education reforms are therefore high on the agenda of most governments around the world. Also,\\u000a the resurgence of neo-liberalism in public sector management has become a worldwide trend. The underpinnings of this “new”\\u000a paradigm are the notions
University reforms around the world reflect many of the ideas and measures associated with the New Public Management (NPM) reform wave that emerged in Australia and New Zealand in the early 1980s. However, they also display features of the post-NPM reforms introduced in the last decade. In this article I focus on university reforms in Japan,…
This study aims to examine factors affecting adoption of e-procurement in public sector with special reference to Indonesian context. The Perceived Characteristics of Innovating defined by Moore and Benbasat  used as the framework. Based on a survey to 87 contractors/suppliers in the city of Yogyakarta, the study finds that only trialability that affects use intention of e-procurement among the contractors/suppliers. The survey conducted in the early stage of e-procurement implementation is of the possible explanations. Government policy that forces the contractors/suppliers to use the e-procurement also partakes in this context. Practical implication of the findings are also discussed in the paper.
Background An ongoing evaluation system is essential to determine if the academic system in place has worked to produce a better product, hence the objective of our study was to evaluate the satisfaction level among medical students regarding their academic teaching and assessment method and what measures will they suggest for the future to rectify the current situation. This questionnaire based cross sectional study was conducted in a public sector medical university from February to July 2010. A well structured questionnaire was administered to a random sample of 375 final year medical students. However 292 of the students provided informed consent and filled in the questionnaire which included their demographic profile as well as questions in line with the study objective. Data was entered in a Statistical Package for Social Sciences (SPSS version.16) and analyzed using descriptive statistics. Findings The male to female ratio in our study was 1:2. Most of the students (57.2%) were dissatisfied with the quality of teaching in the university. Fifty-seven percent of the participants believed that the current standard of their institute were not at par with those of international medical universities. BCQ's were the mode of examination questions preferred by the majority of the students. Most of the students (66.1%) wanted the university to conduct career planning seminars to help them plan their career. Conclusions These results suggest that the students of public sector medical universities are unsatisfied from current academic facilities and teaching activities. Students recommend increased emphasis on better lectures and practical training as well as a need to incorporate career planning sessions for the students to help plan them their future career paths. PMID:21974939
Vahtera, Jussi; Laine, Sari; Virtanen, Marianna; Oksanen, Tuula; Koskinen, Aki; Pentti, Jaana; Kivimaki, Mika
Objective To examine the association between worktime control and subsequent retirement on health ground (disability pension) among employees. Methods A prospective cohort study of 30 700 public sector employees (78% women) aged 18 to 64 at baseline. Two scores of worktime control, self-assessed and co-worker assessed, were obtained from responses to the baseline survey in 2000-2001 (score range 1 to 5). Information on cause-specific disability pension during follow-up was collected from national registers. Results During a mean follow-up of 4.4 years, 1178 employees were granted disability pension (incidence per 1000 person-years 9.2 in women and 8.7 in men). The most common causes of a disability pension were musculoskeletal disorders (43% of all pensions), mental disorders (25%), tumours (8%), and diseases of the circulatory system (6%) and the nervous system (6%). A 1 unit increase in self-assessed and co-worker assessed worktime control score was associated with a 41-48% lowering of the risk of disabling musculoskeletal disorders in men and 33-35% lowering in women. This association was robust to adjustment for all 17 baseline covariates (in men and women combined, adjusted hazard ratio 0.76, 95% CI 0.67-0.87 and 0.64, 95% CI 0.51-0.79 per 1 unit increase in self-assessed and co-worker assessed worktime control, respectively).Self-assessed worktime control was also associated with the risk of disability retirement due to mental disorders in women, but this association was not replicated using co-workers’ assessment. Disability pensions from other disease categories were not related to control over working times. Conclusions In this cohort of public sector employees, high worktime control among employees was associated with reduced risk of early retirement caused by musculoskeletal disorders independent of baseline characteristics. PMID:19914911
Valeria Costantini; Francesco Crespi
Many industrialized countries have introduced environmental policy measures in order to reduce negative externalities linked\\u000a to economic activities. These policy actions produce different effects on the economic system depending on the regulatory\\u000a tools adopted and the specific objective of public intervention. The impact on innovation is particularly difficult to predict,\\u000a especially with regard to the direction of technological change. As
Sam Brody; Himanshu Grover; Eric Lindquist; Arnold Vedlitz
Climate change has become a more salient issue on the US policy agenda at all levels of government. Increasing empirical evidence and identification of its potential risks to human populations have increased media, public, and policy-maker interest. There is a gap, however, in our knowledge of sub-national decision-making which suggests several questions: Are community leaders deciding to take action in
Paula Wilton; Richard D. Smith
Governments in most developed nations have been looking to organisational and financial reform of health systems over the last decade. Although the structure and problems of the health care sector in each country may differ, with countries correspondingly adopting different reform agendas, there has been some element of commonality in reforms: that of (managed) competition. Of particular importance in such
Howard, David H; Roy, Kakoli
Objective To determine whether patients who use private sector providers for curative services have lower vaccination rates and are less likely to receive prenatal care. Data Sources/Study Setting This study uses data from the 52d round of the National Sample Survey, a nationally representative socioeconomic and health survey of 120,942 rural and urban Indian households conducted in 1995–1996. Study Design Using logistic regression, we estimate the relationship between receipt of preventive care at any time (vaccinations for children, prenatal care for pregnant women) and use of public or private care for outpatient curative services, controlling for demographics, household socioeconomic status, and state of residence. Data Collection/Extraction Methods We analyzed samples of children ages 0 to 4 and pregnant women who used medical care within a 15-day window prior to the survey. Principal Findings With the exception of measles vaccination, predicted probabilities of the receipt of vaccinations and prenatal care do not differ based on the type of provider at which children and women sought curative care. Children and pregnant women in households who use private care are almost twice as likely to receive preventive care from private sources, but the majority still obtains preventive care from public providers. Conclusions We do not find support for the hypothesis that children and pregnant women who use private care are less likely to receive public health services. Results are consistent with the notion that Indian households are able to successfully navigate the coexisting public and private systems, and obtain services selectively from each. However, because the study employed an observational, cross-sectional study design, findings should be interpreted cautiously. PMID:15544642
Wells, Lawrence C.
This catalogue discusses major Minnesota proposals over the past two years (through the end of the 1985 legislative session) for improving the quality of K-12 public education in the state. Following a 10-page summary is a legislative update which provides a picture of education reform as enacted by the state legislation, and connects some of the…
Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg
The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087
Frost, J J; Bolzan, M
Results from a 1995 survey of a nationally representative sample of 603 publicly funded family planning agencies reveal that 96% rely on federal funding, 60% on state funding and 40% on local funding to provide family planning and other services. Although only 25% of the contraceptive clients served by these publicly funded agencies--including health departments, hospitals, Planned Parenthood affiliates, independent agencies and community and migrant health centers--are Medicaid recipients, 57% have incomes below the federal poverty level and an additional 33% have incomes of 100-250% of the poverty level. Some 40% of the recipients of family planning services are black, Hispanic or from other minority groups, and 30% are younger than 20. Each agency employs an average of three physicians who together provide approximately seven hours of care per week and seven midlevel clinicians who provide 71 hours of care per week. The pill is the only contraceptive method provided by all agencies, but 96% provide the injectable; at least 90% spermicide, the condom and the diaphragm; 78% periodic abstinence; and 59% the implant. The remaining methods are provided by fewer than 50% of agencies. Almost 70% of agencies have at least one special program of outreach, education or services to meet the needs of teenagers, but far fewer have special programs for such hard-to-reach groups as the homeless, the disabled or substance users. PMID:9119045
Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.
A framework is introduced, describing three aggregate competences for technical issues, management and governance, and a meta-competence for continuous learning and innovation, for the water sector. The four competences are further organised in a T-shaped competence profile. The framework and an assessment methodology were tested in a case study on post-graduate water education for professional staff in the Directorate General Water Resources (DGWR) in Indonesia. Though DGWR professionals have a firmly "technical" orientation, both the surveys and interviews show strong interest in the other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. A discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that could be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With only little competence in these disciplines, it will be difficult for professionals to communicate and collaborate effectively in an interdisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this seems partly compensated by the attention for continuous learning and innovation. The exposure to a different culture and learning format is reported as fundamentally formative. The policies of DGWR have gone through three distinct phases. In the first phase (1970-1987) technical competence and learning were valued highly and training was arranged effectively; in the current phase the need to develop new competences is raising new challenges.
Callahan, John J.; And Others
This study focuses on how central city school districts can benefit from educational finance reform. The publication is designed for use by both those charged with the responsibility for education matters and by the general public. The document begins with a discussion of the fiscal impact of several popular alternative school finance reforms,…
Edinburgh, University of
DUNCAN PRITCHARD Reforming Reformed Epistemology* 0. Introduction There has been a renaissance of interest in the epistemology of religious belief over the last twenty years which has been largely inspired of religious epistemology is a rejection of the supposedly evidentialist assumptions which drive standard
Logan, John R.; Fang, Yiping; Zhang, Zhanxin
Housing reform in China has proceeded on two tracks: privatization of public housing and development of a new private housing sector. During this period of transition, rents have remained relatively low in the remaining public housing, and purchase prices offered to occupants of public housing have been well below market prices. Although these rents and prices are partly based on known formulas, there is considerable variability in how much people pay for similar apartments. This study uses 2000 Census data to estimate the housing subsidy received by the remaining renters in the public sector and purchasers of public housing, based on private sector prices for housing of comparable quality and size. The paper also analyzes variation in the estimated discount from market prices that these people receive. The findings show that the biggest winners in China’s transition from socialist housing allocation are those who were favored in the previous system, based on such factors as residence status, education and occupation. PMID:24163494
Amirkhanyan, Anna A.; Kim, Hyun Joon; Lambright, Kristina T.
Are public and private organizations fundamentally different? This question has been among the most enduring inquiries in public administration. Our study explores the impact of organizational ownership on two complementary aspects of performance: service quality and access to services for impoverished clients. Derived from public management…
The 2008 presidential campaign season featured health care reform proposals. I discuss 3 approaches to health care reform and the tools for bringing about reform, such as insurance market reforms, tax credits, subsidies, individual and employer mandates, and public program expansions. I also discuss the politics of past and current health care reform efforts. Market-based reforms and mandates have been less successful than public program expansions at expanding coverage and controlling costs. New divisions among special interest groups increase the likelihood that reform efforts will succeed. Federal support for state efforts may be necessary to achieve national health care reform. History suggests that state-level success precedes national reform. History also suggests that an organized social movement for reform is necessary to overcome opposition from special interest groups. PMID:19299668
Ross, Johnathon S
The 2008 presidential campaign season featured health care reform proposals. I discuss 3 approaches to health care reform and the tools for bringing about reform, such as insurance market reforms, tax credits, subsidies, individual and employer mandates, and public program expansions. I also discuss the politics of past and current health care reform efforts. Market-based reforms and mandates have been less successful than public program expansions at expanding coverage and controlling costs. New divisions among special interest groups increase the likelihood that reform efforts will succeed. Federal support for state efforts may be necessary to achieve national health care reform. History suggests that state-level success precedes national reform. History also suggests that an organized social movement for reform is necessary to overcome opposition from special interest groups. PMID:19299668
Panos Karkatsoulis; Nikos Michalopoulos; Vasso Moustakatou
Purpose – The paper seeks to concern itself with the research field of public sector performance measurement and to introduce the national identity as a performance factor, through a case study. Design\\/methodology\\/approach – The paper attempts an innovative presentation and identification of the attitudes, motivations and beliefs of both Greek people and the volunteers regarding the organisation, the success and
Kirk R. Karwan; Robert E. Markland
One relatively unanswered question regarding operational efficiency and effectiveness is whether and how public sector or government operations can employ service strategy and design concepts to deal with the conflicting objectives of minimizing expenditures while providing for an increasing number of “causes” [Haywood-Farmer, J., Nollet, J., 1991. Service Plus: Effective Service Management, G. Morin Publisher, Quebec]. In this paper, we
Birch, Derek W.; Cuthbert, R. E.
A discussion is presented of the process of resource allocation and the use of performance indicators in public sector higher education in Britain. First, background is presented on the method of providing resources to institutions of advanced further education (AFE) and non-advanced further education (NAFE) on the basis of pooled recurrent…
Gorton, Matthew; Zaric, Vlade; Lowe, Philip; Quarrie, Steve
Using primary survey data and interview evidence this paper analyses the implementation and enforcement of public and private environmental regulation in the Serbian Fresh Fruit and Vegetable (FFV) sector. This provides a basis for engaging in a wider debate on the nature of agri-food regulation in post-socialist economies. Depictions of the…
Garnick, Deborah W; Lee, Margaret T; Horgan, Constance; Acevedo, Andrea; Botticelli, Michael; Clark, Spencer; Davis, Steven; Gallati, Robert; Haberlin, Karin; Hanchett, Andrew; Lambert-Wacey, Dawn; Leeper, Tracy; Siemianowski, James; Tikoo, Minakshi
Five states (Connecticut, Massachusetts, New York, North Carolina, and Oklahoma) have incorporated the Washington Circle (WC) substance abuse performance measures in various ways into their quality improvement strategies. In this article, we focus on what other states and local providers might learn from these states' experiences as they consider using WC performance measures. Using a case study approach, we report that the use of WC measures differs across these five states, although there are important common themes required for adoption and sustainability of performance measures, which include leadership, evaluation of specification and use of measures over time, state-specific adaptation of the WC measure specifications, collaboration with consultants and partners, inclusion of WC measures in the context of other initiatives, reporting to providers and the public, and data and resource requirements. As additional states adopt some of the WC measures, or adopt other performance measurement approaches, these states' experiences could help them to develop implementations based on their particular needs. PMID:21257282
Garnick, Deborah W.; Lee, Margaret T.; Horgan, Constance; Acevedo, Andrea; Botticelli, Michael; Clark, Spencer; Davis, Steven; Gallati, Robert; Haberlin, Karin; Hanchett, Andrew; Lambert–Wacey, Dawn; Leeper, Tracy; Siemianowski, James; Tikoo, Minakshi
Five states (Connecticut, Massachusetts, New York, North Carolina, and Oklahoma) have incorporated Washington Circle (WC) substance abuse performance measures in various ways into their quality improvement strategies. In this paper we focus on what other states and local providers might learn from these states’ experiences as they consider using WC performance measures. Using a case study approach, we report that the use of WC measures differs across these five states, although there are important common themes required for adoption and sustainability of performance measures which include: leadership, evaluation of specification and use of measures over time, state-specific adaptation of the WC measure specifications, collaboration with consultants and partners, inclusion of WC measures in the context of other initiatives, reporting to providers and the public, and data and resource requirements. As additional states adopt some of the WC measures, or adopt other performance measurement approaches, these states’ experiences could help them to develop implementations based on their particular needs. PMID:21257282
Giraldes, Maria Do Rosário
The main aim of this article is to evaluate the hospital expenditure by user in an efficiency perspective and to evaluate the quality of the health system using process indicators and outcome indicators. In an efficiency perspective the concept of technical efficiency has been chosen, and a correction has been made, as well, in what concerns a case-mix index (CMI). The indicators have been calculated by user in what concerns the main hospital activities (the expenditure in inpatient care by treated patient, in day hospital by treated patient, in outpatient care by consultation, etc), and as well the auxiliary sections of clinic support and the hotel support services. All the indicators have been corrected according to the case-mix index, in 2004, and have been weighted according to the relevance of its expenditure in total expenditure. In a quality perspective two types of indicators have been considered: process indicators and outcome indicators. Process indicators, as the percentage of surgeries in ambulatory care, the percentage of caesareans in total deliveries and the rate of autopsy. The outcome indicator number of episodes of inpatient care due to surgery infection in total days of inpatient care The composite indicator of efficiency, weighted by the inverse of the case-mix index presents the lower values in Tondela, Seia, and Fafe, while the Hospital of the Litoral Alentejano is, in this group, the most inefficient. The Agueda Hospital presents the better Composite Efficiency Indicator, in Group II, followed by the Barcelos and S. João da Madeira Hospitals, while the Figueira da Foz Hospital presents the worst situation. In hospitals from Group III the Hospitals of Vale de Sousa, EPE, and the Vila Franca de Xira Hospital present the better Composite Efficiency Indicator followed by the Barreiro Hospital, EPE. In Group IV it is the Hospital of S. Sebastião, EPE, that presents the lowest Composite Efficiency Indicator, followed by the Cascais Hospital, SPA, and by the Garcia de Orta Hospital, which are the less efficient hospitals. In Group V, with central hospitals and hospitals with functions of central hospital, it is the Hospital of Vila Real/Régua, EPE, to present the best situation of the Composite Efficiency Indicator, followed by the Santo António Hospital, EPE, the Santa Maria Hospital, EPE, and the HUC, while the hospitals with a worst situation of the Composite Efficiency Indicator are the Hospitals of Faro, Evora and S. José. In Group VI hospitals with a better Composite Efficiency Indicator are the hospitals of Santa Marta, Gama Pinto Institute and Orthopedic Hospital of Outão, while the Estefânia Hospital is the most inefficient. Tondela, Valongo and Peniche Hospitals (Group I), have a good value of the Composite Efficiency and Quality Indicator, while Barcelos, Oliveira de Azeméis and Póvoa de Varzim/Vila do Conde Hospitals (Group II) present also good values of this indicator. The Hospitals of Vila Franca de Xira, Bragança and Setúbal (Group III), the Hospitals of Santarém, Garcia de Orta, and Curry Cabral (Group IV), the Hospital of Vila Real/Régua, the Egas Moniz Hospital and the Santa Maria Hospital (Group V), and the Gama Pinto Institute, the Orthopedic Hospital of Outão, and the Santa Cruz Hospital (Group VI) are the best classified in their groups. EPE Hospitals (Hospitals publicly owned with private management) are the best classified in their groups in what efficiency is concerned, what is a better result tan the one shown in 2003. The lower inequality in relation to management indicators, in all hospital groups, exists in the areas of expenditure with inpatient care by user, what shows the existence of a norm of proceeding, in this traditional hospital area. The higher inequalities are those of day hospital, drugs in day hospital, drugs in outpatient care and rehabilitation by user. In what management indicators are concerned incentives must be created. The most efficient hospitals should be compensated and contract-programmes, between other, must be celebrated. The low rate o
Background In recent years, there has been a massive growth in the private medical education sector in South Asia. India’s large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. Methods Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. Results There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. Conclusion There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions. PMID:24034988
Hongyi Harry Lai
Why did reform in China and the former Soviet Union produce drastically different outcomes? Why did some provinces in China embrace faster economic reform than others? This article argues that the state sector and reform initiatives in the sub?national units, reform strategies, entrenchment and maturation of central planning, the size of the defence industry, policy choice and the historical context
Parochial and private schools in the United States have maintained opportunities for students to attend same-gender settings without interference from policies governing public education. The gender composition and curriculum of public schools, however, have been influenced by societal regulations and expectations that have often utilized…
Abrams, Melinda; Nuzum, Rachel; Zezza, Mark; Ryan, Jamie; Kiszla, Jordan; Guterman, Stuart
In addition to its expansion and reform of health insurance coverage, the Affordable Care Act (ACA) contains numerous provisions intended to resolve underlying problems in how health care is delivered and paid for in the United States. These provisions focus on three broad areas: testing new delivery models and spreading successful ones, encouraging the shift toward payment based on the value of care provided, and developing resources for systemwide improvement. This brief describes these reforms and, where possible, documents their initial impact at the ACA's five-year mark. While it is still far too early to offer any kind of definitive assessment of the law's transformation-seeking reforms, it is clear that the ACA has spurred activity in both the public and private sectors, and is contributing to momentum in states and localities across the U.S. to improve the value obtained for our health care dollars. PMID:26040019
Rispel, Laetitia C.; Moorman, Julia
Background Globally, flexible work arrangements – through the use of temporary nursing staff – are an important strategy for dealing with nursing shortages in hospitals. Objective The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Methods Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7,?2010 prices). Results In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Conclusion Hospital managers and policy-makers need to address the effective utilisation of agency nurses and quality of patient care in tandem. PMID:25971399
Describes the methods and results of the transfer of the SCAN bibliographic database, sponsored by the Administration on Aging (AoA) to the private sector American Association of Retired Persons (AARP) when Congress repealed authority for AoA. Steps involved in the establishment of a bibliographic database are outlined. Four sources are given.…
This report reviews the six most recent major acquisition reform reports, starting in 1949 with the Hoover Commissions and including McNamara's Total Package Procurement, Fitzhugh Commission, the Commission on Government ...
Lewin, A.Y.; Morey, R.C.
The problem of measuring the effectiveness and efficiency of any organization---private or public---has been of concern to practioners and organization researchers at least since the writings of Taylor and Fayol. It has become fundamental to any society concerned with accountability and the social and economic performance of its institutions. The concept of measuring effectiveness and efficiency is based on the view of organizations as production systems, transforming multiple inputs (resources) into multiple outputs (goods and services) through organization, management, and technology. Although normative theories, models, and methodologies of organization design abound, the state of the art of the field precludes choosing between different organization designs in terms of tradeoffs in performance. Furthermore, the problem of assessing the efficiency of an organization has in the past been made difficult due to the noncommensurate nature of the many inputs and outputs involved and the difficulty in accounting for factors not under the control of the organization. This paper describes the application of the Data Envelopment Analysis Methodology (DEA)---an application of fractional linear programming---to the measurement of the relative efficiency of public sector organizations performing like tasks, such as municipalties, courts, police departments, schools, etc. The DEA methodology, using the principle of Pareto optimality, can decompose the overall efficiency of an organization into technical and managerial components and adjust for variables not under management control. The methodology can also be used to calculate the resource conservation potential of an organization as well as the maximum outputs that could be obtained by the organization if it were to become as efficient as the most efficient unit in the set. The DEA approach is illustrated using actual data comparing the performance of 43 Navy recruiting district over a three-year period.
Anselmi, Laura; Lagarde, Mylene; Hanson, Kara
This review aims to identify, assess and analyse the evidence on equity in the distribution of public health sector expenditure in low- and middle-income countries. Four bibliographic databases and five websites were searched to identify quantitative studies examining equity in the distribution of public health funding in individual countries or groups of countries. Two different types of studies were identified: benefit incidence analysis (BIA) and resource allocation comparison (RAC) studies. Quality appraisal and data synthesis were tailored to each study type to reflect differences in the methods used and in the information provided. We identified 39 studies focusing on African, Asian and Latin American countries. Of these, 31 were BIA studies that described the distribution, typically across socio-economic status, of individual monetary benefit derived from service utilization. The remaining eight were RAC studies that compared the actual expenditure across geographic areas to an ideal need-based distribution. Overall, the quality of the evidence from both types of study was relatively weak. Looking across studies, the evidence confirms that resource allocation formulae can enhance equity in resource allocation across geographic areas and that the poor benefits proportionally more from primary health care than from hospital expenditure. The lack of information on the distribution of benefit from utilization in RAC studies and on the countries' approaches to resource allocation in BIA studies prevents further policy analysis. Additional research that relates the type of resource allocation mechanism to service provision and to the benefit distribution is required for a better understanding of equity-enhancing resource allocation policies. PMID:24837639
Objectives The aim of this study was to evaluate musculoskeletal and psychosocial perception and compare these conditions regarding the type of job (white or blue-collar) and the type of management model (private or public). Methods Forty-seven public white-collar (PuWC), 84 private white-collar (PrWC) and 83 blue-collar workers (PrBC) were evaluated. Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial factors. Nordic Musculoskeletal Questionnaire (NMQ) was used to assess musculoskeletal symptoms. Pressure Pain Threshold (PPT) was measured to evaluate sensory responses. Results According to JCQ, all groups were classified as active profile. There was a significant association between work engagement and workers’ categories (p?0.05). PrWC workers had the highest scores for all the UWES domains, while PrBC had the lowest ones. PPT showed that PrBC workers had an increased sensitivity for left deltoid (p?0.01), and for both epicondyles (p?0.01), when compared to the other groups. PrWC workers had an increased sensitivity for both epicondyles than PuWC (right p?0.01; left, p?=?0.05). There was no significant association in the report of symptoms across the groups (p?>?0.05). Conclusion This study showed differences in psychosocial risk factors and musculoskeletal symptoms in workers engaged in different types of jobs and work organization. Personal and work-related characteristics, psychosocial factors and PPT responses were different across workers’ group. Despite all, there was no significant difference in reported symptoms across the groups, possibly indicating that the physical load is similar among the sectors. PMID:25854836
Prudhomme O'Meara, Wendy; Smith, Nathan; Ekal, Emmanuel; Cole, Donald; Ndege, Samson
Insecticide-treated nets (ITNs) are one of the most important and cost-effective tools for malaria control. Maximizing individual and community benefit from ITNs requires high population-based coverage. Several mechanisms are used to distribute ITNs, including health facility-based targeted distribution to high-risk groups; community-based mass distribution; social marketing with or without private sector subsidies; and integrating ITN delivery with other public health interventions. The objective of this analysis is to describe bednet coverage in a district in western Kenya where the primary mechanism for distribution is to pregnant women and infants who attend antenatal and immunization clinics. We use data from a population-based census to examine the extent of, and factors correlated with, ownership of bednets. We use both multivariable logistic regression and spatial techniques to explore the relationship between household bednet ownership and sociodemographic and geographic variables. We show that only 21% of households own any bednets, far lower than the national average, and that ownership is not significantly higher amongst pregnant women attending antenatal clinic. We also show that coverage is spatially heterogeneous with less than 2% of the population residing in zones with adequate coverage to experience indirect effects of ITN protection. PMID:22022481
Balicer, Ran D; Shadmi, Efrat
In March 2010 the United States enacted the most significant health care reform in several decades. The Patient Protection and Affordable Care Act, amongst other provisions, addresses two of the main current shortcomings of the U.S. health system: the large portion of the population that are uninsured and the high percentage of hsealth expenditures (mostly private] which amounts to about 16% of the GDP. Changes to the current structure and financing of the U.S. health system will have implications for other health systems, for science (e.g., through enhanced federal funding for comparative effectiveness research), and for technological advance (e.g., through accelerated development and use of electronic health records). There are several lessons from the reform, and the factors leading to its implementation, for the Israeli health system. Firstly, the basic principles of the Israeli health system are a source of pride, and undermining its main values can have deleterious effects. Overreliance on private, out-of-pocket, spending and lack of support for public practice of medicine (in community and hospital settings) will weaken the public sector, strengthen the private sector, and could result in a tiered lower quality and less accessible public system with greater widening of gaps in health and health care utilization. This paper reviews the main provisions of the U.S. health care reform and the potential implications for the IsraeLi health system. PMID:21939111
Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. PMID:10916919
Thomas Andersson; Stefan Tengblad
Purpose – The purpose of this paper is to demonstrate how new public management (NPM) reform from the national level is implemented as practice in a local unit within the police sector in Sweden. Design\\/methodology\\/approach – A qualitative case-study approach is applied using semi-structured interviews, participant observations and analysis of documents. Findings – The paper illustrates different kinds of resistance
Amy Qiaoming Liu; D. Jacqueline Carrigan; Britte H. Livingston
Like the public in California (71%) and in the United States (72%), more than seventy percent (71%) of residents in the Sacramento region think the Social Security program is either in crisis (23%) or has major problems (48%). Only three percent say the program has no problems. This is very similar to the perception of other Californians (71%) and Americans
Easton, John Q.; Storey, Sandra
This report offers a review of the Chicago Public Schools' official policy on promotion and retention, a discussion of research on the issue of retention, and an analysis of June, 1989 retention rates in Chicago. The first section covers retention and promotion policies in Chicago and other cities and research on the effects of retention and…
Mansfield Univ., PA. Rural Services Inst.
This report presents the annual survey of public opinion in Pennsylvania. Telephone surveys were conducted with 1,744 people whose telephone numbers were randomly selected from all listed telephone numbers. Results of the survey indicate that: (1) Pennsylvanians strongly favor mandatory birth control counseling for welfare mothers, but opinion is…
This case describes the experience of a new school board member in Miami-Dade County Public Schools, Marta Perez, as she discovers a wide range of ethical and management problems in the school district and attempts to deal with them. Layered throughout the case are challenges pertaining to the school board's roles and responsibilities,…
Bulkley, Katrina E.; Burch, Patricia
Recent years have seen a shifting landscape around private engagement in K-12 public education, one that involves a reorientation of education policy and practice around the principles of the marketplace. In this article, we examine the roles of both not-for-profit and for-profit agencies, as distinct from government agencies, in this movement.…
Marsh, Julie A.; Strunk, Katharine O.; Bush, Susan
Purpose: Despite the popularity of school "turnaround" and "portfolio district" management as solutions to low performance, there has been limited research on these strategies. The purpose of this paper is to address this gap by exploring the strategic case of Los Angeles Unified School District's Public School Choice…
Spurrier, F.R.; DeZubay, E.A.; Murray, A.P.; Vidt, E.J.
Slab-shaped high efficiency catalytic reformer configurations are disclosed particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot combustion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant. 14 figs.
Srihari, Vinod H; Tek, Cenk; Kucukgoncu, Suat; Phutane, Vivek; Breitborde, Nicholas J. K.; Pollard, Jessica; Ozkan, Banu; Saksa, John; Walsh, Barbara C; Wood, Scott W
Objective This study seeks to determine the effectiveness of a comprehensive first-episode service (the clinic for Specialized Treatment Early in Psychosis, STEP) based in an urban U.S. community mental health center, compared to treatment as usual. Methods This pragmatic randomized controlled trial enrolled 120 ‘first-episode psychosis’ patients within 5 years of illness onset and 12 weeks of antipsychotic exposure. Referrals were mostly from area inpatient psychiatric units and enrollees were randomly allocated to STEP or referral to routine care (TU). Main outcomes included hospital utilization (primary), ability to work, attend age-appropriate schooling or actively seek these opportunities (‘vocational engagement’), and general functioning. Analysis was by modified intent to treat (excluding only 3 who withdrew consent) for hospitalization and completers for other outcomes. Results After one year, STEP effected reductions on all measures of inpatient utilization vs. usual treatment: not psychiatrically hospitalized (77% vs. 56%, RR 1.38, 95% confidence interval (CI) 1.08–1.58); mean hospitalizations (0.33±0.70 vs. 0.68±0.92, p=0.02) and mean bed days (5.34±13.53 vs. 11.51±15.04, p=0.05). For every 5 patients allocated in STEP vs. usual treatment, one additional patient avoided psychiatric hospitalization over the first year (NNT = 5, CI 2.7–26.5). STEP also delivered better vocational engagement (91.7% vs. 66.7%, RR 1.40, 95% CI 1.18–1.48) and salutary trends in measures of global functioning. Conclusions This trial demonstrates the feasibility and effectiveness of a U.S. public sector model of early intervention for psychotic illnesses. Such services can also support translational research and are a relevant model for other serious mental illnesses. Trial registration www.ClinicalTrials.gov: NCT00309452. PMID:25639994
van de Vijver, Steven; Oti, Samuel; Tervaert, Thijs Cohen; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela B.; Brewster, Lizzy; Agyemang, Charles; Lange, Joep
Introduction Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD) and African Population and Health Research Center (APHRC), collaborated with private-sector Boston Consulting Group (BCG) to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year). The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO), and leading non-governmental organizations (NGOs). Conclusion Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by relevant policymakers and NGOs. PMID:24149078
Abbott, Ann L
The Patient Protection and Affordable Care Act (PPACA) put new requirements on not-for-profit (NFP) hospitals to document provision of community benefits, to justify their tax-exempt status. Specific PPACA provisions include requirements that NFP hospitals conduct or participate in a community health needs assessment and work to address the needs identified. Consideration is given to these particular PPACA mandates and to Internal Revenue Service (IRS) actions to implement them. The background of concerns that have been expressed about whether the NFP hospitals' tax exemption should be continued and a brief history of that exemption is noted. Not-for-profit hospitals have resources that the federal government is requiring them to bring to public health improvement, during a time when the public health agencies at the federal and state level continue to experience reductions in funding. Linking of the NFP hospitals' compliance activities with the public health agency community health planning activities will help fulfill its PPACA requirements and the regulatory reporting requirements for the IRS. PMID:21964364
McClendon, Rodney Prescott
school reform efforts began, the public?s general perception is that university engagement with public schools is superficial or missing (DePaola, 1998; American Association of State Colleges and Universities [AASCU], 2002; Stukel, as cited...
Herreco, Jose Maria Maravall
In Spain, social change and crisis, and the need for higher education reform, have been particularly intensive. However, it was not until the recent University Reform Act that a framework for reorganization based on the principles of the public university was established. (MSE)
Card, David E., Ed.; Blank, Rebecca M., Ed.
This book contains 13 papers on labor market and welfare reform, with special emphasis on the demand for low-wage workers, wages and job characteristics in the less skilled labor market, public politics to increase employment and earnings of less skilled workers, and the impact of welfare reform. The following papers are included: "The Labor…
Sarason, Seymour B.
In this book, the author candidly confronts errors he made of omission, commission, misplaced emphases, and watering down the depth and scope of his criticisms of the reform arena in his half-century involvement in educational reform. No other major figure in this arena has made public such a searching self-critique. Sharing his thoughts about the…
The latest movement to reform German spelling is discussed, focusing on the need for greater consistency in spelling of words from other languages and the major changes proposed. Issues addressed include capitalization, specific idiosyncracies in German spelling, concerns related to computerization, public opinion, and the scope of the reform.…
Moini, Joy S.; Bikson, Tora K.; Neu, C. Richard; DeSisto, Laura
In 2003, the State of Qatar engaged the RAND-Qatar Policy Institute to assist Qatar University, the nation's first and only public higher education institution, with reform of its major administrative and academic structures, policies, and practices. This monograph summarizes that reform effort, which formally lasted from October 2003 through…
Michael Keen; Jenny E. Ligthart
A key obstacle to fundamental tariff reform in many countries is the revenue loss that it ultimately implies. This paper establishes and explores a simple and practicable strategy for realizing the efficiency gains from tariff reform without reducing public revenue, showing that for a small economy a cut in import duties (respectively, export taxes) combined with a point-for-point increase in
The school reform movement which has accelerated over the last two years provides a point of departure for this discussion of where educators stand today in the battle to preserve and strengthen the public schools and of directions that need to be taken toward democratic school reform, particularly in the social studies. Much of the discussion is…
Wendel, Frederick C., Ed.
This publication contains four chapters that examine the reform of administrator preparation programs. In "The Reform Paradigm: Exploring the Fuzzy Logic of Educational Administration," William Ammentorp and Thomas Morgan develop a model based on linguistic algorithms to understand qualitative policy formation and decision making. In "Student…
Joskow, Paul L.
We now have over a decade of experience with the privatization, restructuring, regulatory reform, and wholesale and retail competition in electricity sectors around the world. The objectives and design attributes of these ...
A Progress Report on the Reforms in D.C. Public Schools. Hearing before the Subcommittee on Oversight of Government Management, Restructuring, and the District of Columbia of the Committee on Governmental Affairs. United States Senate, One Hundred Fifth Congress, First Session (September 8, 1997).
Congress of the U.S., Washington, DC. Senate Committee on Governmental Affairs.
A hearing before the oversight committee for the District of Columbia (D.C.) public schools provided the opportunity for several senators and educators to comment on the progress of educational reform in the District's public schools. The hearing was held at a time when the opening of the city's public schools was delayed because of their many…
Since 2001 the government of Cambodia has striven to advance policy-led education reform based on a sector-wide approach. This paper critically reviews the status and progress of Cambodia's education reform from the perspective of the aid's effectiveness. The paper looks at the performance of the sector reform in the three priority areas…
Numerous studies have examined the elasticities of electricity demand---residential as well as commercial and industrial---in the private sector. However, no one appears to have examined the behavior of the public sector demand. This study aims to fill that gap and to provide insights into the electricity demand in the public sector, using the U.S. Navy bases as a case study. This study examines electricity demand data of 38 Navy activities within the United States for a 16-year time period from 1985 through 2000. The Navy maintains a highly diverse shore infrastructure to conduct its mission and to support the fleet. The types of shore facilities include shipyards, air stations, aviation depots, hospital, and many others. These Navy activities are analogous to commercial or industrial organizations in the private sector. In this study, I used a number of analytical approaches to estimate short-run and long-run elasticities of electricity demand. Estimation using pooled data was rejected because it failed the test for homogeneity. Estimation using the time series data of each Navy activity had several wrong signs for coefficients. The Stein-rule estimator did not differ significantly from the separate cross-section estimates because of the strong rejection of the homogeneity assumption. The iterative Bayesian shrinkage estimator provided the most reasonable results. The empirical findings from this study are as follows. First, the Navy's electricity demand is price elastic. Second, the price elasticities appear to be lower than those of the private sector. The short-run price elasticities for the Navy activities ranged from -0.083 to -0.157. The long-run price elasticities ranged from -0.151 to -0.769.
This book is based on a study of a 4-year reform effort in the Newark (New Jersey) public schools. The discussion focuses on an elementary school as it attempted reform in an effort that was ultimately unsuccessful. Part I opens the discussion of the effects of social class and race on educational reform. To see why inner city schools have not…
Library of Congress, Washington, DC. Congressional Research Service.
This document compiles materials and bibliographic references to assist national high school debaters in researching the 1989-1990 topic, "How Can the Federal Government Reform Prisons and Jails in the United States?" Materials are organized into a section of general materials and around each of three official debate propositions within the topic:…
Kerchner, Charles T.; Mitchell, Douglas E.
Reviews present labor statutes and examines three alternatives to current practices; proposes that teaching, by its nature, is not well administered by industrial standards or well adjudicated through industrial unionism. Suggests "professional unionism" as a means of effecting educational reform. (DR)
Transforming the commercial buildings market to become "net-zero-energy-capable" will require dramatically lower levels of energy use sector wide. A comprehensive and concerted industry effort, partnering with utilities and government, must...
Background In Uganda, long-lasting insecticidal nets (LLIN) have been predominantly delivered through two public sector channels: targeted campaigns or routine antenatal care (ANC) services. Their combination in a mixed-model strategy is being advocated to quickly increase LLIN coverage and maintain it over time, but there is little evidence on the efficiency of each system. This study evaluated the two delivery channels regarding LLIN retention and use, and estimated the associated costs, to contribute towards the evidence-base on LLIN delivery channels in Uganda. Methods Household surveys were conducted 5-7 months after LLIN distribution, combining questionnaires with visual verification of LLIN presence. Focus groups and interviews were conducted to further investigate determinants of LLIN retention and use. Campaign distribution was evaluated in Jinja and Adjumani while ANC distribution was evaluated only in the latter district. Costs were calculated from the provider perspective through retrospective analysis of expenditure data, and effects were estimated as cost per LLIN delivered and cost per treated-net-year (TNY). These effects were calculated for the total number of LLINs delivered and for those retained and used. Results After 5-7 months, over 90% of LLINs were still owned by recipients, and between 74% (Jinja) and 99% (ANC Adjumani) were being used. Costing results showed that delivery was cheapest for the campaign in Jinja and highest for the ANC channel, with economic delivery cost per net retained and used of USD 1.10 and USD 2.31, respectively. Financial delivery costs for the two channels were similar in the same location, USD 1.04 for campaign or USD 1.07 for ANC delivery in Adjumani, but differed between locations (USD 0.67 for campaign delivery in Jinja). Economic cost for ANC distribution were considerably higher (USD 2.27) compared to campaign costs (USD 1.23) in Adjumani. Conclusions Targeted campaigns and routine ANC services can both achieve high LLIN retention and use among the target population. The comparatively higher economic cost of delivery through ANC facilities was at least partially due to the relatively short time this system had been in existence. Further studies comparing the cost of well-established ANC delivery with LLIN campaigns and other delivery channels are thus encouraged. PMID:20406448
Public-Private Sector Collaboration in Education: Implications for Research, Policy, and the Education of Professional Educators. Proceedings of the Annual Rupert N. Evans Symposium (10th, Urbana, Illinois, May 2-3, 1989).
Phelps, L. Allen, Ed.; Thurston, Paul W., Ed.
These proceedings contain 11 papers that examine several diverse collaborative efforts designed to improve education and training programs through substantive involvement of the private sector. Authors and titles are as follows: "Public-Private Sector Collaboration in Education: Implications for Research, Policy, and the Education of Professional…
Donmoyer, Robert, Ed.; Merryfield, Merry M., Ed.
This theme issue highlights the diversity of reform initiatives in order to provide a deep understanding of the complexities associated with educational reform in general and the reform of science education in particular. Systemic reform initiatives at the national and state levels along with locally-inspired efforts at reform are outlined.…
Cortes, Ernesto, Jr.
Community engagement should be at the heart of public school reform. In Texas, the Industrial Areas Foundation Alliance Schools demonstrate how parents and community leaders are serious partners in shaping school environments and educational programs. (SK)
Pajak, Edward F.
Background/Context: Scholars have described American culture in recent decades as narcissistic, manifested by displays of self-absorption tantamount to a pathological syndrome that has reached epidemic proportions. An education reform movement that is highly critical of public schools, teachers, and students has simultaneously emerged, espousing a…
Waring, Justin; Bishop, Simon
Health policies increasingly support private businesses to take an active role in the organisation and delivery of public healthcare services. For the English NHS, this is exemplified by the introduction of Independent Sector Treatment Centres. A number of these facilities involve the wholesale secondment of NHS clinicians to the private sector which, we suggest, raises important questions about the identities of healthcare professionals accustomed to working in the public sector. Our paper investigates this transition highlighting three prominent discontinuities in clinical work: the ethos of private sector ownership, new lines of authority and fragmented relationships. Drawing on Giddens, we examine how clinicians experience and interpret these changes and how they keep their biographical 'narrative going'. The 'pioneers' interpreted the independent sector as an opportunity to re-invigorate their practice through new roles, relationships and higher quality care; the 'guardians' as an opportunity to replicate and protect the customs and standards of the NHS in the private sector; whilst the 'marooned' longed to return to the NHS. Our study illustrates how the sectoral context can shape healthcare identities, and how contemporary reforms aimed at promoting partnerships across public and private sectors can have profound implications for clinicians. PMID:21314688
Van Lerberghe, W; Ammar, W; el Rashidi, R; Sales, A; Mechbal, A
This first of two papers on the health sector in Lebanon describes how unregulated development of private care quickly led to a crisis situation. Following the civil war the health care sector in Lebanon is characterized by (i) ambulatory care provided by private practitioners working as individual entrepreneurs, and, to a small extent, by NGO health centres; and (ii) by a fast increase in hi-tech private hospitals. The latter is fuelled by unregulated purchase of hospital care by the Ministry of Health and public insurance schemes. Health expenditure and financing patterns are described. The position of the public sector in this context is analyzed. In Lebanon unregulated private care has resulted in major inefficiencies, distortion of the health care system, the creation of a culture that is oriented to secondary care and technology, and a non-sustainable cost explosion. Between 1991 and 1995 this led to a financing and organizational crisis that is the background for growing pressure for reform. PMID:10176265
This article examines the political economy of subsoil law reform under the Putin administration. Despite repeated promises of imminent reform, the overhaul of the main legal basis governing some of the most important sectors of the Russian economy was subjected to repeated delays during the eight years of Putin's presidency. This article shows that the interaction of three major influences—the
Background Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia. Methods Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. Results 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were distributed through the private sector, but often comprised non-artemisinin therapies, and in the DRC and Nigeria, oral artemisinin monotherapies. Provider knowledge of the first-line treatment was significantly lower in the private sector than in the public/not-for-profit sector. Conclusions These standardized, nationally representative results demonstrate the typically low availability, low market share and high prices of ACT, in the private sector where most anti-malarials are accessed, with some exceptions. The results confirm that there is substantial room to improve availability and affordability of ACT treatment in the surveyed countries. The data will also be useful for monitoring the impact of interventions such as the Affordable Medicines Facility for malaria. PMID:22039838
Panda, Arun Kumar
Restructuring and privatization, used as major tools in electricity sector reform, are often viewed as part of the same process and the terms used interchangeably. Although related, they represent quite different dimensions of change and reform. Privatization is the result of change in the management/ownership. Restructuring, on the other hand, refers to changes in structure such as the unbundling of vertically integrated utilities, and the introduction of competition. Most studies attempt to assess the impact of privatization of the electric utilities on their tariff structure, performance and efficiency. They have not tried to estimate the effect of restructuring on the performance of the unbundled utilities. Using panel data on the state electricity boards and the thermal power plants, and employing variance-component fixed effects and random effects models, this study examines the effects of restructuring and ownership on the performance of India's electricity sector. We also study the effects of absolute majority of political parties on performance. The study also uses a cross-country-comparison-framework to compare the electricity sector reforms of India with those of Chile, Hungary and Norway. Results show that restructuring has significantly positive effects on such performance indicators as plant availability, plant load factor, forced outage, average tariff collection, and sales revenue as a ratio of cost. With regard to labor efficiency indicators, we find mixed results. Restructuring also appears to entail reduction in the extent of cross-subsidization. However, the cost of supply seems to be unaffected by restructuring. Absolute majority of the party in government shows adverse effects on costs, sales revenue as a ratio of cost, and labor efficiency. The effects of ownership are somewhat mixed, with state ownership (as opposed to federal or private) indicating adverse effects on plant performance. Interestingly, after controlling for location-specific effects, we do not find significant difference between privately owned plants and other plants in areas like plant availability, and plant load factor. In a developing country like India with a long tradition of public ownership and vertical integration in electricity sector, this has important policy implications.
The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as "free choice models" in which "the money follows the patient." The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented. PMID:19069288
This volume presents the data for 15 industrial sectors, identified by Standard Industrial Classification (SIC) codes, that are presently required to report to TRI. These chapters set the TRI data in context of economic, regulatory, and technological developments that influence industry-wide releases and other waste management. They also analyze reporting by industrial activities at the four-digit SIC code level. Industry sectors covered are: Food and Beverage Processing; Tobacco Products; Textile Mill Products; Apparel and Fabricated Textiles; Lumber and Wood Products; Furniture; Printing and Publishing; Rubber and Plastics Products; Leather and Leather Products; Stone, Clay, Glass, and Concrete; Fabricated Metals; Industrial Machinery; Transportation Equipment; Instruments and Photographic Equipment; and Miscellaneous Manufacturing.
This book shares what one educator learned as a teacher and administrator in public and private schools and business, examining where the country is in the process of reforming public education and suggesting that it is tired out from so many reform efforts. It notes that new programs often suffocate under the latest federal, state, or district…
The pay determining process of CEOs of UK higher ed ucation institutions is modelled using three econometric methodologies appl ied to a large and unique dataset for the academic years 1997\\/98 throu gh to 2005\\/06. A gender differential in pay is detected and this differential remains robust across the specifications reported and across higher education sub-sectors. There is evidence that
In order to promote public awareness and raise charitable donations for patients with amyotrophic lateral sclerosis (ALS), a charity activity known as the "Ice Bucket Challenge" went "viral" from social media in the US to the rest of the world in the summer of 2014. The Challenge had an obvious impact with a large number of participants and increasing charity donations. However, the effort has also garnered criticism for wasting water, possible safety concerns, and its status as a publicity stunt or grandstanding. A system of medical care for and research into rare diseases has been established in some countries in order to protect the rights and interests of patients with rare diseases, but such systems have yet to be established in other countries. An activity like the "Ice Bucket Challenge" is clearly not enough to improve the plight of patients with ALS or other rare diseases. However, the public awareness attracted by this challenge may provide the impetus for those countries that lack a system of medical care for and research into rare diseases to establish such a system. The public sector should bear the responsibility for taking on the important task of promoting the sustained development of a system of medical care for and research into rare diseases. PMID:25364651
The public administration reform in the Czech Republic set off with a reform of the territorial public administration at the end of the 90s. The reform established a joint public administration model in the territories, power decentralization, and de?concentration of operative functions from ministries to regions and municipalities. The reform outcomes largely depend on the quality of human resources in
Dunn, Abe; Shapiro, Adam Hale
This study examines the impact of major health insurance reform on payments made in the health care sector. We study the prices of services paid to physicians in the privately insured market during the Massachusetts health care reform. The reform increased the number of insured individuals as well as introduced an online marketplace where insurers compete. We estimate that, over the reform period, physician payments increased at least 11 percentage points relative to control areas. Payment increases began around the time legislation passed the House and Senate-the period in which their was a high probability of the bill eventually becoming law. This result is consistent with fixed-duration payment contracts being negotiated in anticipation of future demand and competition. PMID:25497755
Hughey, Aaron W.
Advocates collaboration by universities with public, private, and nonprofit organizations to create value-added innovative economies in their regions. Discusses the advantages of such partnerships and various approaches to regional economic development. (Contains 29 references.) (SK)
Francesco Bof; Pietro Previtali
Often e-Procurement systems are implemented because authorities' guidelines, tools or legal setting mandates them. The growing relevance of e-Procurement systems and tools in public health care organisations (HCOs) has raised much attention in business practice and the academic literature, also related to the improvement of public health care services and community welfare (e.g. Henriksen et al., EU Directives 17-18\\/2004). The
Kenney, Genevieve M.; Dorn, Stan
Moving toward universal coverage has the potential to increase access to care and improve the health and well-being of uninsured children and adults. The effects of health care reform on the more than 25 million children who currently have coverage under Medicaid or the Children's Health Insurance Program (CHIP) are less clear. Increased parental…
Chow, Eric P. F.; Jing, Jun; Zheng, Jun; Zhao, Junshi; Zhang, Lei
This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants’ attitudes towards NSPs, (2) participants’ opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users’ risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users’ addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation. PMID:26114556
Imke Kruse; Henry Edward Orren; Steffen Angenendt
After many years without substantial activity in immigration policy, the German Red–Green government which came to power in 1998 introduced an American-style Green Card and a new citizenship law. From these beginnings, the immigration reform campaign captured the public imagination, and for two years a broad spectrum of figures from German public life took part in a lively debate on
Mulcahy, Dennis M.
On September 10, 1996, the government of Newfoundland and Labrador (Canada) announced that public consultation on education reform would begin on September 16. Just prior to the first hearing, the government circulated a document entitled "Structuring the Education System: A Public Consultation Paper for Educational Change in Newfoundland and…
Eliana Minelli; Gianfranco Rebora; Matteo Turri
Purpose – The aims of the paper are to: present a theoretical framework for analysing the functioning and consequences of control systems; understand and compare the structure and impact of control systems on two Italian public administrations also in relation to possible situations of crisis and failure; and examine the possible link between the organisational impact of control systems (and
Hamlin, Robert G.; Ruiz, Carlos E.; Wang, Jia
Stephen M. Shortell, dean of the School of Public Health, distinguished professor of health policy and management, and professor of organization behavior in the Haas School of Business, University of California-Berkeley, has argued that evidence-based management needs to be married with evidence-based medicine if sustainable improvement in the…
Yaghi, Abdulfattah; Goodman, Doug; Holton, Elwood F.; Bates, Reid A.
Jordanian policymakers rely on trained supervisors to lead organizational change in public administration. The impact of training, however, remains weak unless trainees apply what they have learned (training transfer). In order to assess training transfer, the present study validates a Classic Arabic version of the Learning Transfer System…
McPake, B.; Mills, A.
Most commonly, lessons derived from comparisons of international health sector reform can only be generalized in a limited way to similar countries. However, there is little guidance as to what constitutes "similarity" in this respect. We propose that a framework for assessing similarity could be derived from the performance of individual policies in different contexts, and from the cause and effect processes related to the policies. We demonstrate this process by considering research evidence in the "public-private mix", and propose variables for an initial framework that we believe determine private involvement in the public health sector. The most influential model of public leadership places the private role in a contracting framework. Research in countries that have adopted this model suggests an additional list of variables to add to the framework. The variables can be grouped under the headings "demand factors", "supply factors", and "strength of the public sector". These illustrate the nature of a framework that could emerge, and which would help countries aiming to learn from international experience. PMID:10916918
Background We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. Methods We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. Results In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. Conclusions We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply transformed the sector. Patients converted into consumers are exposed to the biomedicalization of their lives helped by the biopedagogies, which using subtle mechanisms present discourses as if they are objective and created to empower consumers. The analysis of judicialization of health policies in Brazil could help to understand the complexity of the problem and to develop democratic mechanisms to improve the regulation of the health sector. PMID:21349181
Section 11 of the Federal Nonnuclear Research and Development Act mandates an annual public hearing on the adequacy of attention to energy conservation method and the environmental consequences of the application of energy technologies. This report summarizes the views of 88 indi...
Wong, V C; Chiu, S W
Analyses the features, strategies and characteristics of health-care reforms in the People's Republic of China. Since the 14th Central Committee of the Chinese Communist Party held in 1992, an emphasis has been placed on reform strategies such as cost recovery, profit making, diversification of services, and development of alternative financing strategies in respect of health-care services provided in the public sector. Argues that the reform strategies employed have created new problems before solving the old ones. Inflation of medical cost has been elevated very rapidly. The de-linkage of state finance bureau and health service providers has also contributed to the transfer of tension from the state to the enterprises. There is no sign that quasi-public health-care insurance is able to resolve these problems. Finally, cooperative medicine in the rural areas has been largely dismantled, though this direction is going against the will of the state. Argues that a new balance of responsibility has to be developed as a top social priority between the state, enterprises and service users in China in order to meet the health-care needs of the people. PMID:10351255
Sitra Mulepo; Akiko Niwa; Takuji Date
This article aims to share a practical experience of how to set up a simple framework for better medical equipment management\\u000a at public hospitals and health centres in Uganda for the 2006–2009 period. Three steps approach was employed. At first, all\\u000a available medical equipment was categorised in six operational conditions and that were indicated on the equipment by eye-catching\\u000a colour
Dan Goldhaber; Katharine Destler; Daniel Player
Some scholars and policymakers who are concerned about the inequitable distribution of quality teachers suggest offering financial incentives for working in hard-to-staff schools. Previous studies have estimated compensating differentials using hedonic modeling, an approach potentially undermined by district-wide salary schedules and the lack of labor market competitiveness. To address this problem, we build hedonic wage models for both public and
Rivera, William M.; Alex, Gary
Public agricultural extension services around the world are being pressured to adapt to new funding constraints and a changing agricultural sector. The global perspective on extension is no longer that of a unified public sector service, but of a multi-institutional network of knowledge and information support for rural people. This reality and…
On January 19, 1999, Tony Blair's government announced the most radical restructuring of the House of Lords, the UK's second chamber, in its 600-year existence. Honoring the Labour Party election manifesto, the Bill will remove all 759 hereditary peers, those with an automatic right to sit by virtue of birthright, within the year. In the meantime, a Royal Commission will formulate proposals for a new upper house and issue a report by December 31, 1999. A fully reformed chamber is expected to be in place by 2002, and in the meantime, publicly nominated "People's Peers" may sit in the Lords in addition to the politically appointed Life Peers. The BBC Special Report outlines this momentous constitutional change in Britain, and offers analysis, commentary, and the latest news.
The paper compares healthcare reforms in China, South Korea, Singapore and Thailand with the purpose of drawing useable lessons about the appropriate role of the state in the sector. It argues that healthcare reforms in China and Korea offer many negative lessons for healthcare reformers while Singapore and Thailand offer positive lessons that may be considered for emulation elsewhere. The
Concerns over the progress in Resource Conservation and Recovery Act (RCRA) cleanup efforts since 1984 have prompted the Environmental Protection Agency to publish "RCRA Cleanup Reforms," which describes the implementation process of these administrative reforms.
As health intervention, vaccination has had a tremendous impact on reducing mortality and morbidity caused by infectious diseases. Traditionally vaccines were developed and made in the western, industrialised world and from there on gradually and with considerable delay became available for developing countries. Today that is beginning to change. Most vaccine doses are now produced in emerging economies, although industrialised countries still have a lead in vaccine development and in manufacturing innovative vaccines. Technology transfer has been an important mechanism for this increase in production capacity in emerging economies. This review looks back on various technology transfer initiatives and outlines the role of WHO and other public and private partners. It goes into a more detailed description of the role of the National Institute of Public Health and the Environment (RIVM) in Bilthoven, the Netherlands. For many decades RIVM has been providing access to vaccine technology by capacity building and technology transfer initiatives not only through multilateral frameworks, but also on a bilateral basis including a major project in China in the 90 s of the previous century. Looking forward it is expected that, in a globalizing world, the ambition of BRICS countries to play a role in global health will lead to an increase of south-south technology transfers. Further, it is argued that push approaches including technology transfer from the public domain, connecting innovative enabling platforms with competent developing country vaccine manufacturers (DCVM), will be critical to ensure a sustainable supply of affordable and quality vaccines to national immunization programmes in developing countries. PMID:22902679
A major structural reform of the Danish public sector took place in 2007 when the number of administrative units at the regional and municipal levels was reduced. The larger administrative units allowed for a new hospital structure with a reduced number of acute hospitals covering a population of between 200,000 and 400,000 inhabitants. The restructuring involves creation of acute hospitals with a 24-h acute service by a range of specialists. The idea was to weight quality higher than geographical closeness to the nearest hospital. Concurrently, the pre-hospital service will be expanded. The National Board of Health was given authority to approve regional plans for specialties rather than provide guidelines. The use of private hospitals was increased as a means to fulfil a waiting time guarantee of between 2 and 1 month. Increased use of private insurance also increased use of private hospitals. A new way of financing health care was intended to give municipalities incentives to invest in health prevention and health promotion. Concurrent reforms included economic incentives to increase hospital production as measured by DRGs; quality programmes to secure high quality and patient safety; and electronic patient records and increased use of IT systems. PMID:22521580
Background Depressive and anxiety disorders are common among working adults and costly to employers and individuals. Mental health screening is often an important initial strategy, but the resultant data are often of unknown representativeness and difficult to interpret. In a public sector workforce, this study used a brief screener for depression/anxiety to: a) compare prevalence of high psychological distress obtained from a researcher survey with an employer survey and population norms and b) verify whether expected correlates were observed in a screening setting. Methods Participants were public servants working for an Australian state government. High psychological distress (Kessler-10 ?22) stratified by age and sex was compared for a random weighted sample researcher survey (n?=?3406) and an anonymous volunteer employer survey (n?=?7715). Prevalence ratios (PR) were estimated from log binomial regression. Results Referencing the researcher survey, prevalence of high psychological distress was greater by age and sex in the employer survey but was only dependably higher for men when compared with population norms. Modelling suggested this may be due to work stress (effort-reward imbalance) (PR?=?3.19, 95% CI 1.45-7.01) and casual/fixed-term employment (PR 2.64, 95% CI 1.26-5.56). Conclusions Depression and anxiety screening using typical employer survey methods could overestimate prevalence but expected correlates are observed in a screening setting. Guidance for employers on screening and interpretation should be provided to encourage engagement with mental health prevention and treatment programs in the workplace. PMID:24498884
Sekhon, Jasjeet S.
June 2013 Californians and Immigration Reform Alternatives Jack Citrin Morris Levy Gabriel Lenz about immigration reform remains a com- plex subject," said IGS Director Jack Citrin, who led the re IGS Survey, June 2013 Californians and Immigration Reform Alternatives2 Citrin, who developed
Burger, M.; Jensen, V.
Performance contracting has worked well in large multi-family buildings markets, such as public housing authorities. As equally deserving a market are assisted housing developments, which tend to be smaller scale in terms of size and ownership. This scale discourages energy service companies (ESO's) from approaching these developments because marketing and other transaction costs may be considered prohibitive. One answer to this barrier is a partnership that may act as an umbrella and aggregator for this market. The Illinois Housing Development Authority, assisted by the US Department of Energy's Chicago Regional Support office, is piloting such a partnership for developments that has its mortgages. Working with ESCO Landis and Staefa, Inc., this ongoing initiative is expanding performance contracting into the assisted housing market.
Given growing interest in multicriteria decision making and multiple cost-effectiveness thresholds' approach, it was decided to investigate its usefulness in Poland. The pricing and reimbursement (P&R) regulations were reviewed and a cross-sectional survey was conducted amongst nurses. The study investigated whether P&R rules are aligned with the preferences of healthcare professional towards the concept of equity. The references to aversion to inequalities in health and capacity to benefit were recognized as the most and least important principle respectively by the group of nurses. Different weightings of health gain dependent on disease severity were accepted by half of the study's population. In the review of legal acts, references to capacity to benefit were frequently found. The opposite was registered for other concepts of equity. There is room for further improvement with respect to the alignment between the Polish P&R decision making criteria and public preferences regarding allocation principles. PMID:25052370
Johnson, Brian R
State, county, and local governments are currently facing a myriad of economic issues, based on shrinking tax revenues combined with increased expenditures. Of these, the costs related to defined benefit pension plans are one of the most serious issues facing many public employers. Through a comprehensive review of the existing literature, this article examines how the shift from the defined benefit (DB) to defined contribution (DC) pension plan has the potential to enhance levels of labor unrest due to changes in union militancy, bargaining skills deficits, intra-organizational conflict, and issues related to economic trade-offs. Besides the capacity for immediate and deleterious ramifications in the collective bargaining process, the transition to the DC pension also presents some potentially negative consequences related to human resource management, including changes in the psychological contract, recruitment strategies, employee turnover, and changes in retirement patterns. Recommendations to improve labor relations and human resource management practices in the DC pension environment are also explored. PMID:23484365
Recent reforms of initial teacher education (ITE) in the learning and skills sector (LSS) in England are standards based and emphasise subject specialism. The reforms are underpinned by objectivist epistemological assumptions which are incompatible with socio?cultural theories of professional knowledge, and ignore the diverse teaching roles and contexts in the sector and wider systemic issues. A qualitative scoping study found
Al-Hassan, Suha M.; Obeidat, Osama M.; Lansford, Jennifer E.
The present study evaluates a major education reform in Jordan—the implementation of public kindergartens—and provides an example of how evaluation can be incorporated into education reform. In the context of education reform in Jordan, 532 public kindergartens have been created over the last five years. A stratified random sample of kindergartens was selected to represent these new public kindergartens (n = 84) and previously existing private kindergartens (n = 23). Independent observers rated the quality of kindergarten environments in seven domains. Overall, 13% of public kindergarten environments were observed to be inadequate, 43% were of minimal quality, 43% were good, and 1% were excellent. In four of the seven domains, the quality of public kindergartens was significantly higher than the quality of private kindergartens; there were no significant differences in the other domains. Findings suggest the importance of continuing to implement high quality kindergartens in Jordan and of incorporating evaluations into education reform. PMID:21170163
Social Welfare Policy and Public Assistance for Low-Income Substance Abusers: The Impact of 1996 Welfare Reform Legislation on the Economic Security of Former Supplemental Security Income Drug Addiction and Alcoholism Beneficiaries
Hogan, Sean R; Unick, George J.; Speiglman, Richard; Norris, Jean C.
Prior to January 1, 1997, individuals with drug- or alcohol-related disabilities could qualify for federal public assistance through the Supplemental Security Income (SSI) program. During the welfare reforms of the Clinton administration, this policy was changed resulting in lost income and health care benefits for many low-income substance abusers. This paper examines the historical underpinnings to the elimination of drug addiction and alcoholism (DA&A) as qualifying impairments for SSI disability payments. Following this, empirical evidence is presented on the effect this policy change had on the subsequent economic security of former SSI DA&A beneficiaries. Findings indicate that study participants that lost SSI benefits suffered increased economic hardship following the policy change. These findings have important implications for future social welfare policymaking decisions. PMID:20396645
Alvarez, R. Michael
We study public opinions about convenience voting reforms, using a unique state-by-state survey conducted in the 2008 presidential election. Our analysis of the American voting public’s support for potential convenience ...
Carter, Julie H.
In the growing trend toward urban school reform vital educational stakeholders often function at cross-purposes in determining the mode and trajectory of change. This tug-of- war is even more poignant in cities with racially charged public school histories, and where reform movements serve to bolster hopes for the rescue of ailing economies.…
Shaughnessy, Lana, Ed.; Morris, Joann Sebastian, Ed.
This publication features profiles of 25 outstanding school reform programs at Bureau of Indian Affairs schools. These innovative schools have captured various aspects of school reform that encompass more challenging, real world curricula; school-to-work transitions; new ways of assessing student achievement; higher order thinking and…