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This article addresses the development of new performance management systems related to publicsectorreforms. 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
Purpose – The purpose of this study is to examine the ongoing dynamics of the public service sectorreform through an embedding process of a municipal enterprise from the field of basic social and health care services – a pilot model in Finland. Design\\/methodology\\/approach – The framework of a multi-level perspective on transitions is used to describe the change process.
Satu Pekkarinen; Lea Hennala; Vesa Harmaakorpi; Tomi Tura
Is it possible to imagine New Public Management without marketization? In Denmark the present liberal-conservative Government has, throughout its 10 years in power, designed and implemented more than 15 major management reforms in the publicsector. Although most of the reforms are rhetorically firmly rooted in neo-liberal ideologies they have, in practice, promoted tools and mechanisms of the “traditional,” or
Purpose – This paper aims to consider the suitability of Anglo-American new public management (NPM) practices in the context of publicsectorreform in Japan. Design\\/methodology\\/approach – The paper examines the two principal alternative approaches that have been taken to publicsectorreform in the UK and the USA. These comprise in the case of the UK the setting of
This article explores the patterned variations in the references in election manifestos of political parties in OECD countries to market-oriented reforms of the publicsector, irrespective whether these references are in favour of these reforms or not. It is expected that these variations are structured by institutional features which are related to national, partisan and sectoral differences.The empirical analysis shows
Publicâprivate partnerships involve organisations from the public and private sectors working together to provide public services. This introductory issue of the International Journal of Public Policy comprises two papers that consider PPP at the theoretical level, and seven papers that explore partnership arrangements in four different countries: the UK, Australia, USA and France. In some countries the term PPP is
This article considers some of the effects of health sectorreform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the publicsector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the publicsector, because the publicsector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts. Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation. The increase in private sector provision has led health workers to move to the private sector. For those remaining in the publicsector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements. Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.
This article considers some of the effects of health sectorreform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector.Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the publicsector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the publicsector, because the publicsector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts.Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation.The increase in private sector provision has led health workers to move to the private sector. For those remaining in the publicsector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements.Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed. PMID:15560841
This paper focuses on the transition of governmental management innovations from the national, political level to the local, institutional level. In order to throw some light on the complex process of two-level reforms in publicsector financial management, I discuss the case of introducing prospective payment systems in Norwegian hospitals during 1987–1999. The empirical studies are based on official documents
Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation—namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability—have been eroded by NPM reforms. Despite improvements in specific operational tasks of the publicsector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in publicsector administration reform.
This paper analyses changes in university management structures and practices as a response to publicsectorreforms in Ugandan higher education using Makerere University as a case study. The study uses the organisational learning theory and a review of the higher education literature. Two adaptive responses in the management structures and…
Organizational design is considered in policy literature as a forceful policy tool to put policy to action. However, previous research has not analyzed the project organization as a specific form of organizational design and, hence, has not given much attention to such organizations as a strategic choice when selecting policy tools. The purpose of the article is to investigate the project as a policy tool; how do such temporary organizations function as a specific form of organization when public policy is implemented? The article is based on a framework of policy implementation and is illustrated with two welfare reforms in the Swedish publicsector, which were organized and implemented as project organizations. The case studies and the analysis show that it is crucial that a project organization fits into the overall governance structure when used as a policy tool. If not, the project will remain encapsulated and will not have sufficient impact on the permanent organizational structure. The concept of encapsulation indicates a need to protect the project from a potential hostile environment. The implication of this is that organizational design as a policy tool is a matter that deserves more attention in the strategic discussion on implementing public policies and on the suitability of using certain policy tools. PMID:22733712
Jensen, Christian; Johansson, Staffan; Löfström, Mikael
The article examines various healthcare systems reform projects in Canada and some Canadian provinces and reveals some tendencies in governance renewal. The analisis is based on the hypothesis that reform is an exercise aiming at the renewal of governance conception and practices. In renewing governance, reform leaders hope to use adequate and effective levers to attain announced reform objectives. The article shows that the conceptions and operational modalities of governance have changed over time and that they reveal tensions inherent to the transformation and legitimation process of public healthcare systems. The first section discusses the relationships between reform and change. The second section defines the conception of gouvernance used for the analisis. Based on a content analisis of the various reform reports, the third section reveals the evolution of the conception of governance in healthcare systems in Canada. In order to expose the new tendencies, ideologies and operational principles at the heart of the reform projects are analysed. Five ideologies are identified: the democratic ideology, the "population health" ideology, the business ideology, the managerial ideology and the ideology of equity and humanism. This leads to a discussion on the dominant influence of the managerial ideology in the current reform projects. PMID:20963305
Denis, Jean L; Lamothe, Lise; Langley, Ann; Stéphane, Guérard
Background Because both public health surveillance and action are crucial, the authors initiated meetings at regional and national levels to assess and reform surveillance and action systems. These meetings emphasized improved epidemic preparedness, epidemic response, and highlighted standardized assessment and reform. Methods To standardize assessments, the authors designed a conceptual framework for surveillance and action that categorized the framework into eight core and four support activities, measured with indicators. Results In application, country-level reformers measure both the presence and performance of the six core activities comprising public health surveillance (detection, registration, reporting, confirmation, analyses, and feedback) and acute (epidemic-type) and planned (management-type) responses composing the two core activities of public health action. Four support activities – communications, supervision, training, and resource provision – enable these eight core processes. National, multiple systems can then be concurrently assessed at each level for effectiveness, technical efficiency, and cost. Conclusions This approach permits a cost analysis, highlights areas amenable to integration, and provides focused intervention. The final public health model becomes a district-focused, action-oriented integration of core and support activities with enhanced effectiveness, technical efficiency, and cost savings. This reform approach leads to sustained capacity development by an empowerment strategy defined as facilitated, process-oriented action steps transforming staff and the system.
This article describes the reforms to the functions of central government in New Zealand that have been introduced since 1985. It sketches the political and economic situation which motivated the changes to the systems of public management. Some of the theoretical influences that provided insights to the advice given to the government by its officials are noted. The essential elements
Power sectorreforms in India were initiated in the face of mounting commercial losses due to poor fiscal health of State Utilities, endemic capacity and energy shortages and increasing subsidy burden on the states. Investment in the sector was falling far short of demand in power supply. The Government of India, in 1991 embarked upon an ambitious program for reforming
This study examines the experience of the United Nations interventions to reform Haiti's security sector as part of a larger effort to rebuild the Haitian state. Despite multilateral attempts in the 1990s to demobilize the army, create a police force and implement reforms, the lack of elite support, insufficient judicial sector capacity and persistence of corruption led to the current
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…
Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the\\u000a compatibility of “governance-for-adaptation” with the current paradigms of public administration has generally been overlooked.\\u000a Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly\\u000a called “New Public Management” (NPM) in an effort to improve administrative
Hallie EakinSiri; Siri Eriksen; Per-Ove Eikeland; Cecilie Øyen
Contents: List of Abbreviations; Sammanfattning; Executive Summary; Background; Method; The role and character of Security SectorReform; The Nordics and the Baltic states, present and future SSR activities in the MoD sphere; Other factors promoting succe...
Purpose – Capitalist transformation of the publicsector is global phenomenon that affects many countries. This paper seeks to examine recent publicsectorreforms introduced by the Government of Botswana to improve civil service performance. The underlying political philosophy behind the change in the publicsector is explored by relating the neoliberal ideology which is driving the reform agenda to
Purpose – The paper aims to explore the consequences of new public management (NPM) inspired reforms in general and outsourcing of traditional publicsector responsibilities in Sweden to private organizations in particular. At centre stage are the roles of entrepreneurs, women-owned small and medium enterprises (SMEs) and socially constructed paradigms of gender in this process. The paper's aim is to
Tenure has lost public legitimacy. Of 30 states reforming civil-service systems or proposing reforms, Georgia has gone the farthest. Since 1996, new state government hires have been "at will" employees. Erosion of private-sector union strength may aid antitenure political leaders' efforts. A sidebar outlines states' actions. (10 references) (MLH)
Purpose – The purpose of this paper is to examine the role of publicsector accounting in implementing neoliberal reforms. Design\\/methodology\\/approach – The proposition that the adoption and development of accrual accounting in the publicsector is a technical development intended to improve transparency and accountability is investigated. The paper compares the development and use of accrual accounting in public
Power sectorreforms in India were initiated at a juncture when the sector was plagued with commercial losses and burgeoning subsidy burden. Investment in the sector was not able to keep pace with growing demand for electricity. This paper takes stock of pre-reform situation in Indian power sector and identifies key concerns that led to initiation of the process of
This report synthesizes the findings from several areas of work undertaken to assess what impact publicsector employment has had on both the level and structure of employment. It also examines the impact of the publicsector as employer on the labor market from two viewpoints: the level and share of publicsector employment and the structure of…
Organisation for Economic Cooperation and Development, Paris (France).
Since passage of the 1978 Civil Service Reform Act, which mandated new systems for executive selection, development, and performance appraisal, the importance of describing managerial and executive jobs in the publicsector has increased. This recent atte...
This work analyzes the neoliberal health sectorreforms that have taken place in Latin America, the preparation of health care workers for the reforms, the reforms' impacts on the workers, and the consequences that the reforms have had on efficiency and quality in the health sector. The piece also looks at the process of formulating and implementing the reforms. The piece utilizes secondary sources and in-depth interviews with health sector managers in Bolivia, Colombia, Costa Rica, the Dominican Republic, Ecuador, El Salvador, and Mexico. Neoliberal reforms have not solved the human resources problems that health sector evaluations and academic studies had identified as the leading causes of health system inefficiency and low-quality services that existed before the reforms. The reforms worsened the situation by putting new pressures on health personnel, in terms of both the lack of necessary training to face the challenges that came with the reforms and efforts to take away from workers the rights and benefits that they had gained during years of struggles by unions, and to replace them with temporary contracts, reduced job security, and lower benefits. The secrecy with which the reforms were developed and applied made workers even more unified. In response, unions opposed the reforms, and in some countries they were able to delay the reforms. The neoliberal reforms have not improved the efficiency or quality of health systems in Latin America despite the resources that have been invested. Nor have the neoliberal reforms supported specific changes that have been applied in the publicsector and that have demonstrated their ability to solve important health problems. These specific changes have produced better results than the neoliberal reforms, and at a lower cost. PMID:15826401
It is fashionable to think there is a tide, or sequence, of basically similar public management changes sweeping through Western Europe, North America and Australasia, and British ministers have proclaimed that the UK is an admired and copied leader in publicsectorreforms. This article argues that a uniform ‘one-track’ picture is not at all accurate. Looking at 15 years
The transition from cash accounting to accrual accounting has been a trend in the publicsector in many countries during the last two decades. In Sweden this movement started in the mid 1980s and it is a process still at work. In Finland both the local and central government adopted accrual accounting during the latter half of the 1990s. The
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.
Examines the three-way relationship among sports, the British military, and the English public schools during the nineteenth century. Describes the public school system prior to and following the reforms of the Clarendon Commission in the late Victorian period. Finds the reforms ending certain hardships of school life, while increasing…
This case study examines why public-sectorreform in education often fails to deliver expected performance gains. Longitudinal evidence from a secondary comprehensive located in a former coalfield is used to identify constraints that frustrate government policies. Although the head and senior staff at Norcross School adopted transformational,…
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 publicsector, noting that there are no exact figures on how many public entities have EAPs. Previous…
The purpose of the paper is to provide an overview of the institutional reforms in the World Bank's sector adjustment operations (SECALs) and to assess the Bank's experience in implementing them. The review covers institutional reforms in 55 of the 65 SEC...
Since its publication in 2000, Public Management Reform has established itself as the standard text in the field, presenting a comparative analysis of recent changes in Public Management and Public Administration in a range of countries in Europe, North America, and Australasia. This completely rewritten second edition radically expands, develops, and updates the original. Two countries have been added to
The Mexican publicsector has undergone significant transformations in recent decades. This article argues against the view that these changes are the result of New Public Management-style reforms. Even though the Mexican government has applied some of the tools associated with this paradigm, the essential NPM doctrines - granting more autonomy to public agencies and government officials, and using market
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 publicsector 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…
Building on the convergence\\/divergence approach, this paper examines whether recent new public management (NPM) inspired reforms entailing inter alia cutbacks in the publicsector, marketisation and management by performance measures have had significant implications for service provision and employment relations in the Danish, Norwegian and Swedish publicsector. In this paper, we argue that although differences exist across the Scandinavian
Christian Lyhne Ibsen; Trine Pernille Larsen; Jørgen Steen Madsen; Jesper Due
Points out that more and more union members now work in the publicsector and are more likely to be female, highly educated, white collar, and work in bureaucratic settings. Considers consequences of this shift in the composition of union membership on national union movements. Contains 35 references. (JOW)
Over the past 10 years the poorest countries, especially in Africa, have struggled with worsening economic conditions and reduced public finance for health services. Some governments have responded in a piecemeal fashion, reacting to internal and external pressures. Others have embarked on major reforms of various aspects of their health systems. This paper reviews two specific types of strategy that have been initiated by governments: reform of financing strategies, and reform of publicsector organization and procedures. Particular attention is paid to the experience of introducing user fees, community financing and decentralization since these have been some of the most popular strategies. The paper describes the nature, objectives and extent of reforms. It then presents an evaluation framework related to the criteria of efficiency and equity, and evaluates current reform experience using this framework. It concludes that assessment of the potential impact of reforms on efficiency and equity is undermined by the limited duration of many reforms and the limited nature of existing evaluations. It is clear, however, that a policy package is required rather than implementation of isolated reform strategies, and that in order to design an effective policy package, more needs to be known about the implementation and operation of reforms--particularly with respect to the influence of context, actors and processes. PMID:10156640
1. By taking the visionary steps of consulting the public about the role of the security sector and placing human security and development at the center of its national security framework, South Africa went beyond mere reform to transform the security sector. These steps helped repair the security sector's legitimacy and credibility with the country's people.
Joseph S. Nye; Donald K. Steinberg; Susanna Agnelli; Oscar Arias; Derek Bok; John Brademas; Jimmy Carter; Kevin Clements; Roger Fisher; John Kenneth Galbraith; John Galvin; Noeleen Heyzer; Jose Ramos Horta; Edward M. Kennedy; Olara Otunnu; Edward Perkins; Kenneth Roth; William Schulz; Leticia Ramos Shahani; Sheila Sisulu; Simon Wiesenthal; Jody Williams; Hizkias Assefa; Leon Fuerth; Ellen Johnson Sirleaf; Jane Holl Lute; Rita Manchanda; Jane Mansbridge; Luz Méndez; Thandi Modise; John Ruggie; Nancy Soderberg
The World Bank's Economic Development Institute has recently developed Health Reform.online to provide distance education opportunities for those interested in "health sectorreform, health economics or sustainable financing." The site will house educational modules based on EDI's Health SectorReform and Sustainable Financing training program. The first module, "Introduction to the concepts and analytical tools of health sectorreform 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.
On the 10th anniversary of the recommendations published by the National Association of Schools of Public Affairs and Administration (NASPAA) on information system instruction in schools and departments of public administration, sweeping information management reforms were instituted throughout the federal sector by the passage of the Clinger-Cohen Act (CCA) of 1996. This research examines the extent to which these programs
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…
The analysis of the distributional impact of policy reforms on the well-being or welfare of different stakeholder groups, particularly on the poor and vulnerable, has an important role in the elaboration and implementation of poverty reduction strategies in developing countries. In recent years this type of work has been labeled as Poverty and Social Impact Analysis (PSIA) and is increasingly
Purpose – While the term “entrepreneurship” was almost exclusively associated with private sector, it is now found with increasing frequency in the literature on the publicsector and public administration. However, research on public entrepreneurs remains restricted to top and middle managers and elected politicians and focuses on policy promotion and initiatives concerning publicsector transformation. The perpose of 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…
ABSTRACT Commercialisation of,publicsector accounting in Australia has essentially been achieved through extension of private sector accounting standards to the publicsector, with the exception of two ,standards. The first standard relates to financial reporting by segments and,the ,second ,to related ,party ,disclosures. This paper ,briefly outlines ,the commercialisation process of publicsector accounting as a vehicle to promote privatisation
This study seeks to provide information on water pricing in Ghana. It looks at the experiences in water pricing practices, the problems and successes encountered in the country. It outlines the reforms instituted in the water sector for the provision and sustainability of urban, rural, and agricultural water supplies to address the problems. Also discussed are the institutional arrangements put
The authors argue that ''health for all'' is not achievable in most countries without health sectorreform that incorporates a process of coordinated health and human resources development. They examine the situation in countries in the Eastern Mediterranean Region of the World Health Organization. Though advances have been made, further progress is inhibited by the limited adaptation of traditional health
In the past two decades, British public administration has been subjected to substantial reform. First, a set of changes that came to be identified with the New Public Management (NPM) movement altered the structures and operations of the state. More recently, moves toward information-age government, or e-government, have prompted further change. This article examines first the nature, mechanics, and causes
The article discusses the relationship between New Public Management reforms and professional roles in European countries. The author presents the traditional autonomous role of professionals and argues that this role is challenged in New Public Management reforms. Then the author looks more closely into the comparative European literature on New Public Management reforms to find general messages about the specific
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
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…
An intriguing experiment is afoot in some of the nation's struggling public schools. New "Parent Trigger" laws passed in California and on the agenda in New York, Ohio, Colorado, and Chicago, allow parents of chronically failing schools to unseat the schools' leadership and staff. But the initiative has pitfalls. It's easy to mobilize parents to…
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 reformpublic dental services. PMID:22998313
Because their resources are inadequate, philanthropic foundations cannot bring about educational reform by themselves. Foundations are best when serving as midwives, parking garages, conversations pits, burning glasses (to focus thought), levers, and lighthouse tenders. The American people are responsible for acting voluntarily to support public…
Publicsector regimes in Australasia are reforming their operations to enhance effectiveness and efficiency. Competition and contracts are presented as mechanisms facilitating such reform in areas such as costs, productivity and quality. This paper argues that short-term contractual arrangements such as compulsory tendering do not live up to such reformist expectations. Unresolved questions thus preclude any final judgement about the
This article1 deals with the fuzzy concept of organizational innovation in publicsector 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
ERAN VIGODA-GADOT; AVIV SHOHAM; NITZA SCHWABSKY; AYALLA RUVIO
Examines Kentucky's statutory and decisional law concerning publicsector labor relations, as well as the practice and future of publicsector relations as perceived by city and county officials. Available from Salmon P. Chase College of Law, 1401 Dixie Highway, Covington, Kentucky 41011; 1.50 per reprint. (Author/IRT)
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 publicsector labor market. Melvin Reder examines the effect of the absence of the profit motive on employment and wage determination in the publicsector. Orley…
Examines the development of marketing in the public service and presents a short discussion of the growth of marketing in public service organizations over the last 20 years. A critical analysis of marketing as applied to the public service, argues that, if it is applicable, it needs to be adapted to the particular character of the public realm. Gives an
This paper addresses three main issues in the publicsector of the Nigerian economy, namely, problems in the management of public expenditure, constraints in the implementation of policy reforms to overcome the Management problems and prospects of successful implementation of policy reforms. It observes that while the management problems cannot be divorced from the largeness of the sector, size per
In early 1990s, Jamison, Mosley and others concluded that a profound demographic and consequent epidemiological transition is taking place in developing countries. According to this classical model, by the year 2015, infectious diseases will account for only about 20% of deaths in developing countries as chronic diseases become more pronounced. These impending demographic and epidemiological transitions were to dominate the health sectorreform agenda in developing countries. Following an analysis of fertility, mortality and other demographic and epidemiological data from South Asian and other developing countries, the paper argues that the classical model is in need of re-evaluation. A number of new 'challenges' have complicated the classical interplay of demographic and epidemiological factors. These new challenges include continuing population growth in some countries, rapid unplanned urbanization, the HIV/AIDS pandemic in Sub-Saharan Africa (and its impending threat in South Asia), and globalization and increasing marginalisation of developing countries. While the traditional lack of investment in human development makes the developing countries more vulnerable to the vicissitudes of globalization, increasing economic weakness of their governments forces them to retreat further from the social sector. Pockets of poverty and deprivation, therefore, persist giving rise to three simultaneous burdens for South Asia and much of the rest of the developing world: continuing communicable diseases, increasing burden of chronic diseases, and increasing demand for both primary and tertiary levels of health care services. While these complex factors, on the one hand, underscore the need for health sectorreform, on the other, they make the task much more difficult and challenging. The paper emphasizes the need to revisit the classical model of demographic and epidemiological transition. It is argued that the health sector in developing countries must be aware of and effectively address these 'new challenges'. Although it has included data from many developing countries, the focus is primarily on South Asia. PMID:11897374
Institutional and technical aspects of manpower planning are discussed in the context of a systematic approach to organizational manpower planning in the publicsector. Opening chapters present an overview of manpower planning and review the typology and ...
The book is an attempt to extend the concepts and techniques of analytical economics into employment in the publicsector. It includes discussions of: (1) How employment and wage determination differ between profitmaking industry and the rest of the econo...
What are the main factors in the publicsector workplace that are likely to attract university graduates to seek publicsector employment? This research on final-year Australian university students examines the importance that they attach to three areas in the workplace – extrinsic rewards, intrinsic rewards and line managers – and the reasons behind their views. This article utilizes the psychological contract theory to
This document presents findings on the impact of privatization to date at a meeting at the Ford Foundation co hosted by the William Penn Foundation, Carnegie Corporation of New York, and Ford. Increasingly, the private sector (both for-profit and non-profit) is providing resources and alternative delivery models for urban public schools. Beyond…
Purpose – The starting point for the paper is an assessment of the impact of a 1993 special issue of Accounting, Auditing & Accountability Journal, which provided an interdisciplinary analysis of the pursuit of accountable management reforms in the UK publicsector. From this assessment, the paper offers a set of reflections on the development over the last two decades
Even though the publicsector in African countries was expected to spearhead socioeconomic development to reduce poverty, it has proved largely ineffective in performing this task. Some of the reasons for this ineffectiveness are excessive politicization, lack of accountability and representation, inability to promote the public interest and authoritarian tendencies. The ineffectiveness has led to the call for a redefinition
The "Victorian Free Library Service Board Act" of 1946 was the culmination of a long campaign to replace the mechanics' institute model of library provision with free libraries funded by state and local government. Given that library reform required legislation by the state government, this paper is mainly concerned with the political campaign…
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.
\\u000a Governmental reform has been on Switzerland’s political agenda since the 1970s. In the 1990s, the ideas of NPM (New Public\\u000a Management) spread quickly within the Swiss publicsector. From the mid 1990s, the three levels of government also began experimenting\\u000a with electronic government. Ten years later these experiments have matured and Switzerland is regularly ranked among the top\\u000a countries for
We study how state practitioners account for the shape and action of the state. We focus on the implementation, from the early 2000s onwards, of a reform of public management in France which called for a revision of the description of the boundaries and achievements of the action of the state. The reform targeted the rules governing the budgetary process
\\u000a This paper describes a methodology for the participatory design of services in the publicsector. The stakeholders participating\\u000a in the design include three major players, the public which uses the service, the government body which sponsors and finances\\u000a the service, and the organization (government or third party) that delivers the service. We propose a method for a) gathering\\u000a the –
Alan Hartman; Anshu N. Jain; Jay Ramanathan; Antonis Ramfos; Willem-Jan Van der Heuvel; Christian Zirpins; Stefan Tai; Yannis Charalabidis; A. Pasic; T. Johannessen; T. Grønsund
This study examined the effects of pressures for change in the publicsector and the potential mechanisms by which employee Hardiness impacts feelings of and reaction to stress. Data provided by 325 senior-level employees of different state government agencies were used to test a hypothesized model via covariance structure analysis. Results strongly supported the model, linking pressure for change with
Michael C. Rush; William A. Schoel; Steven M. Barnard
This paper deals with technological methods for consolidating assets lists of available publicsector information (PSI) for re-use. In this direction, the effort is to review the state of the art in delivering access to PSI throughout the world and to prioritize the necessary engagements for joining available PSI catalogues. We propose an architectural framework grounded on Semantic Web technologies
Christos L. Koumenides; Manuel Salvadores; Harith Alani; Nigel R. Shadbolt
Although the government's role as provider of social services and guardian of individual rights has had little effect on the economic position of women and minorities, as an employer it has greatly improved their welfare in terms of job opportunities and earnings. U.S. census data from 1960 to 1980 show that the publicsector currently employs…
A study examined the patterns of employment in the publicsector as compared to the private, possible changes in that pattern in the last decade, and implications for educational policy. By using the human capital concept (employment patterns depend on productivity differences in individuals) and labor market segmentation analysis, the following…
New Public Management was a new model of public administrative management that was popular in the 1980's and became one of the guiding ideas for the western countries to conduct administrative management reform in a large scale. Currently, although the new public management system is not mature, its essence and principle have outstanding characteristic and advantages, which is very inspiring
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…
Although there is widespread publicity about the involvement of businesses with schools, and as President Reagan as well as authors of reform reports continue to call upon the private sector to help education, it is unclear to what extent such relationships exist and what they are accomplishing. A 10-page, 55-question survey was mailed to the…
BACKGROUND: Supported by development partners, the Government of Bangladesh carried out a comprehensive reform of health services in Bangladesh between 1998 and 2003, intended to make services more responsive to public needs: the Health and Population Sector Programme (HPSP). They commissioned a series of surveys of the public, as part of evaluation of the HPSP. This article uses the survey
Anne Cockcroft; Neil Andersson; Deborah Milne; Enamul Karim
The Urban Water Sector has undergone important reforms in recent years, which are creating new risks pertaining to the sustainability of capital investments and the universality of service provision. In this paper we draw together the factors that influence the vulnerability of these two elements at risk, and assess whether the hazards created by the reform affect positively or negatively
Kazakhstan has been at the forefront of power sectorreform in EBRD's countries of operations. Starting in 1996, a regulator was set up, the industry was partially unbundled, some distribution and generation companies were privatised, and the large user market was liberalised. A number of reform challenges remain however in the area of privatisation, regulation and competition. The paper proposes
The objectives of a publicsector management program should be to use resources more efficiently rationalize publicsector operations and reduce financial disequilibrium. This report presents a comprehensive policy program to improve public finances in Honduras. It recommends that Honduran authorities prepare an action plan for improving publicsector management. The plan should include the following measures: (a) increase savings;
Surveys the legal status of union security in the publicsector and indicates that the basic policy options are to limit union security to the voluntary dues check-off, to authorize the parties to negotiate union or agency shop agreements, or to establish a mandatory fee for the exclusive representative. (Author/IRT)
China's market-oriented labor market reform has been in place for about one and a half decades. This study uses individual data for 1981 and 1987 to examine the success of the first half of the reform program. Success is evaluated by examining changes in the wage setting structure in the state-owned sector over the reform period. Have the market reforms
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…
A general trend is easily observable in the literature on public administration reforms in post-communist countries and it consists in analyses of the degree of adoption and success of the New Public Management (NPM) model. A relevant implementation gap for some areas of reform which cannot be ascribed to the NPM are highlighted. The combination of these two features -
This paper asks how strong African Public Financial Management (PFM) has become, after a decade and more of reform. How well do African PFM systems in place now facilitate effective public financial management? Where are the next challenges and how can they be met? It analyzes recent PFM assessments in 31 governments to answer these questions, identifying patterns of strengths
Can the European regulatory state be managed? The European Union (EU) and its Member States have looked at Better Regulation as a possible answer to this difficult question. This emerging public policy presents conceptual challenges to scholars of public management and administrative reforms, but also opportunities. In this conceptual article, we start from the problems created by the value-laden discourse
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 publicsector and to create \\
Instead of following the Restructuring Model most often used in the international community since the 1990s, developing countries should adopt an alternative conceptual model called the Integrated Model in order to develop and implement effective electricity reform programs. (author)
This dissertation looks into the reasons that pushed European countries to liberalize their electricity industries. The analysis of the political process leading to that decision in the areas pioneers of regulatory reform in this sector (United Kingdom, Sweden and the European Commission) shows that the liberalization of the European power sectors does not conform to the traditional theoretical explanations for
Non-profit organizations such as publicsector organizations have some specifics, which make renovation projects significantly different. It is clear that radical changes in the execution of busi- ness processes and in the organizational structures are not suitable for the publicsector because they are not possible for many, also political, reasons. A business process change in publicsector mostly means
Mojca Indihar Stemberger; Andrej Kovacic; Jurij Jaklic
The mostly private sector literature on call centre work suggests two distinct images: electronic sweatshops and customer focus (Deery & Kinnie 2002). In the publicsector, call centres have become widespread as governments import private sector management practices. Under the rubric of New Public Management (NPM) contestability, and client focus require call centres and other public services to compare or
Whether publicsector projects should be discounted at a lower rate than private sector projects is highly contentious. This paper assesses the appropriate private and publicsector discount rates in the context of public private partnerships. It shows that there are powerful arguments for using a higher rate to discount private projects than publicsector projects and that failure to
Relations between professionals and managers in public domains are the subject of\\u000asharp controversies, especially in domains like education. According to public opinion,\\u000athe rise of Managerialism has fuelled clashes between managers and professionals. In\\u000athe past few years, academic research has mainly studied how management reforms\\u000aaffect professionals and their work. How managers, such as school managers, are\\u000aaffected
A framework for the explication of the theoretical basis of public management reforms is developed. The framework is applied to the Best Value regime in UK local government. The implicit assumptions of policy makers are that the Best Value regime will generate service improvements through changes in organizational structures, processes, culture and strategy content. Empirical evidence on the relationship between
The purpose of this article is to discuss Zimbabwe's public education system. First, the article provides a brief look at pre-independence education in Zimbabwe. Second, it discusses some of the reforms that took place in the Zimbabwe education system following independence. Third, it looks at the current structure of Zimbabwe's education system…
New forms of accounting and new forms of accountability have emerged out of the set of reforms that are often referred to as “New Public Management.” These changes, which are transnational even if they are not yet global, have had an impact on actors in a diverse range of settings including education, culture, policing, probation, prosecution, healthcare, social services, transport
The King of Jordan's vision for education is resulting in innovative projects for the country. King Abdullah II wants Jordan to develop its human resources through public education to equip the workforce with skills for the future. From King Abdullah II's vision, the Education Reform for a Knowledge Economy (ERfKE) project implemented by the…
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…
Recent polling data suggest that there is a growing consensus to pay special attention to children's needs in the health care reform debate. The public generally desires children to have greater access to health care services, even if this would mean higher taxes, but is unsure that government is the best vehicle to provide such services. (MDM)
The Personal Responsibility and Work Reconciliation Act of 1996 reformedpublic 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…
Purpose – The project management literature contains a growing body of research addressing information technology (IT). Currently, the majority of these studies direct attention towards projects completed within private sector organizations. Given the unique characteristics surrounding publicsector organizations, this paper aims to argue that it is inappropriate to apply the lessons learned from private sector organizations in the public
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.
...Public Housing Reform Act: Changes to Admission and Occupancy Requirements for the Public...available upon request, their respective admission and occupancy policies for both the public...available for inspection policies related to admission and continued occupancy, so as to...
A number of studies have suggested a quantitatively important relationship between public-sector capital accumulation and private sector productivity, with the most compelling evidence derived from analyses of state-level data. estimates herein of production functions that use standard techniques to control for unobserved, state-specific characteristics, however, reveal essentially no role for public-sector capital in affecting private sector productivity. Only estimates of
Traditionally, when the publicsector wanted more capital assets, it borrowed funds for the purpose. Under the Private Finance Initiative (PFI), private consortia borrow funds to build assets and then, in return for a charge, use them to provide services for the publicsector. The authors explore the implications for the public finances of using the PFI. A widely held
Despite the gains that Philippines posted towards improving the health of the Filipinos, more challenges need to be hurdled to further improve the country's health status i.e. high threat from infectious diseases, increasing degenerative conditions, emerging health problems due to environmental and work-related factors, etc. The development and implementation of the Health SectorReform Agenda (HSRA) is expected to address these problems through organization/policy changes and financing structure needed to improve health care delivery, regulation and financing: 1. Provide fiscal autonomy to government hospitals; 2. Secure funding for priority public health programs; 3. Promote development of local health systems; 4. Strengthen health regulatory agencies' capacities; 5. Expand the coverage of the National Health Insurance Program. There is a need however to evaluate the implications of the HSRA implementation in the private hospital system as this sector accounts for 67.91% of the total number of hospitals, servicing 48.35% of the country's total bed requirements. Major effects are: 1. Increased competition for patient market; and consequently; 2. for funding/payments; 3. Lesser capital and financing access for service/facility improvement; versus; 4. pressure from consumers/patients to render better quality, high-technology service at a lower cost. Certainly, any adverse effect on their operation will affect the access of a large percentage of the population currently using their services. This paper will provide an in-depth analysis of the implications of the HSRA implementation on private hospitals, major initiatives being undertaken to minimize adverse effect and innovations that can be capitalized to survive/grow in the new health environment. The authors' active participation in the National Health Planning Committee convened to oversee the HSRA implementation, the dialogues and conferences held with hospital sector for the Philippine Hospital Association, and actual involvement in hospital operation will provide a unique perspective and authority for this analysis. PMID:11696994
The relationship between health sectorreform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sectorreform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways – reacting to transformations, supporting, blocking and distorting the proposed ways of action. This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them.
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 publicsector 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.
Management Sciences for Health (MSH) has been a partner in the Latin America and Caribbean Health SectorReform Initiative (LACHSRI) for nearly a decade, beginning with the FPMD Project and more recently under the Management and Leadership (M&L) and Ratio...
A. Alas J. Seltzer F. Nauseda E. Lewis R. L. Kolehmainen-Aitken
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.
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…
This report examines current knowledge about the nature, development, and consequences of competition and market reform in the Australian vocational education and training (VET) sector. In the process, the policy context and key aspects of the theory and practice of a competitive training market are analyzed. These other topics related to the…
A major challenge facing Romania, as a new member of the European Union (EU), is the implementation of Public Administration Reform. Among the significant supporting initiatives it can mention the project Young Professionals Scheme launched in 2003 that includes mentoring as a basic component of training Romanian public managers under this scheme. On the other hand, an extended documentary research
The decline in perceived happiness within economic prosperity in Chinese society calls for further examination. In this research, we investigate the effect of employment in publicsector work units on perceived happiness through the mediation of economic and social status relative deprivations. In the reform era of China, work unit is still an important mechanism maintaining social inequality, and those working in government/Communist Party agencies and public institutions have advantages of getting access to high wage, comprehensive welfare and the manipulation of administrative public power. Such economic and social status advantages are expected to reduce their relative deprivation and further promote their perceived happiness. Using a nationwide survey data conducted in 2006, we find working in publicsector can significantly reduce the odds of experiencing economic relative deprivation, which is further contributive to the improvement of subjective wellbeing. PMID:22717616
For the time being, public management reform represents the concern of most states, no matter their development level, geographical and strategic position, membership to various supranational structures or political and social organisation systems. This process represents the topic of several papers and publications of outstanding international scientists or specialized structures of international organizations, such as OECD. In the EU Member
An important aspect of the impact of the economic crisis is how pay in the publicsector responds ? in the face not only of the evolution of pay in the private sector, but also extreme pressure on public spending (of which pay is a very large proportion) as fiscal deficits soar. What are the effects on the income distribution
Non-profit organizations such as publicsector organizations have some specifics, which make renovation projects significantly different. It is clear that radical changes in the execution of business processes and in the organizational structures are not suitable for the publicsector because they are not possible for many, also political, reasons. Therefore classic business process renovation methodologies have to be adapted.
Conflicts of interest are a key factor in the contemporary decline of trust in government and public institutions, eroding public trust in government and democratic systems. Drawing on two unique empirical studies involving policing and the broader publicsector, this paper explores the meaning and dimensions of conflict of interest by examining public complaints about conflict of interest and providing
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 sectorreforms 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.
Background Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries . Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC) underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals . Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments), and distribution. Methods Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. Results The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Conclusion Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of interest guidelines which, if present and consistently administered, limit the promulgation of corrupt practices. Other major contributing factors are the inconsistency in documentation of procedures, lack of public availability of such documentation, and inadequacies in monitoring and evaluation. What is most critical from this study is the identification of areas that still remain permeable to corruption and, perhaps, where more appropriate checks and balances are needed from the Nigerian government and the international community.
Garuba, Habibat A; Kohler, Jillian C; Huisman, Anna M
Eight seminar papers and subsequent discussion evaluate the undesirable growth of Government control and initiative over ever expanding sectors of once private industry in Great Britain and similar trends in the United States. The keynote paper divides Br...
Purpose – The purpose of this paper is to analyse Malaysia's shift towards results-based management in two key areas of the public service: budgeting and human resource management. More specifically, it shows how and to what extent the values of results-based management have been incorporated in the Malaysian publicsector and describes their constraints and challenges. Design\\/methodology\\/approach – The paper
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
Since the signing of the Oslo Peace Accords and the establishment of the Palestinian Authority in 1994, reform activities have targeted various spheres, including the health sector. Several international aid and UN organizations have been involved, as well as local and international non-governmental organizations, with considerable financial and technical investments. Although important achievements have been made, it is not evident that the quality of care has improved or that the most pressing health needs have been addressed, even before the second Palestinian Uprising that began in September 2000. The crisis of the Israeli re-invasion of Palestinian-controlled towns and villages since April 2002 and the attendant collapse of state structures and services have raised the problems to critical levels. This paper attempts to analyze some of the obstacles that have faced reform efforts. In our assessment, those include: ongoing conflict, frail Palestinian quasi-state structures and institutions, multiple and at times inappropriate donor policies and practices in the health sector, and a policy vacuum characterized by the absence of internal Palestinian debate on the type and direction of reform the country needs to take. In the face of all these considerations, it is important that reform efforts be flexible and consider realistically the political and economic contexts of the health system, rather than focus on mere narrow technical, managerial and financial solutions imported from the outside.
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 publicsector 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 publicsector 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 publicsector. PMID:20637908
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,
Considers the public nature of charter schools, comparing Michigan charter school reformers' rhetoric with that of 19th century common school reformers, noting the conflicting definitions of what constitutes public schooling and suggesting that charter schools frame education principally as a consumer good, thus privatizing the purpose of public…
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…
Lake Snell Perry & Associates, Inc., Washington, DC.
It is important that a strategic planning approach be chosen that is compatible with the culture of Botswana. This choice will enhance the managerial effectiveness, productivity, and performance of publicsector organizations in Botswana. Western manageme...
... Procurement under publicsector procedures. 201.22 Section 201.22...INTERNATIONAL DEVELOPMENT RULES AND PROCEDURES APPLICABLE TO COMMODITY TRANSACTIONS FINANCED BY USAID Procurement Procedures; Responsibilities of Importers...
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.
Lubben, Marianne; Mayhew, Susannah H.; Collins, Charles; Green, Andrew
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.
In this dissertation, I study the performance impact of information technology (IT) investments in the publicsector. IT has been one of the key assets in public administration since the early MIS era. Even though the information systems (IS) discipline has witnessed a considerable amount of research efforts on the subject of IT business value for…
Civil servants have a bad reputation of being lazy. However, citizens' personal experiences with civil servants appear to be significantly better. We develop a model of an economy in which workers differ in laziness and in public service motivation, and characterise optimal incentive contracts for publicsector workers under different informational assumptions. When civil servants' effort is unverifiable, lazy workers
Civil servants have a bad reputation of being lazy. However, citizens' personal experiences with civil servants appear to be significantly better. We develop a model of an economy in which workers differ in laziness and in public service motivation, and characterise optimal incentive contracts for publicsector workers under different informational assumptions. When civil servants' effort is unverifiable, lazy workers
Civil servants have a reputation for being lazy. However, people's personal experiences with civil servants frequently run counter to this stereotype. We develop a model of an economy in which workers differ in laziness and in public service motivation, and characterise optimal incentive contracts for publicsector workers under different informational assumptions. When civil servants’ effort is unverifiable, lazy workers
Purpose – The aim of this study is to investigate whether performance management practices affect performance in publicsector organizations. Design\\/methodology\\/approach – Theoretically, the research project is based on economic as well as behavioral theories. The study distinguishes amongst quantitative performance (efficiency, quantities produced) and qualitative performance (accuracy, quality, innovation and employee morale) and uses survey data from 93 public
A recent development in macroeconomic theory suggests that public investmentper se is relevant to economic growth, without regard to the means of financing government activity. This study undertakes an empirical investigation of this proposition, comparing two subperiods of the manufacturing sector's performance in Greece. Our test results support the conventional view that the size of public capital formation and the
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…
Summarizes the management of change in a high profile public service with more than its fair share of political influences. Demonstrates the scale of change possible, given a clear strategy and a strong managerial commitment. Argues that this leads to high productivity, quality and value for money, with a strong element of organizational loyalty and ownership of the end product. PMID:10144652
Following the destruction of Cambodia's health infrastructure during the Khmer Rouge period (1975-1979) and the subsequent decade of United Nations sanctions, international development assistance has focused on reconstructing the country's health system. The recognition of Cambodia's heavy burden of tuberculosis (TB) and the lapse of TB control strategies during the transition to democracy prompted the national tuberculosis programme's relaunch in the mid-1990s as WHO-backed health sectorreforms were introduced. This paper examines the conflicts that arose between health reforms and TB control programmes due to their different operating paradigms. It also discusses how these tensions were resolved during introduction of the DOTS strategy for TB treatment. PMID:17768522
This report presents a methodological framework to evaluate publicsector financial risk exposure when delivering transportation infrastructure through public-private partnership (PPP) agreements in the United States (U.S.). The framework is based on U.S....
This study examined the state of Oregon's efforts at administrative reform in public higher education. The early stages of implementation of the Higher Education Administrative Efficiency Act initiated by Oregon during the 1995 session were analyzed. Four factors were found to be primarily responsible for the need to reformpublic higher education…
Since 1991 the housing sector in Kolkata has been the subject of significant reforms based on profound changes in the political economy of the State of West Bengal. The paper reviews four reform initiatives: public-private partnership, privatisation of public rental housing, development of New Towns, and the finance sector deregulation in Kolkata and discusses their relevance to the urban context
This collection of 12 papers examines various aspects of public employee collective bargaining and unionization. Public employee unions in the United States have caused growing concern since the mid-1960s when wages in the publicsector began to rise more rapidly than those of private employees. Public employee strikes became significant for the…
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.
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. The setting for the study is upper tier English local governments, and data
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.…
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
We model the conditions under which incumbent firms may purposefully create an intellectual property (IP) commons such that no firm has the incentive to invest in new product development, despite the potential profitability of a publicsector invention. The strategy of spoiling incentives to innovate by eliminating exclusive IP rights - the strategy of the commons - is motivated by
We model the conditions under which incumbent firms may purposefully create an intellectual property (IP) commons such that no firm has the incentive to invest in new product development, despite the potential profitability of a publicsector invention. The strategy of spoiling incentives to innovate by eliminating exclusive IP rights—the strategy of the commons—is motivated by a fear of cannibalization
The aim of this article is to discuss how learning opportunities can be organized to promote expansive learning in work practice. The discussion draws on results from a case study examining local development work and conditions that facilitate processes of expansive learning in a work team within a publicsector organization in a Swedish…
In the original paper, it was argued that while there is an array of methods and methodologies available, their use is delimited by the culture of accountability that prevails in publicsector institutions, a fact that is particularly problematic given the complexity and diversity of evaluation contexts today. This short rejoinder, to responses…
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 publicsector. In this context, we review the growing body of evidence about how performance measurement and incentive systems function in practice and how individuals and organizations
This study lends support for the hypothesis that management attitudes toward the union have a strong influence on the success of the union-management relationship in the publicsector. However, the causal direction of this correlation was not thoroughly determined. (Author)
This paper focuses on recent, significant court decisions in publicsector collective bargaining under the following categories: the job security clause, the choice of instructional materials as the province of the school board under collective bargaining agreements, the effect of open meetings acts on the board of education in collective…
There are essentially four main approaches used in attempts to strengthen the management of health services in developing countries. These are: information system development; management training; use of planning and evaluation methodologies; and, health sectorreform. As part of a collaborative research project based in Kisarawe District, Tanzania, we tested the hypothesis that a combination of the first three of these approaches would be sufficient to ensure that decisions and actions were taken to bring about major improvements in the management of health services. It was assumed that the decentralization, which took place as part of the 1982 reorganization of local government responsibilities, had provided managers with sufficient decision-making autonomy to allow them to bring about improvement in health service performance, provided that the other conditions were met. In fact, it was found that despite being presented with clear evidence of serious inefficiencies and inequities in the allocation of health resources, managers were often highly reluctant to decide upon actions which would alleviate the problems in situations where there were potential losers as well as winners, even if the benefits greatly outweighed the costs. This article argues that interventions based solely on training, information systems, or planning and evaluation protocols will make only marginal improvements to health service management, and that changes to the system as a whole are needed in order to provide managers and health professionals with incentives to rectify performance failings. Some ideas for health sectorreform, to give managers power and incentives for improving efficiency and quality of care, are put forward. Since it is likely that the systemic problems of the health sector in Tanzania are shared by many other developing countries, the lessons drawn from this study probably have more general applicability. PMID:10172194
According to public service motivation theory, individuals with a strong public service orientation are attracted to government jobs. This proposition was investigated in three studies by measuring publicsector motivation at a pre-entry level as an individual difference variable affecting perceptions of fit and organizational attraction. Results…
Carpenter, Jacqueline; Doverspike, Dennis; Miguel, Rosanna F.
Competing values complicate debates on the reform of public services. Attention for competition and efficiency is balanced by concerns for equity and universality in service delivery. These potential value conflicts are best visible in the reform of services of general interest. Despite debates at the European and the national level, current research on services of general interest has been limited
The reform stages known by the Romanian public administration after the 1989 Revolution reflected the modifications occurred in the economic and social-political context of the state, by passing from communism to capitalism, from the planned, centralized economy, to the market economy. Today, the running of the administrative reform process is strongly made more difficult, the situation being determined, beyond the
This paper examines the institutional reform conducted at three public universities in Mexico: the University of Sonora, the University of Guadalajara, and the University of Puebla. In the universities analyzed here, reform came on the heels of conflict resulting from institutional collapse. These organizations had seen their internal control systems dissolve and their external legitimacy relationships crumble. The focus is
Numerous criticisms of college social studies methods courses have generated various reform efforts. Three of these reforms are examined, including competency-based teacher education, the value analysis approach to teacher education, and the human relations approach to teacher education. Competency-based courses develop among future teachers…
Health sectorreform was implemented in many Latin American countries in the 1980s and 1990s, leading to reduced public expenditure on health, limitations on public provision for disease control, and a minimum package of services, with concomitant growth of the private sector. At first sight, Ecuador appeared to follow a different pattern: no formal reform was implemented, despite many plans to reform the Ministry of Health and social health insurance. The authors conducted an in-depth review and analysis of published and gray literature on the Ecuadorian health sector from 1990 onward. They found that although neoliberal reform of the health sector was not openly implemented, many of its typical elements are present: severe reduction of public budgets, "universal" health insurance with limited coverage for targeted groups, and contracting out to private providers. The health sector remains segmented and fragmented, explaining the population's poor health status. The leftist Correa government has prepared an excellent long-term plan to unite services of the Ministry of Health and social security, but implementation is extremely slow. In conclusion, the health sector in Ecuador suffered a "silent" neoliberal reform. President Correa's progressive government intends to reverse this, increasing public budgets for health, but hesitates to introduce needed radical changes. PMID:22611652
To assess whether public service modernisation in Ireland is a ‘useful myth’, we examine aggregate indicators of leadership behaviours and the interview responses of recognised ‘change agents’ to assess whether there is a gap between the rhetoric and reality of follower engagement in pursuit of a transformative vision that official rhetoric highlights as a potentiality in this sector. The persistence
Resource-based views of the firm and in particular Kay's (Why Firms Succeed. Oxford: Oxford Univ. Press, 1995) model of sustainable competitive advantage have been used to advance an understanding of differences in the competitive advantage of private-sector firms. We extend the analysis to a public-sector firm where its major purpose includes engaging in public good by giving away its knowledge
This report contains information about education reform efforts in U.S. public schools as reported by school teachers through a mail survey. The information has not been independently verified. Because of the survey questions and collection methodology us...
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.
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))
The involvement of the public in educational reform processes in modern democratic societies primarily serves the purpose of politically legitimizing the reform agenda. This study examines the rationales implicitly or explicitly submitted to the public to explain why educational reforms in the two countries should be endorsed. Although differences in the political culture caution against a hasty comparison of the two case studies, a number of politico-economic similarities allow for a valid juxtaposition. In Poland the context of socio-political and economic renewal prompted the reformers to emphasize the human-capital model which heightened public awareness and participation in the debate surrounding the reform. Public involvement in Saskatchewan was negatively affected for mainly two reasons. First, the government evidently manipulated public input by various means and thereby appears to have predetermined the outcome. Second, the rationale for the reform, based on a free-market model, tightened the linkage between the needs of the labour market and the mandate of the schools. As a result, public interest and participation was greatly diminished.
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,
This article evaluates the Brown-effect ‘real’ and ‘potential’ on public services production in the UK. It is observed, rather unsurprisingly, that Gordon Brown's approach to public services reform is a logical extension of the New Labour modernisation project and represents the extension of new public management (NPM) methods articulated in the populist rhetoric of ‘choice’, ‘personalisation’ and ‘user’ engagement. It
Current activities of the program to accelerate specific applications of space related technology in major publicsector 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.
What is the macroeconomic impact of announcing a pension system reform in advance? The Italian reform in 1992 represents an illustrative case to address this question. Using an overlapping-generations model, we simulate the pre-announcement of five-year increase in the retirement eligibility age within 1992 Italian pension system. The simulation results show that the transition would be characterized by a drop
Background In this paper the real role and place of human resource (HR) in health system reform will be discussed and determined within the whole system through the comprehensive Human Resource Management (HRM) model. Method: Delphi survey and a questionnaire were used to 1) collect HR manager ideas and comments and 2) identify the main challenges of HRM. Then the results were discussed in an expert panel after being analyzed by content analysis method. Also, a deep focus study of recorded documents related to Health Human Resource Management was done. Then based on all achieved results, a rich picture was drawn to illustrate the right place of HRM in health sector. Finally, the authors revitalize the missed function of HRM within the health sector by drawing a holistic conceptual model. Result: The most percentage of frequency about HR belongs to “Lack of reliable HR information system” (91%) and the least percentage of frequency belongs to “Low responsibility of HR” (28%). The most percentage of frequency about HR manager belongs to “Inattention to HR managers as key managers and consider them in background” (80%) and the least percentage of frequency belongs to “Lack of coordination between universities’ policies” (30%). According to the conceptual framework, human resources employed in health system are viewed from two comprehensive approaches: instrumental approach and institutional. Conclusion: Unlike the common belief that looks HRM through the supportive approach, it is discussed that HRM not only has an instrumental role, but also do have a driver role.
This article analyzes if, and to what extent, the public service motivation (PSM) construct has an added value to explain work motivation in the publicsector. In order to address the specificity of PSM when studying work motivation, the theoretical model underlying this empirical study compares PSM with two other explanatory factors: material incentives, such as performance-related pay, and team
Simon Anderfuhren-Biget; Frédéric Varone; David Giauque; Adrian Ritz
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.
The purpose of this guide is to answer common questions about publicsector labor relations with special emphasis on how this sector differs from the private sector. A beginning section offers general information defining and explaining publicsector labor relations. A segment on labor relations law details legislation and the function of…
Indiana Univ., Bloomington. Midwest Center for Public Sector Labor Relations.
The attractiveness of publicsector jobs in Italy may induce parents working in this sector to use their positions and the\\u000a network of relationships to favor their sons\\/daughters in gaining access to publicsector jobs. We verify whether children\\u000a of public employees effectively enjoy an advantage, estimating a model of the probability of working in the publicsector\\u000a controlling for
This paper explains the current reforms in basic and higher education in the Philippines. Specifically, internal and external enablers in the educational environment were reviewed as justifications of the reforms both at the national level as well at the individual teacher. The reforms were treated in the light of four perspectives in the…
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 publicsector organizations: Some of the questions addressed include: To what extent is OD--as a strategy for planning and implementing change--relevant to publicsector management? What are the salient differences between public and private sector
Users may download this report and accompanying charts from the HUD USER site. The report "examines the implications of welfare reform for public housing authorities (PHAs), whose residents traditionally contribute a portion of their incomes for rent." The report focuses on a small number of diverse housing authorities and finds that the effects of welfare reform on tenant incomes and PHA rent revenues will most probably vary considerably.
For the time being, public management reform represents the concern of most states, no matter their development level, geographical and strategic position, membership to various supranational structures or political and social organisation systems. This process represents the topic of several papers and publications of outstanding international scientists or specialized structures of international organizations, such as OECD. In the EU Member
This study investigated national public opinion on school health education and the implications for health-care reform initiatives. Telephone surveys of 1,005 adults nationwide indicated that the public at large believes in the importance of health education to reduce health problems among children, considering it the responsibility of parents and…
Court intervention in special education systems and prisons has varied consequences. This paper comparatively reviews a series of case studies of court ordered prison and school reform. Several factors conspire to frustrate attempts to improve public services: the allocation of costs and benefits of the proposed change, the realities of the public…
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…
Evers, Williamson M., Ed.; Izumi, Lance T., Ed.; Riley, Pamela A., Ed.
Since the 1990s, power sectorreforms have become paramount in energy policy, catalyzing a debate in Africa about market-based service provision and the effects of reforms on access. My research seeks to move beyond the conceptual divide by grounding attention not in abstract 'market forces' but rather in how development institutions shape energy services and actually practice policy on the ground. Using the case of Tanzania, a country known for having instituted some of the most extensive reforms and a 'success story' in Africa, I find that reforms are creating large burdens and barriers for access and use of services, including: increasing costs, enforcement pressures, and measures to impose 'market' discipline. However, I also find that many of the most significant outcomes are not found in direct 'market' changes, but rather how reforms are selective, partial, and shaped by the wider needs and claims of the institutions driving reforms, so that questions of how reforms are implemented, how they are measured, and who tells the story become as important as the policies themselves. Using a multiple-arenas framework, including (i) a household and community level study of urban energy conditions, (ii) a study of service and management conditions at the national electric utility, (iii) an examination of the international policy process, and (iv) a study of the history of electricity services across colonial, post-independence, and reform periods, I show that African energy reforms are a technical and political project connecting energy to international investments, donor aid programs, and elite interests within national governments. Energy reforms also involve fundamental service changes that are reorganizing how the costs and benefits of energy systems are distributed, allocated, and managed. The effects of reform extend beyond formal services to have wide-reaching repercussions within natural resources, and uneven social dynamics on the ground. These features point to the importance of critical ethnographic studies of energy, not simply as technical policy, but also as technical-political practice. It is in these grounded, institutional, and power-laden terms of how development is actually practiced that the wider outcomes of reform are revealed. Situating energy in development reveals the wider politics and relations of reforms.
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…
Electricity sectors in both developed and developing countries have been subject to restructuring to introduce private capital\\u000a and increase competition. Although the effects of such reforms in a number of the developed economies are now well documented,\\u000a the experience of developing countries is much less well researched. This paper provides an econometric assessment of the\\u000a effects of privatization, competition and
Purpose – The purpose of this paper is to quantify the impact of socio-economic characteristics on out-of pocket expenditures for prescribed medications in Tajikistan and provide recommendations for healthcare sectorreform. The research question in this paper is: what household, personal, economic, and health factors help explain expenditures on medications? From a theoretical perspective, this paper contributes to the on-going
The European Commission has asked Copenhagen Economics and KPMG AG in collaboration to study the VAT rules applied to the publicsector in EU member states, and make a comparison with the VAT\\/GST rules applied in key OECD countries outside the EU.The study collects and analyses relevant studies already carried out at international, EU or national level. The study describes
How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the publicsector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms. PMID:23161587
Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M
In his 18-page paper entitled 'The Challenges of Governance, PublicSectorReform and Public Administration in Africa: Some Research Issues', Guy Mhone made central to publicsectorreforms the need to promote procedural rationality in the operation of the publicsector and instrumental rationality in terms of economic, social and political outcomes. The present paper contributes to the debate on
This working paper "investigates" the role of Vocational Education and Training in Schools (VETiS) in providing leaders with a driver for reforming Senior L/earning (Years 10, 11 and 12). Using a "case study methodology", this paper explores the collaboration and cooperation across different borders and sectors among leaders in the reform to…
Quite opposite to common public metaphor on public administration as sleepy, slow and secretive bureaucracy, the Croatian public administration looks like a windsurfer. It rides the waves of domestic political storms and foreign doctrinal (i.e. NPM) and organizational influences, business community attacks and European coincidences, desperately asking for institutional stabilization, ethical standards and professionalism. State administration in Croatia developed during
Purpose – Practice demonstrates and research validates that entrepreneurship is moving from the individual to the organization and from the private sector to the social and not-for-profit sectors. The present study endeavors to complement the emerging public entrepreneurship literature by aiming to identify which of those factors that stimulate corporate entrepreneurship in the publicsector are preferred by entrepreneurial civil
For more than a decade, competence development has been a key concept of modern management in both the private and the publicsector, but to some extent its meaning and practice have been different in the two sectors. In the publicsector in particular, competence development has been closely related to a number of other buzzwords characterizing…
Conventional wisdom of ‘sector matters’ suggests that those working in the government are more risk averse than those employed by business enterprises. However, whether publicsector 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
Most studies on service quality have been conducted in the context of the private sector of the economy. In fact, in the healthcare setting, for a long time, public-sector hospitals were not expected to excel in the provision of service quality. In a country such as India, even now, public-sector hospital staffs enjoy relatively higher salaries, flexible work schedules, and
This paper analyzes the effects of health reform in Colombia on public health programs at the local level, particularly the Expanded Program of Immunization (EPI) and the tuberculosis control program. The research was developed in three health districts in two States by analysis of documents, direct observation, and longitudinal follow-up of the transition process. The health districts were unprepared for the change, resulting in insufficient technical skills among staff as well as lack of awareness of important elements in the new system, associated with a reduction in immunization coverage and tuberculosis case detection. Structural problems in the new system included loss of immunization opportunities and lack of examination of tuberculosis contacts. The potentialities of the new system were the local development of a new organizational structure and the improvement of the information system; a limiting factor was exposure of the health system to local political interests. The general conclusion is that the transition period takes far longer than anticipated and requires a much greater information flow to both the local level and the community. There are transitory but also structural maladjustments that require a political response. PMID:12488905
The publicsector passenger transport has been crucial sector for transportation of people in developing countries like India. But there is less emphasis on customer expectations in this sector. This study aims at evaluating the customer expectations of this service sector in India. A questionnaire containing eighteen quality characteristics was administered to various customers of three bus depots of one
M. Vetrivel SEZHIAN; C. MURALIDHARAN; T. NAMBIRAJAN; S. G. DESHMUKH
A program designed to improve the availability of vasectomy in public-sector clinics trained physicians at 43 facilities in no-scalpel vasectomy between 1993 and 1995. Among the 38 clinics that responded to a follow-up survey in 1996, the number of clinics providing vasectomies rose from 23 to 32, an increase of almost 40%, while the number of vasectomies performed rose by 18%. Seventeen of the 32 clinics performed more vasectomies after the training; 10 of the 17 had not previously provided the procedure. In-depth interviews with staff from seven sites that experienced large caseload increases and from seven that experienced decreases identified three elements for the successful establishment or expansion of vasectomy services-sufficient numbers of trained providers, funds to subsidize vasectomies for men who cannot afford them and activities to raise awareness about the availability of low-cost or free vasectomy. PMID:9258652
Background: India's health sector witnessed some major policy changes in 1990s that aimed at making health services more accessible to the population. Methods: In this paper, I tried to present some preliminary results of the significant changes that occurred between 1995/6 and 2004, especially in relation to the question of access to healthcare for the poor and rural population using data from 52nd (1995-6) and 60th round (2004) of National Sample Survey Organization on 'morbidity and healthcare'. Results: The analysis suggests that overall utilization of healthcare services have declined and the odds of not seeking care due to financial inability has further increased among the poor and rural population during the period of reforms. Results of the multivariate logit regression model indicate that the non-poor, middle and above educated people were having greater likelihood of using services from private health care provider. Conclusion: Interestingly, poor and rural residents were more likely to have used healthcare from public facilities in 2004 than in 1995-6, suggesting that the shift from private to publicsector is encouraging, provided they receive good quality health care services at public facilities and do not face catastrophic health expenditures. PMID:24757689
Background: India’s health sector witnessed some major policy changes in 1990s that aimed at making health services more accessible to the population. Methods: In this paper, I tried to present some preliminary results of the significant changes that occurred between 1995/6 and 2004, especially in relation to the question of access to healthcare for the poor and rural population using data from 52nd (1995–6) and 60th round (2004) of National Sample Survey Organization on ‘morbidity and healthcare’. Results: The analysis suggests that overall utilization of healthcare services have declined and the odds of not seeking care due to financial inability has further increased among the poor and rural population during the period of reforms. Results of the multivariate logit regression model indicate that the non-poor, middle and above educated people were having greater likelihood of using services from private health care provider. Conclusion: Interestingly, poor and rural residents were more likely to have used healthcare from public facilities in 2004 than in 1995–6, suggesting that the shift from private to publicsector is encouraging, provided they receive good quality health care services at public facilities and do not face catastrophic health expenditures.
Understanding why government officials behave in certain ways under particular circumstances is an important theme in political science. This research explores the design of policies and incentives targeted at publicsector officials, in particular the use of market based policy tools in a non-market environment, and the influence of that organizational environment on the effectiveness of the policy. The research examines the case of Department of Defense (DoD) facility energy management. DoD energy policy includes a provision for the retention of savings generated by conservation activities: two-thirds of the savings is retained at the installation generating the savings, half to used for further investment in energy conservation, and half to be used for general morale, welfare, and recreation activities. This policy creates a financial incentive for installation energy managers to establish higher quality and more active conservation programs. A formal written survey of installation energy managers within DoD was conducted, providing data to test hypotheses regarding policy effectiveness and factors affecting policy implementation. Additionally, two detailed implementation case studies were conducted in order to gain further insights. Results suggest that policy design needs to account for the environment within which the policy will be implemented, particularly organizational culture and standard operating procedures. The retention of savings policy failed to achieve its intended outcome---retention of savings for re-investment in energy conservation---because the role required of the financial management community was outside its normal mode of operation and interests and the budget process for allocating resources did not include a mechanism for retention of savings. The policy design did not adequately address these start-up barriers to implementation. This analysis has shown that in order for retention of savings, or similar policies based on market-type mechanisms, to be effective in the publicsector context, the required cultural changes and appropriate implementing mechanisms must be provided for in the policy design.
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…
This paper studies the accounting system reform practised in Greek universities since January 2000, and more particularly at the Aristotle University of Thessaloniki (AUTH). It specifically examines the allocation of resources to faculties by university management based on certain criteria. The AUTH is the largest public university in Greece and…
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…
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…
...----------------- DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2010-0065] Public Meetings of National Flood Insurance Program...engaged in a comprehensive reform effort to address the concerns of the wide array of stakeholders involved in the ongoing debate about the NFIP. FEMA chose a participatory policy analysis framework to guide the......
...----------------- DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2010-0065] Public Meetings of National Flood Insurance Program...engaged in a comprehensive reform effort to address the concerns of the wide array of stakeholders involved in the ongoing debate about the NFIP. FEMA chose a participatory policy analysis framework to guide the......
This briefing has been prepared to assist the Scottish Parliament's Local Government and Transport Committee in their scrutiny of the Draft Budget 2007-08. It presents trends in the budget relating to the Finance and Public Service Reform portfolio focussing on local government budget allocations, outlines the Objectives and Targets in the portfolio, considers the latest developments in the Scottish Executive's
Both leadership and public service motivation are important issues in contemporary public administration. By connecting these issues, the aim of this paper is to assess the impact of transformational leadership behaviour (promoting public values) on public service motivation development. Two hypotheses were tested with a dataset of 3507 state civil servants in Belgium. The analysis shows that a positive relation
Within and beyond Africa, it is the publicsector much more than the private sector that is the scene of strikes and other forms of disorder, conflict and difficulty. Yet the private sector can be much affected by the public problems. Effects may be simultaneously positive for the private sector and deleterious for the publicsector. Although a…
In 1947, the Michigan Legislature passed into law the Hutchinson Act banning strikes of state and local workers. The law provided for the termination of striking publicsector workers but did not require state and local agencies to bargain with public employees or their representatives. It even allowed for fines and prison sentences for non publicsector workers who influenced
In 1947, the Michigan Legislature passed into law the Hutchinson Act banning strikes of state and local workers. The law provided for the termination of striking publicsector workers but did not require state and local agencies to bargain with public employees or their representatives. It even allowed for fines and prison sentences for non publicsector workers who influenced
Under New Zealand's radical state sectorreforms, 'empowered' managers are held accountable in an arm's length way by politicians and control agencies through the use of clearly stated objectives and the availability of quality information about progress towards those objectives. However, empirical research indicates that this thermostatic metaphor embodies a number of paradoxes. A great deal of international attention has
To date the publicsector role in facilitating the transition to a sustainable energy future has been envisaged mainly from a regulatory perspective. In such a role, the publicsector provides the push factors---enforcing regulations and providing incentives---to correct market imperfections that impede energy transitions. An alternative and complementary role of the publicsector that is now gaining increasing attention is that of catalyzing energy transitions through publicsector energy management initiatives. This dissertation offers a conceptual framework to rationalize such a role for the publicsector 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 publicsector energy management for promoting energy efficiency in Malaysia. The publicsector 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 publicsector 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 publicsector energy management strategy to be effectively implemented. Overall the analysis of this dissertation contributes to a rethinking of the publicsector 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.
Teacher collective bargaining is expected to have negative consequences for educational reform measures such as merit pay because the union's function is to advance the compensation and benefits of its constituency. The author maintains that the publicsector union is a de facto political party formed to influence public policy. (MLF)
It has been predicted that major introduction of information communication technology (ICT) for health care organisations (HCO) over the next 10 years will be used to achieve the universal coverage and improve the quality of health care delivered to people. Which is the best strategy on ICT transfer, adoption and adaptation for the local Mozambican HCO? This paper argues that a sociotechnical approach of ICT development can help policy makers and health managers to address the technology transfer in a better and more appropriate way to their social context and to the public health reforms in progress. The urgency of health care demands (e.g. AIDS epidemic) and the institutional changes implemented by the Government and the local Ministry of Health (MOH), open a dynamic process of re-organisation inside the health institutions in the next years. This process needs to be monitored and initiatives planned, which places pressure on the evolution of health information system (HIS). The increase in the use of ICT can be an ally for health managers. The emergence of the open source software (OSS) and the recent ICT market trends towards networking may also enable local HCO to better face and solve the long process of health care standardisation, which usually prepares and accompanies any introduction of ICT. On the other side, the "big bang" introduction of electronic packages, devices and software applications may be an obstacle framing and anchoring local HCO to external settings, "modern" and universal models. Thus, a uniform step-by-step implementation of hospital-based health information system is desirable. PMID:16807083
For most of the past decade the policy debate over improving U.S. public education has centered on teacher quality. In this debate, teachers and their unions have often been seen as the problem, not part of the solution. Further, current discourse often assumes that conflicting interests between teacher unions and administration is inevitable.…
In late 2008, Cincinnati Public Schools (CPS) participated in The New Teacher Project's (TNTP's) research for a national study, "The Widget Effect," published in June 2009. In summer 2009, CPS, the Cincinnati Federation of Teachers (CFT) and the Cincinnati Association of Administrators and Supervisors (CAAS) asked TNTP to explore a broader range…
During the past decade, economic and political forces have caused radical transformations in health care systems resulting in changed circumstances within which nursing executives must function. This paper provides an understanding of nursing executives' roles and responsibilities and the impact changes in the health industry have had on their careers. One hundred and forty-seven (52%) of the 281 nursing executives employed in the Queensland Public Health Sector completed a postal self-administered survey. The findings of this study demonstrate their role has expanded to include not only nursing administration, but also responsibility for financial, human resources, strategic and resource management, staff development and quality improvement. The impact of these role changes has affected the health and well-being of nursing executives, with nearly half reporting increased stress, frustration and irritation. Their workload has increased and some reported deterioration in their health, specifically, exhaustion, fatigue and insomnia. Respondents reported they now have less time to spend with families and friends, which has had a negative impact on family relationships. Overall, nursing executives were satisfied with their current position, the work itself and their relationships with their co-workers, but dissatisfied with organisational aspects, especially the quality of mentorship and opportunities for promotion. PMID:11496477
The arts sector can be plagued by characteristics that make its sustainability difficult, and it would appear that those in the arts sector consider that Australia's tax system has an important role to play in contributing to a sustainable arts sector. For example, within the 2020 Summit, at least 19 recommendations by the committee on “Towards a creative Australia” related
A study was conducted at the University of Texas to: (1) examine the management effectiveness of publicsector comprehensive health planning; and (2) test the hypothesis that the underlying principles of business planning models can be applied to public s...
Throughout the 1980s and 1990s there have been major reforms with regard to the mode of operation of the publicsector. The pervading theme running through these reforms is that of attempting to make the management of public services more accountable for the efficient and effective deployment of public resources. Focuses on how successful the reforms have been in engendering
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 publicsector. 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 publicsector 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.
At present, there is some problem, For example, human resources management concept is out in Chinese publicsector, evaluation and incentive mechanism is not perfect, human resource management strategic planning. We should promote the publicsector human resource management development under four main heads: focusing on modernizing human resources management concepts, creating human resource management excitation mechanism, establishing and improve
Private sector provision of public infrastructure in Australia all levels of government, including local government has steadily increased over the past twenty years. Nevertheless, this method of providing public infrastructure remains controversial. This paper seeks to provide a critical review of the arguments surrounding private sector provision of infrastructure in Australian local government. It examines both the case for private
Purpose – The purpose of this paper is to examine the measures put in place by the largest publicsector organizations in Sweden in order to communicate the ethos of their codes of ethics to their employees. Design\\/methodology\\/approach – This paper is based upon a longitudinal survey approach. Findings – In the publicsector organizations of Sweden the use of
The focus of this paper is upon the relationship between publicsector procurement and small business. It explores whether the signs that the UK publicsector is now becoming more interested in the adoption of lean approaches has particular consequences for small firm suppliers. Evidence from a survey of UK local government procurement officers determines a number of developments that
The paper focuses on the empirical evidence on the use and usefulness of performance measures in the publicsector. It begins with consideration of the features of the publicsector which make the use of performance measures complex: the issues of multiple principals and multiple tasks. It discusses the form that performance measures may take, the use made of these
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 publicsector employment...
Few conceptual efforts have been made to design the public administration of tomorrow which makes full use of the potential of information technology to create new structures and work processes. Business process re?engineering, the Internet and other sources of innovative information systems at the citizen interface, are important directions into which efforts at developing the publicsector of the future
This paper is an analysis of South Africa's public service improvement strategies since 1994. It first describes the historical factors that underpinned South Africa's service delivery initiatives before 1994. It is argued that the pre-1994 public service sector was racialised and highly politicised, as opposed to being people-centred and service delivery oriented. The transition to democracy in 1994 necessitated a
For more than a decade, competence development has been a key concept of modern management in both the private and the public\\u000a sector, but to some extent its meaning and practice have been different in the two sectors. In the publicsector in particular,\\u000a competence development has been closely related to a number of other buzzwords characterizing dominant Neo-Liberal political
This paper develops a customer-oriented service model for the publicsector. Although customer-oriented service models have become popular since 1980, most studies have been restricted to the private sector. In addition, they have emphasised the management of service operations rather than system design. This paper proposes a customer-oriented service-enhancement system (COSES) for the publicsector. The model employs two dimensions:
The paper is a review of the reform process in the Manyame Catchment (one of the seven gazetted catchments that cover Zimbabwe). A critical analysis is made of the minutes of meeting of the council and of one sub-catchment council.A review is also undertaken of informal communication amongst stakeholders both before and after the promulgation of the new act. A
In this article, we analyse the effects of teaching reforms in Italy. These were introduced in 1999, and changed the entire organization of university courses, where the Bachelor-Master (BA-MA) structure was adopted. The first step is to define the production process of higher education (HE). This process consists of several inputs (professors,…
The prevailing political science wisdom is that narrow interests regularly triumph over the general public. Yet the stunning passage of broad-based policy reforms in the face of intense clientele opposition suggests that the U.S. political system has a greater capacity to serve diffuse interests than has often been thought. Some of the most provocative policy-oriented political-science research during the 1980s
With its transition to a market-oriented economy, China has gone through significant changes in health care delivery and financing\\u000a systems in the last three decades. Since 1998, a new public health insurance program for urban employees, called Basic Medical Insurance Program (BMI), has been established. One theme of this reform was to control medical service over-consumption with new cost containment
The unprecedented degree of attention given to the learning and skills sector in England by successive New Labour governments has led to a significant increase in what is expected of the teaching workforce. To help meet these expectations, a "step change" in the quality of initial teacher training for the sector is promised, alongside provisions…
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.
Craglia, Massimo; Friis-Christensen, Anders; Ostländer, Nicole; Perego, Andrea
The life-history method is a valuable tool for social policy research. Taking an anthropological approach to studying policy, the article analyses the usefulness of the method using data drawn from a set of recently collected life-work histories from the UK. These life- work histories document the experiences of individuals who have crossed over between the publicsector and the 'third
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…
\\u000a Economical and reliable supplies of electricity make possible many of the services that we associate with modern life. From\\u000a electric lights and microwave ovens, to television, telephones, and computers, electricity is a critical input supporting\\u000a a wide range of consumption, transportation and production activities. The electricity sector is also a major manufacturing\\u000a sector, accounting for about 210 billion of annual
Social cohesion, the "glue" that keeps a society together, is influenced by the various sectors or "pillars" of that society-educational institutions, social and religious institutions, business institutions, and government. In this article, the effect of the three branches of government (executive, legislative, and judicial) on social cohesion is…
Background Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse. Methods A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients. Results All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a publicsector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the publicsector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system. Conclusion The study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures requiring better management practices could substantially improve the working environment and hence retention of nurses.
The major participants in the agricultural research sector are composed of domestic and international public institutes, non-profit organizations, and private firms. Institutes, research councils, and research divisions of ministries primarily compose the...
Discusses why publicsector organizations should focus on developing employment websites to supplement recruiting activities. Presents a model of job surfer behavior that should be considered when designing a website. (Contains 48 notes and references.) (JOW)
Cober, Richard T.; Brown, Douglas J.; Blumental, Alana J.; Doverspike, Dennis; Levy, Paul
This thesis evaluates a variety of documented cases of customer- focused business practice initiatives to discern common principles of implementation within the private and publicsectors. The business practices Quality, Activity-Based Costing (ABC), Cust...
The objective of this thesis was to describe and compare different existing and evolving financial reporting models used in both the public and private sector. To accomplish the objective, this thesis identified the existing financial reporting models for...
This descriptive state-of-the-art report presents a survey of recent distance learning developments in Britain, mainly by local colleges in the public education sector, and discusses the motivation and experience of adult learners. Distance learning in ge...
Adopts a descriptive and normative theory of planning to explore some of the differences in assumptions, methodologies, and intended outcomes of the process of planning as it seems to be applied to public and private sector planning. (Author/WM)
Publicsector union membership rolls will swell by over 40,000 Transportation Security Officers (TSO) as the Transportation Security Administration (TSA) embarks on transitioning to a unionized screener workforce. Proponents argue that screening operation...
Reviews the legal rulings and statutes that have shaped public employee labor relations in Texas since the late 19th century. In the absence of one comprehensive labor/management act, Texas has many diverse laws and precedents that affect the public employee. Available from Baywood Publishing Company, Inc., 43 Central Drive, Farmingdale, NY 11735;…
Organizational choices shape the way in which individuals experience their employment relationship. Given the multiple differences between the public and the private sectors, this study seeks to identify variations in employee perceptions of their psychological contract depending upon the sector in which they work. The psychological contract is seen as lying at the heart of the employer-employee exchange relationship. The
Publicsector economic analysis differs from private sector analysis in that the former assumes continuous functions and very small departures from existing conditions while the latter is generally concerned with large discrete either-or decisions. This paper (1) defines an analytic measure that relates effectiveness and cost so that the…
This article examines the combined impact of the employment guarantee for graduates and publicsector compensation policies on the Egyptian labor market. Besides contributing to an unsustainable rate of growth in the government labor force, these policies have encouraged queuing for government jobs, contributed to high graduate unemployment rates, and reduced the employment of graduates in the private sector. Despite
The present paper examined the lifetime rates of mental health service use in a representative sample of youths identified as receiving services in at least one sector of care in a publicly funded service system of a large, metropolitan area. Service use was examined in relation to age, gender, mental health diagnostic status, and service sector involvement. Participants were 1,706
Andrea L. Hazen; Richard L. Hough; John A. Landsverk; Patricia A. Wood
This article compares the effectiveness of the administrative subculture of public and private sector employees by comparing the efficacy of their organizational processes. The paper provides some evidence that assumptions about the superiority of private sector administrative subculture (as measured by comparing the effectiveness of organizational communication processes in reducing task ambiguity) are probably not warranted. The perception that private
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…
CONTEXT: In 2007, first-trimester abortion was legalized in Mexico City. Limited research has been conducted to understand clients'perceptions of the abortion services available in public-sector facilities. METHODS: Perceptions of quality of care were measured among 402 women aged 18 or older who had obtained abortions at any of three public-sector sites in Mexico City in 2009. Six domains of quality
Davida Becker; Claudia Díaz-Olavarrieta; Clara Juárez; Sandra G. García; Patricio Sanhueza; Cynthia C. Harper
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
Manuel Sánchez Pérez; Juan Carlos Gázquez Abad; Gema María Marín Carrillo; Raquel Sánchez Fernández
Hospitals compose a large share of total health spending in most countries, and thus have been the target of reforms to improve efficiency and reduce costs. In China, the government implemented national health care reform to improve access to essential services and reduce high out-of-pocket medical spending. A key component is the comprehensive reform of public hospitals on a pilot basis, although it remains one of the least understood aspects of health care reform in China. This article outlines the main goals of the reform of public hospitals in China, progress to date and the direction of reform between now and 2015. Then, we review experiences from industrialized countries and discuss the applicability to the Chinese reform process. Based on the policy directions focusing on efficiency and quality, and reflecting on how hospital systems in other countries have responded, the article concludes that the hospital of the future in China operates at county level. Barriers to realizing this are discussed. PMID:23612847
Barber, Sarah L; Borowitz, Michael; Bekedam, Henk; Ma, Jin
This article describes the evolution of the application of marketing techniques to the publicsector and evaluates how political\\u000a science and public administration have responded to them. Within the framework of the new definition of marketing established\\u000a by the American Marketing Association (AMA), this article also discusses the potential of marketing in contemporary public\\u000a management and its coherence with democratic
A psychological contract is a set of unwritten reciprocal expectations between trainee and training program. Public agency trainers must establish and manage psychological contracts through clearly defined objectives and development of a learning climate that leads to effective training. (SK)
This study sought to: (1) Compare the relative predictive powers of job attachment and job satisfaction with respect to turnover among a sample of public employees; and (2) Compare the relative influences on both attitudes of individual and job characteri...
Kolb's Experiential Learning Model suggests that people differ in how they perceive and process information. Public agency training should incorporate knowledge of brain hemisphere dominance and learning style preferences in training design. (SK)
How can a community ensure that its public schools reflect local values and beliefs about education? The complexities involved in the reform of existing public schools, or the creation of a new system of schooling, have caused some researchers to explore new methodological avenues to change (Banathy, 1991; Duffy, Rogerson, & Blick, 2000; Jenlink,…
The United Kingdom (UK) is frequently referred to as the textbook case of new public management (NPM). This country was, of course, not alone in adopting a reform pro- gramme devoted to the introduction managerial techniques and economic incentives to guide the design and operation of public services and executive government since the late 1970s. It is widely claimed, however,
This paper is an analysis of the politics of public administration reform in Poland, Slovakia, and the Czech Republic that examines why, despite the ambition and scope of such reform, its results have been disappointing and sometimes even counterproductive. It examines the genesis, implementation, and political consequences of policies to reform state administration. The first section lays out the theory
Summary One of the main challenges for the publicsector in the developed world is to deliver improved services through a motivated workforce in an age of austerity. This age of austerity has been brought on by the financial crisis that has left governments running enormous budget deficits, but facing electorates still expecting increased standards in public services, especially as
Performance measurement in the publicsector is largely based on objective metrics, which may be subject to gaming behaviour. This paper investigates a novel subjective performance evaluation system where independent inspectors visit schools at very short notice, publicly disclose their findings and sanction schools rated fail. First, I demonstrate that inspection ratings can aid in distinguishing between more and less
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…
An issue for Congress and state and local governments is whether the pay and benefits of public workers are comparable to those of workers in the private sector. To deal with budget deficits, many policymakers are looking at the pay and benefits of public...
This article focuses on the emerging role of the publicsector in dealing with catastrophic disasters. An empirical analysis of the 9\\/11 response operations provides a detailed case study with an eye to its implications for not only emergency management practice but public policy as well. The “horde of hurricanes” inundating Florida in 2004 provides a brief example of a
The development of transport networks requires public investments, in terms of government expenditure, on several types of (road, rail, port, airport, and urban public transport) infrastructure, including their operational and maintenance services. This paper develops and implements a system-wide spatioeconomic model to analyze the expenditure competition among different types of investment in the Greek transport sector. The suggested approach can
Supervision plays a key role in the provision of health and human services. An extensive literature exists on supervision as an element of professional development in behavioral health care. However, much less attention has been given to the practice of supervision in publicly funded systems of care for persons with mental and substance use conditions. This article provides a comprehensive
Michael A. Hoge; Scott Migdole; Melanie S. Farkas; Allison N. Ponce; Christie Hunnicutt
Hurricane Katrina's impact on the economy and infrastructure of Louisiana, Mississippi and Alabama represents an immediate concern to commercial enterprises, area residents, and policymakers at all levels. Understanding the severity of the damages and the magnitude of the recovery efforts are important for both private and public decision makers deploying resources in the affected area. This paper provides initial estimates
Pharmaceuticals are essential for preventive and therapeutic health services. Unfortunately, significant demand, limited funds and high prices contribute to frequent shortages of drugs in many public health programs. One method for financing pharmaceutical supplies has been the establishment of revolving drug funds (RDFs) in which, after an initial capital investment, drug supplies are replenished with monies collected from the sale
Peter N. Cross; Maggie A. Huff; Jonathan D. Quick; James A. Bates
Deregulation and liberalization of health services take several forms in Europe: public-private partnerships; contracting out of services; and corporatization of health care institutions. The impact on health workers includes changes in terms and conditions of employment, breakup of collective bargaining agreements, and often more stressful working conditions. The author examines four types of trade union responses to deregulation. National health trade union action has used campaigning, awareness raising, and judicial review. Health workers' unions in alliance with other trade unions have taken part in wider campaigns against privatization and in promoting public services. Health workers' unions joining with social movements have become involved in wider alliances that link with broader public policy issues such as poverty reduction and urban/regional regeneration. European-wide action, seen through the work of the European Federation of Public Service Unions, has concentrated on the development of an alternative health policy, and the promotion of social dialogue at a European level. Trade unions must adopt a range of approaches to challenge the effects of deregulation. Increasingly, trade union members need to be aware of how to take action at both the national and European levels. PMID:15346679
Outsourcing the provision of traditionally publicly-provided services has become commonplace in most industrialized nations. Despite its prevalence, there still is no consensus in the academic literature on the magnitude (and determinants) of expected cost savings to the government, nor the sources of those savings. After articulating the differences between outsourcing and privatization, this article considers the arguments for (and against)
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 publicsectorreform 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
Penn-Kekana, Loveday; Blaauw, Duane; Schneider, Helen
New Public Management (NPM) was the catch phrase of the reforms in the public research and higher education sector for the last decades. The postulated effect of the NPM reforms is increased efficiency in governmental resource spending on the public higher education and research institutions. Though backed by theoretical considerations, this hypothesis has hardly been tested empirically. Using a unique
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…
While private sector organizations have implemented enterprise resource planning (ERP) systems since the mid 1990s, ERP implementations within the publicsector 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…
This article reports on a survey study of 382 managers from a variety of public and private sector organizations, on the values that guide sectoral decision making. Just as some important classical differences emerge, a number of similarities between the public and private sector appear to result in a set of common core organizational values. Furthermore, the data support neither
Background There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the publicsector. Methods Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist ‘dual practice’, that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. Results Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel ‘needed’ and ‘relevant’. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of publicsector dissatisfaction appeared just as important, if not more important, than wage disparities. Conclusions The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the publicsector. Policy recommendations center around boosting publicsector resources and building trust of the publicsector through including health workers more in decision-making, inter alia. These interventions may be more cost-effective for retention than wage increases, and imply that it is not necessarily just a matter of putting more money into the publicsector to increase retention.
Implementation science is a quickly growing discipline. Lessons learned from business and medical settings are being applied but it is unclear how well they translate to settings with different historical origins and customs (e.g., public mental health, social service, alcohol/drug sectors). The purpose of this paper is to propose a multi-level, four phase model of the implementation process (i.e., Exploration, Adoption/Preparation, Implementation, Sustainment), derived from extant literature, and apply it to publicsector services. We highlight features of the model likely to be particularly important in each phase, while considering the outer and inner contexts (i.e., levels) of publicsector service systems.
Implementation science is a quickly growing discipline. Lessons learned from business and medical settings are being applied but it is unclear how well they translate to settings with different historical origins and customs (e.g., public mental health, social service, alcohol/drug sectors). The purpose of this paper is to propose a multi-level, four phase model of the implementation process (i.e., Exploration, Adoption/Preparation, Implementation, Sustainment), derived from extant literature, and apply it to publicsector services. We highlight features of the model likely to be particularly important in each phase, while considering the outer and inner contexts (i.e., levels) of publicsector service systems. PMID:21197565
Aarons, Gregory A; Hurlburt, Michael; Horwitz, Sarah McCue
New Zealand public hospitals and related services were grouped into 23 Crown Health Enterprises and registered as companies in 1993. Integral to this change was the introduction of corporate governance. New directors, largely from the business sector, were appointed to govern these organisations as efficient and effective businesses. This article presents the results of a survey of directors of New Zealand publicly-owned health provider organisations. Although directors thought they performed well in business systems development, they acknowledged their shortcomings in meeting government expectations in respect to financial performance and social responsibility. Changes in public health sector provider performance indicators have resulted in a mixed report card for the sector six years after corporate governance was instituted. PMID:10947611
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.
Perks, Carol; Toole, Michael J.; Phouthonsy, Khamla
Background Kenya’s human resources for health shortage is well documented, yet in line with the new constitution, responsibility for health service delivery will be devolved to 47 new county administrations. This work describes the publicsector nursing workforce likely to be inherited by the counties, and examines the relationships between nursing workforce density and key indicators. Methods National nursing deployment data linked to nursing supply data were used and analyzed using statistical and geographical analysis software. Data on nurses deployed in national referral hospitals and on nurses deployed in non-publicsector facilities were excluded from main analyses. The densities and characteristics of the publicsector nurses across the counties were obtained and examined against an index of county remoteness, and the nursing densities were correlated with five key indicators. Results Of the 16,371 nurses in the public non-tertiary sector, 76% are women and 53% are registered nurses, with 35% of the nurses aged 40 to 49 years. The nursing densities across counties range from 1.2 to 0.08 per 1,000 population. There are statistically significant associations of the nursing densities with a measure of health spending per capita (P value?=?0.0028) and immunization rates (P value?=?0.0018). A higher county remoteness index is associated with explaining lower female to male ratio of publicsector nurses across counties (P value <0.0001). Conclusions An overall shortage of nurses (range of 1.2 to 0.08 per 1,000) in the publicsector countrywide is complicated by mal-distribution and varying workforce characteristics (for example, age profile) across counties. All stakeholders should support improvements in human resources information systems and help address personnel shortages and mal-distribution if equitable, quality health-care delivery in the counties is to be achieved.
Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.
Garrick, C.J.; Garrick, J.M.; Rue, D.R. [NEOS Corp., Lakewood, CO (United States)] [NEOS Corp., Lakewood, CO (United States)
Pharmaceuticals are essential for preventive and therapeutic health services. Unfortunately, significant demand, limited funds and high prices contribute to frequent shortages of drugs in many public health programs. One method for financing pharmaceutical supplies has been the establishment of revolving drug funds (RDFs) in which, after an initial capital investment, drug supplies are replenished with monies collected from the sale of drugs. All too often however, the funds actually recovered are insufficient to replenish supplies and the fund is soon depleted. In this paper we consider the potential benefits and common pitfalls of revolving drug funds and then focus on the central role of financial planning in establishing drug sales programs. Experiences from a variety of countries suggest several causes for the failure of some RDFs, including: under-estimation of capitalization costs, prices set below true replacement cost, frequent failure to collect payment, delays in cash flow which make funds unavailable for replenishment of drug stocks, rapid program expansion for which additional capital funds are not available, losses due to theft and deterioration of drugs, unanticipated price increases due to inflation or changes in parity rates and foreign exchange purchase restrictions. Common to many of these problems is the lack of a businesslike orientation to RDFs and, in particular, lack of careful financial planning and management. Financial planning for an RDF includes four analytical tasks: assessment of the potential market, estimation of the costs of an RDF, establishment of the cost-recovery objectives, definition of the role of subsidies and surcharges.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3515574
We analyze the impact of changing employment patterns and pension reforms on the future level of public pensions across birth cohorts in Germany. The analysis is based on a rich dataset that combines household survey data from the German Socio-Economic Panel Study (SOEP) and process-produced microdata from the German pension insurance. A microsimulation model is developed which accounts for cohort
We analyze the impact of changing employment patterns and pension reforms on the future level of public pensions across birth cohorts in Germany. The analysis is based on a rich dataset that combines household survey data from the German Socio-Economic Panel Study (SOEP) and process-produced microdata from the German pension insurance. A microsimulation model is developed which accounts for cohort
We analyze the impact of changing employment patterns and pension reforms on the future level of public pensions across birth cohorts in Germany. The analysis is based on a rich dataset that combines household survey data from the German Socio-Economic Panel Study (SOEP) and process-produced microdata from the German pension insurance. A microsimulation model is developed which accounts for cohort
This study aims to analyze the public pension schemes in Romania in the light of the challenges presented by global economic crisis and by the Romanian reform inequities and inconsistencies that have been a part of this field since 2001. The contents of this paper examine four types of pension schemes in some Member States (MS) of the European Union
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…
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 publicsector 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 publicsector 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
In 1981, Texas embarked on a 10-year period of educational reform. This report presents findings of a policy research project that documented and analyzed these reforms to serve as a guide for future policy developments. Following the introduction, chapter 2, entitled "Student Reforms," addresses issues of curriculum, assessment and dropout…
In this article, the authors explore the following questions: How have Americans actually responded to these developments? Have they grown more supportive of the current direction of school reform, or are there instead signs of a backlash? And how do the views of teachers compare to those of the public at large? In addition to the views of the…
In last few decades the Public Administration has changed. It is well known that the publicsector is obliged to follow social needs by modernizing its procedures and services. The goal of the Public Administration is to serve society. But, the existed laws and regulations do not always cover the needs of e-citizens. Acceptance of e-Government is a great opportunity
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.
Between 1970 and 2009, US public institutions participated in the research and development of 153 drugs, including 15 vaccines. Between 1990 and 2007, nearly 10% of all the new drugs and vaccines marketed in the US and about 20% of those representing a therapeutic advance originated in public institutions. The proportion of these drugs that represented a substantial therapeutic advance was over twice that of those produced exclusively by the private sector. PMID:23444514
A publicsector comparator (PSC) represents the hypothetical, risk-adjusted cost of a project—such as a road scheme—when that\\u000a project is financed, owned and implemented by government. A PSC is commonly used in public procurement decision-making as\\u000a a yardstick against which private investment proposals are evaluated. Using original material released by the UK Highways\\u000a Agency for the first time, the author
Beyond the existing SERVQUAL-based research, the authors develop an alternative model of public service quality. The various sources of public service quality are explored and a new classification scheme formulated by using critical incidents technique. Four main qualities of public service are identified: process quality, outcome quality, design quality, and relationship quality. The findings suggest that the critical attributes of
This paper reports on a project which analyzed the processes carried out by a unit within a publicsector organization. The method used a combination of strategic and operational analysis tools. This combination proved to be complementary and effective in practice. This outcome of the study suggests that where a process analysis project has strategic considerations, as many do, then
Between 1991 and 1997 West Germany spent on average about 3.6bn euro per year on publicsector sponsored training programmes for the unemployed. We base our empirical analysis on a new administrative database that plausibly allows for selectivity correction by microeconometric matching methods. We identify the effects of different types of training programmes over a horizon of more than seven
ABSTRACT: Contractors failing to meet customers’ objectives in terms of time, quality and cost are a common occurrence. Inmost countries including Malaysia, the publicsector is the main client for the construction industry. Lowest price is the main criterion when awarding contract, even though it has been said by many researchers (for example Hatush and Skitmore, 1998 and Holt et
Mastura Jaafar; Abdul Rashid Abdul Aziz; Ahmad Ismail
Purpose – The paper seeks to report on the results of a regional survey of publicsector HR and union representatives' views and experiences of employee voice techniques in the workplace. Design\\/methodology\\/approach – The research was based on a descriptive survey and subsequent statistical analysis of significant difference between HR and union representatives in terms of their views on the
School sector and educational context seem to make a difference in civic socialization. There is limited knowledge, however, of the mechanisms through which socialization may occur in public and private schools, and the extent to which they have any lasting effect. Does the private school effect on civic socialization persist into young adulthood,…
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 publicsector 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
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
Margaret F. Reid; Myria W. Allen; Cynthia K. Riemenschneider; Deborah J. Armstrong
...EPA-HQ-OAR-2010-0505; FRL-9174-8] Oil and Natural Gas Sector--Notice of Public Meeting...regulations affecting the oil and natural gas industry. The review in progress covers oil and natural gas exploration and production,...
Purpose – This study aims to investigate perception of ethical and moral conduct in the publicsector in Swaziland, specifically, the relationship among: money ethic, attitude towards business ethics, corruption perception, turnover intention, job performance, job satisfaction, and the demographic profile of respondents. Design\\/methodology\\/approach – The study was a survey using self-administered questionnaires. Using stratified sampling technique in selected organisations,
Purpose – The purpose of this paper is to investigate the relationships among role conflict, role ambiguity, the three dimensions of organizational commitment, and turnover intentions. In addition, the paper tests the moderating effect of perceived alternatives in the relationship between continuance commitment and turnover intentions. Design\\/methodology\\/approach – The research was a cross-sectional study of employees in the publicsector
Helena M. Addae; K. Praveen Parboteeah; Nickler Velinor
We present our experiences in defining and documenting business process requirements for a large-scale publicsector Enterprise Resource Planning (ERP) implementation in the United States. The implementing organization, the Naval Air Systems Command (NAVAIR), is investing in packaged software to integrate all aspects of its business processes. Prior to selecting implementation consultants, NAVAIR documented business process requirements to scope the
George Blick; Thomas R. Gulledge; Rainer A. Sommer
Purpose – The aim of this paper is to explore the issues involved in developing and applying performance management approaches within a large UK publicsector department using a multiple stakeholder perspective and an accompanying theoretical framework. Design\\/methodology\\/approach – An initial short questionnaire was used to determine perceptions about the implementation and effectiveness of the new performance management system across
E-government is becoming extremely important, however, it cannot be successfully implemented without changes in business processes that are performed inside governmental institutions. Publicsector has some specifics, which make renovation projects considerably different. It is clear that radical changes in the execution of business processes and in the organizational structures are not suitable because they are not possible for many
This descriptive state-of-the-art report presents a survey of recent distance learning developments in Britain, mainly by local colleges in the public education sector, and discusses the motivation and experience of adult learners. Distance learning in general is examined, and current models of provision and the audiences served by these programs…
Advisory Council for Adult and Continuing Education, Leicester (England).
Purpose: This paper aims to report the results of a replication study of perceived managerial and leadership effectiveness within a Romanian publicsector 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:…
As faculty and other publicsector unions become more sophisticated in collective bargaining, they tend to lay a greater variety of demands on the table. This, in turn, forces the employer to ask, Do I really have to bargain about these subjects? As more employers refuse to bargain, more unions charge them with failing to bargain in good faith,…
Academic Collective Bargaining Information Service, Washington, DC.
Using data from the 1971 National Longitudinal Survey of middle-aged males, this survey simultaneously examines wage differentials in unionized and nonunionized employment in both the public and private sectors. Unlike previous studies conducted by Daniel S. Hamermesh, and Walter Fogel and David Lewin, this study includes a large sample that is…
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…
Privatized service delivery within Medicaid has greatly increased over the past two decades. This public program-private sector collaboration is quite common today, with a majority of Medicaid recipients receiving services in this fashion; yet controversy remains. This article focuses on just one program within Medicaid, school-based services for…
In this global era, IT investment is rapidly increasing. IT governance practices must be emphasized in order to retrieve competitive advantage from IT investment. The aim of this research is to develop IT governance practices model for Malaysian publicsector. Interview sessions with IT personnel at management level at Putrajaya were conducted. Based on the interviews, a theoretical model of
A review of the literature concerning outsourcing by the Australian publicsector in the watershed period from the mid-1990s through to 2000 led to the discovery of a serious evidentiary void regarding the validity of claimed cost savings. This paper provides a report on a contemporaneous, multi-method research study within this context. The prior outsourcing and cost savings research is
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
Yannis Markovits; Ann J. Davis; Doris Fay; Rolf van Dick
Purpose: The purpose of this paper is to develop a theoretical framework for measuring publicsector managers' career success. Design/methodology/approach: The theoretical foundation used in this study is social cognitive career theory. To conduct a literature search, several keywords were identified, i.e. career success, objective and subjective…
Rasdi, Roziah Mohd; Ismail, Maimunah; Uli, Jegak; Noah, Sidek Mohd
Describes the partnership between the public and private sectors in developing and marketing the ERIC database in CD-ROM format. Particular emphasis is given to the marketing research and protocols of partnership that were developed. (Author/CLB)
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 publicsector 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 publicsector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. Conclusions The preference for publicsector 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.
Abstract The Australian publicsector has recently faced a sweep of reforms. Initiatives such as National Competition Policy (NCP), economic rationalism, accrual accounting, financial management initiatives and value-based management,are some ,of the ,many ,reforms that Australia has adopted. This renewed ,focus has inspired reforms in the actual operations of the public hospitals. This paper aims to investigate the production and
In reviewing federal metric conversion (metrication) activities, the General Accounting Office (GAO) evaluated federal agency activities in (1) establishing metric guidelines and preparing reports on the transition, (2) using the metric system in procurements, (3) using the metric system in grants and other business activities, and (4) dealing with private sector and public attitudes toward conversion. Since 1990, federal preparations for metric conversion have advanced dramatically, with more than 30 agencies having developed some combination of guidelines, transition plans, and progress reports that indicate a substantially greater commitment to metrication. However, they are still facing serious difficulties in putting their plans into practice. These difficulties include a procurement environment in which most products are nonmetric and in which federal agencies represent too small a share of the total market to stimulate private sector conversion. Mixed progress has been made toward metric conversion in the areas of federal grants and other business activities. Grants for research require the use of the metric system, but such a commitment has not been made for grants in other areas, such as housing and education. Agencies that undertake other business-related activities, such as federal programs involving farmers or highway signs, are concerned about private sector and public resistance to conversion. Now that most agencies have made significant progress in preparing for metric conversion, a broader national dialogue between the government, the private sector, and the public is needed to discuss the next steps in decision-making about metric conversion.
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 publicsector 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
Any rapid political and economic transformation in a given society requires a great deal of administrative competence to prevent intense social destabilisation. This administrative capacity, however, is exactly what so many transition countries lack most of all. \\
Contributions from seven European countries pinpoint major projects, problems, and prospects of reformingpublic language assessment procedures. Each country has faced unique problems in the reform process, yet there have also been several common themes emerging, such as a focus on multilingualism, communicative skills, standardization, reference…
Current workforce reform, known as Remodelling the School Workforce, is part of an enduring policy process where there have been tensions between public and private sector structures and cultures. I show that the New Right and New Labour governments who have built and configured site based performance management over the past quarter of a century…
Purpose – This paper draws on a recent case study in Ghana that explored the human resource development (HRD) challenges facing local government in a reformingpublicsector. It aims to investigate how publicsectorreform (PSR) has affected worker motivation and effectiveness among civil servants (bureaucrats) serving local government at all levels of operation. Design\\/methodology\\/approach – Based on an
The Comprehensive School Reform (CSR) program is a new initiative that could affect International Reading Association members in the United States--but will benefit only those who take advantage of it. The purpose of the CSR initiative is to provide financial incentives for schools to develop comprehensive school reforms. Funding is available to…
This paper describes how Marche Regional Administration (MRA) introduced an innovative institutional reform of an Agricultural Knowledge and Information System (AKIS) in central Italy. In order to study the main features of the MRA reform we used a methodological approach based on three steps: (i) first we applied a desk analysis to sketch the…
Background: The Education Commission (EC) of Hong Kong, the advisory body set up by the government on the overall development of education in Hong Kong, began developing a policy of education reform in 1998 and published its blueprint in 2000. In 2006, the EC published its fourth official report on the progress of the reform--"Progress Report on…
The present study examines work attitudes in the public health sector using the relative impact of mentoring and organisational constraints on job satisfaction and organisational commitment. Data was collected from 161 employees in a large government-owned hospital in south western Nigeria. Results of the hierarchical regression analysis (which controlled for the effects of relevant covariates) showed that when informal mentoring and perceived organisational constraints were entered in the second step, R2 for organisational commitment and job satisfaction increased from .17 to .45 (p = < .001), and from .15 to .49 (p = < .001), respectively. These findings suggest that work attitudes in the public health sector can be improved by facilitating mentoring relationships and removing organisational obstacles. The implications of these findings for policy formulation and effective health care delivery are explained. PMID:20099584
The Washington Circle, a group focused on developing and disseminating performance measures for substance abuse services, developed three such measures for private health plans. In this article, we explore whether these measures are appropriate for meeting measurement goals in the publicsector and feasible to calculate in the publicsector using data collected for administrative purposes by state and local substance abuse and/or mental health agencies. Working collaboratively, 12 states specified revised measures and 6 states pilot tested them. Two measures were retained from the original specifications: initiation of treatment and treatment engagement. Additional measures were focused on continuity of care after assessment, detoxification, residential or inpatient care. These data demonstrate that state agencies can calculate performance measures from routinely available information and that there is wide variability in these indicators. Ongoing research is needed to examine the reasons for these results, which might include lack of patient interest or commitment, need for quality improvement efforts, or financial issues. PMID:18722075
Garnick, Deborah W; Lee, Margaret T; Horgan, Constance M; Acevedo, Andrea
The paper synthetically tackles the institutional, normative and functional framework resulting from the reforms of the national public administrations of the South-Eastern European states, aiming at the administrative convergence. Approached in a double-folded manner, both theoretical and empirical, the important topics on which the paper focuses are: - relevant features of administrative convergence and their singularity in certain South-Eastern European
Tatiana Dogaru; Ani Matei; Lucica Matei; Oana Stoian
Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two publicsector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in publicsector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.
Background South Africa has large public and private sectors and there is a common perception that publicsector 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 publicsector colleagues in most of the management facets. Publicsector 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 publicsector in South Africa and that there is a significant gap between private and publicsectors. It provides evidence that there is a great need for further development of managers, especially those in the publicsector. 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.
...reform choices? Dated: April 16, 2010. Alastair Fitzpayne, Acting Executive Secretary, Department of the Treasury. James Parrott, Counselor to the Secretary, Department of Housing and Urban Development. [FR Doc. 2010-9309 Filed 4-21-10;...
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
Rachel Jenkins; Ahmed Heshmat; Nasser Loza; Inkeri Siekkonen; Eman Sorour
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.
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.
The question of the links between pension reform and financial markets has two aspects. One concerns the preconditions in terms of financial sector development for the successful implementation of pension reform, while the other refers to the long-term impact of pension reform on the development of financial markets. This paper argues that pension reform and the promotion of private pension
As an employer, the publicsector might be expected to be more meritocratic than the private sector, because of its democratic values and more transparent appointments procedures. In this context meritocratic means that the employer only considers characteristics such as degree and grades, relevant for the position in question. The individuals in this study have completed one of four higher
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 publicsector. Materials and Methods: Present study is descriptive in nature conducted in publicsector 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 publicsector in Delhi.
Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini
Background The objective of this paper is to quantify the cost of periodontitis management at publicsector specialist periodontal clinic settings and analyse the distribution of cost components. Methods Five specialist periodontal clinics in the Ministry of Health represented the publicsector 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 publicsector 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.
Pay for performance is a popular public education reform, and millions of dollars are currently being targeted for pay for performance programs. These reforms are popular because economic and management theories suggest that well-designed incentive pay programs could improve teacher effectiveness. There is little evidence about the characteristics…
This paper investigates the dynamic consequences of demographic change and various pension reform scenarios for Austria. The analysis is based on a computable overlapping-generations model with life-cycle labor supply, savings, and search unemployment. The publicsector is decomposed into general government and an unfunded pension system with a tax-benefit linkage. Our quantitative analysis considers several pension reform scenarios on top
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 Publicsector facilities in Mexico City are providing a generally high level of postabortion family planning care and uptake of postabortion contraception is high.
Becker, Davida; Diaz-Olavarrieta, Claudia; Garcia, Sandra G.; Harper, Cynthia C.
In Bosnia and Herzegovina citizens receive health care from both public and private providers. The current situation calls for a clear government policy and strategy to ensure better position and services from both parts. This article examines how health care services are delivered, particularly with respect to relationship between public and private providers. The paper notes that the publicsector is plagued by a number of weaknesses in terms of inefficiency of services provision, poorly motivated staff, prevalent dual practice of public employees, poor working conditions and geographical imbalances. Private sector is not developing in ways that address the weaknesses of the publicsector. Poorly regulated, it operates as an isolated entity, strongly profit-driven. The increasing burdens on public health care system calls for government to abandon its passive role and take action to direct growth and use potential of private sector. The paper proposes a number of mechanisms that can be used to influence private as well as publicsector, since actions directed toward one part of the system will inevitable influence the other.
Background: This study investigated the presence of the burnout syndrome amongst employees of the banking sector. This topic is of particular interest owing to recent changes in working conditions and the controversial commercial strategies employed in this sector in recent years. Method: A total of 1,341 professionals, 883 men and 458 women took part in the study. A Spanish version of the Maslach Burnout Inventory-General Survey was used, via electronic mail. Results: The results revealed that at least 55.78% of the sample showed a high risk of burnout in at least two of the dimensions. The workers in commercial branch offices dealing with the general public showed a greater risk of burnout than those working in central services. Conclusions: The risk of burnout was higher than in other professions considered to be at risk and appears to be more closely associated with work-related stress and the controversial commercial strategies employed in the sector in recent years than with the possibility of cuts in salary. Psychological intervention programs aimed at stress management would be a recommendable way of helping employees address problems of this kind. PMID:24755024
Amigo, Isaac; Asensio, Elisa; Menéndez, Ignacio; Redondo, Sergio; Ledesma, José A
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 publicsector managed care services. Emphasising theoretically the economic versus non-economic motivations that guide economic behaviour, we extended a long-term research project on publicsector 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
A number of South African cities are planning integrated public transport networks that rely on the introduction of Bus Rapid Transit (BRT), in line with similar trends to expand or upgrade public transport services in emerging and industrialised urban transport markets around the globe. In addition, BRT in South Africa is being used as a mechanism to drive reform in
This paper describes factors affecting health worker motivation and satisfaction in the publicsector in Ghana. The data are from a survey of publicsector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services. PMID:15688876
Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana
Taking an historical view, the paper considers how Japan has struggled to regulate development and examines the impact of land reform in the immediate post-WWII era. This is seen as a key institutional change that precipitated numerous political and policy shifts in subsequent decades and acted as a critical factor in shaping Japanese land use. The focus of the paper
Dominant social, economic, and political philosophies manifested in the recent debate over the University of Costa Rica general studies curriculum reforms are discussed. It is concluded that the debate is really about the university's role in an environment that values privatization, individual (contrasted with social) benefits of higher…
The No Child Left Behind Act declared that improving education in every school in the United States was a top national priority. However, this act did not acknowledge how state departments of education have successfully constructed reforms for the past few decades, despite the power struggle between governors, legislators, school districts, and…
The rediscovery of a role in extending social organization and bringing "order" to distressed neighborhoods has become an educational reform motif in the United States. A full-service school that links education and other support services can contribute to the social capital needed to improve children's learning. While it is a laudable concept,…
This document summarizes the discussions held at a conference of publicsector executives and human resource managers designed to address the problems of attracting and keeping good workers in public service. Presentations made by the governor of Georgia, federal officials, educators, and regional representatives in three plenary sessions…
Researchers have been criticized for applying generic organization and management theories to publicsector organizations on the basis that such theories ignore significant public-private differences. To examine the extent to which generic theories can help us better understand public-private differences, the authors applied a generic leadership theory to both a private and a publicsector organization and found interesting differences
The response of military psychology in times of war or other great public crises may presage the success of the profession in less perilous times. The ability of public-sector psychologists to provide assistance and improve the common welfare during conflict or turmoil is generally followed by an increased demand for psychological services. This…
BACKGROUND: Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private
David H Peters; Subrata Chakraborty; Prasanta Mahapatra; Laura Steinhardt
Corn trade between the European Union (EU) and the United States has undergone substantial changes over the past decade. EU Reforms of the Common Agricultural Policy (CAP), beginning with the Mac Sharry Reforms of 1992 and continuing with the Agenda 2000 Reforms, were directed at bringing EU agricultural policy into compliance with World Trade Organization (WTO) provisions. These reforms have
Although the availability of pharmaceuticals is critical for both curative and preventive health care, drugs are, at best, sporadically available in governmental facilities in sub-Saharan Africa. The religious missions and private sectors are more successful than the publicsector in obtaining and distributing drugs. The publicsector operates under a myriad of constraints inherent in a bureaucracy; the religious missions have the advantages of better management and access to foreign currency; the private sector is innately efficient. Donor assistance to increase the availability of drugs in the publicsector has included support for revolving drug funds, national drug services, the improvement of management techniques, and the local production of pharmaceuticals. None of these interventions has been notably successful. In 1987, UNICEF presented The Bamako Initiative--a proposal to launch an internationally-financed fund for essential drugs for sub-Saharan Africa. However, the proposal is unrealistic in anticipating that the requisite resources and/or hard currency can be raised to support the proposal. As the private sector is a more efficient distributor, it is recommended that the private sector be given responsibility for the distribution of drugs. Nonetheless, some governmental controls will be necessary to ensure that essential drugs are available at the least cost to the consumer. PMID:2756434
Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, publicsector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the publicsector fared consistently lower (P < 0.01). Discordance between what motivational factors health workers considered important and their perceptions of actual presence of these factors were also highest in Uttar Pradesh in the publicsector, where all 17 items had greater discordance for publicsector workers than for workers in the private sector (P < 0.001). Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.
Features comments from Robert L. Hampel, William R. Johnson, Diane Ravitch, and David N. Plank on David Tyack and Larry Cuban's book, "Tinkering toward Utopia: A Century of Public School Reform." The book argues that educational reformers in the 20th century have attempted large-scale systemic reforms instituted from the top down. (MJP)
Studies of public\\/private sector wage differentials typically assume that the govenment and union status of a worker are exogenous variables. Recently, some studies have relaxed this assumption slightly by allowing the union status to be endogenous. In this paper, we consider a more general selection model in which a worker selects among four labor markets: private\\/nonunion, private\\/union, public\\/nonunion and public\\/union.
As an opening of a dialogue on health reforms in Pakistan, the Gateway Paper presents a viewpoint on its proposed directions making a strong case for systems reforms, which need to scope beyond the healthcare system. Positioning the reform process to strengthen Pakistan's health policy cycle, the paper articulates a roadmap for a paradigm shift to achieve health outcomes in Pakistan with major structural reorganization within the health system. The proposed reform points in the four areas namely, reforms within the health sector, overarching measures, reconfiguration of health within an inter-sectoral scope and generating evidence for reforms. Reforms within the health sector focus on developing new models of service delivery and health financing which can enable the state to leverage the private sector outreach to deliver health-related public goods on the one hand and maximize the outreach of the State's health care delivery mechanisms through mainstreaming the role of the private sector on the other, albeit with safeguards. In addition, these call for strengthening the stewardship role to regulate these arrangements. The second area of reform focuses on overarching measures; these include developing frameworks for public-private partnerships which will enable the bringing together of organizations with the mandate to offer public goods and those that could facilitate this goal through the provision of resources, technical expertise or outreach; mainstreaming health into the country's social protection strategy in order to address issues of access and affordability for the poor and introducing civil service and public service reform focused on good governance, accountability, breakdown of institutional corruption which are critical to improving health outcomes. The third area of reform involves broadening health to its inter-sectoral scope, redefinition of objectives and targets within the health sector and garnering support from across the sectors to forester inter-sectoral action particularly with reference to the social determinant of health. The fourth area of reform focuses on generation of evidence around which several priority areas for health systems and policy research have been flagged. The Gateway Paper also underscores the need to develop norms and standards and points to institution mechanisms which need to be created to support the reform process. PMID:17595829
Background Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. Methods We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. Results The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P < 0.05); hypertriglyceridemia, 10.6% (men 12.6%, women 8.7%, P > 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P < 0.05); diabetes, 5.7% (men 5.5%, women 5.9%, P > 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P < 0.05); sedentary lifestyle, 87.2% (men 83.0%, women 91,0%, P < 0.05); and left ventricular hypertrophy, 20% (men 32.0%, women 9.0%; P < 0.05). At least one risk factor was present in 27.7% of the sample; 15.2% had two risk factors, and 31.4% had three or more risk factors. Among the individuals with low socioeconomic status, 41.0% had three or more risk factors. Conclusions The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in Angola. The workers in lower socioeconomic groups had higher incidences of hypertension, smoking, and left ventricular hypertrophy.
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 publicsector 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
The tensions between the administrative reform plans and their impact on effectiveness and legitimation of the politico-administrative system have both theoretically and practically been important and interesting questions in administrative sciences. The aim of this article is firstly to give a comprehensive evaluation summary of the profile and success or failure of the administrative reforms in the 1990's in Finland.
In recent years, both Australia and New Zealand have embarked on significant labor market reforms which have resulted in more\\u000a decentralized and individualized systems of industrial relations. Although both countries share a common heritage of state-sponsored\\u000a conciliation and arbitration, which fostered a centralized approach to labor market regulation, each has responded in its\\u000a own way to economic and political pressures
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…
Bonner, Cameron S.; Herschbach, Dennis R.; Rifkin, Norman
Public administration is incrementally moving on a reform track that leads from responsiveness to collaboration. Attempts to enrich the discussion on the current state of new managerialism in public administration and to explain why and how it makes progress towards higher levels of cooperation and collaboration with various social players such as the private sector, the third sector, and citizens.
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 publicsector 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
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 publicsector 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.
This study was designed to establish the burden of head and neck cancers (HNCA) in publicsector based cancer centres of Pakistan. Data were obtained from the central body governing all the cancer centres in the country. The frequency of treated HNCAs out of the total body cancers treated across Pakistan was found to be 14.5%. Highest prevalence rates amongst all cancers were noted in Sind, notably in Karachi and Jamshoro, followed by Multan in Punjab and a much lower frequency in Peshawar in the North West Frontier Province. This variation presumably reflects levels of betel quid consumption but more data are needed to be gathered in a comprehensive way if the findings are to be applicable for improvement of the national cancer control program. PMID:18990033
Chaudhry, Saima; Khan, Ayyaz Ali; Mirza, Kamran Masood; Iqbal, Hafiz Aamer; Masood, Yasmeen; Khan, Nauman Rauf; Izhar, Faisal
During the second half of the 1970s, the practice of the closed shop became widespread in some parts of the British publicsector, but was resisted in others. This paper examines the issue in relation to the National Health Service, where trade unionists made frequent demands for the closed shop and where many managers were apparently not unwilling to concede it. Yet very few closed shops actually resulted. The paper examines the origin and patterns of these demands, health authority policies towards them, and their outcomes in terms both of the operation of the closed shops which were agreed, and the reasons for failure to agree. The conclusion is that although NHS industrial relations had apparently matured very rapidly between 1973 and 1977, the trade unions were neither strong enough nor united enough to enforce the closed shop; nor were industrial relations so far developed as to make the practice a natural next step. PMID:10302257
Objective To examine in Peru the nature of dual practice (doctors holding two jobs at once – usually publicsector doctors with private practices), the factors that influence individuals' decisions to undertake dual practice, the conditions faced when doing so and the potential role of regulatory intervention in this area. Methods The study entailed qualitative interviews with a sample of twenty medical practitioners based in metropolitan Lima, representing a cross-section of those primarily employed in either the private or publicsectors and engaged in clinical practice or policy making. The interviews focused on: 1. individuals' experience with dual practice; 2. the general underlying pressures that influence the nature and extent of such activities; and 3. attitudes toward, and the influence of, regulation on such activities. Results Dual practice is an activity that is widespread and well-accepted, and the prime personal motivation is financial. However, there are also a number of important broad macroeconomic influences on dual practice particularly the oversupply of medical services, the deregulated nature of this market, and the economic crisis throughout the country, which combine to create major hardships for those attempting to make a living through medical practice. There is some support among doctors for tighter regulation. Conclusion Research findings suggest appropriate policy responses to dual practice involve tighter controls on the supply of medical practitioners; alleviation of financial pressures brought by macro-economic conditions; and closer regulation of such activities to ensure some degree of collective action over quality and the maintenance of professional reputations. Further research into this issue in rural areas is needed to ascertain the geographical generalizability of these policy responses.
National governments are key actors in managing climate variability and change, yet, many countries, faced with exhausted tax bases, high levels of indebtedness and limited donor assistance, have been unable to raise sufficient and timely capital to replace or repair damaged assets and restore livelihoods following major disasters exacerbating the impacts of disaster shocks on poverty and development. For weather extremes, which form a subset of the adaptation challenge and are supposed to increase in intensity and frequency with a changing climate, we conduct an assessment of the costs of managing and financing today's publicsector risks on a global scale for more than 180 countries. A countries financial vulnerability is defined as a function of its financial resilience and its exposure to disaster risk. While disaster risk is estimated in terms of asset loss distributions based on catastrophe modeling approaches, financial resilience is operationalized as the publicsector's ability to pay for relief to the affected population and support the reconstruction of affected assets and infrastructure for a given event. We consider governments financially vulnerable to disasters if they cannot access sufficient funding after a disaster to cover their liabilities. We operationalize this concept by the term resource gap, which we define the net loss associated with a disaster event after exhausting all possible ex-post and ex ante financing sources. Extending this approach for all possible disaster events, the risk that a resource gap will occur over a given time-span can be calculated for each country individually and dependent on the risk level different risk instruments may have to be applied. Furthermore, our estimates may inform decisions pertaining to a "climate insurance fund" absorbing "high level" country risks exceeding the ability of any given country to pay in the case of an extreme event. Our estimates relate to today's climate, yet we suggest that estimates of current climate variability and related risks, although also associated with substantial uncertainty, can be interpreted as a baseline for very uncertain future projections.
Hochrainer-Stigler, Stefan; Mechler, Reinhard; Pflug, Georg; Williges, Keith
This article examines the major political challenges associated with the adoption of health reform proposals, through the experience of one country, the Dominican Republic. The article briefly presents the problems of the health sector in the Dominican Republic, and the health reform efforts that were initiated in 1995. The PolicyMaker method of applied political analysis is described, and the results of its application in the Dominican Republic are presented, including analysis of the policy content of the health reform, and assessment of five key groups of players (publicsector, private sector, unions, political parties, and other non-governmental organizations). The PolicyMaker exercise was conducted in collaboration with the national Office of Technical Coordination (OCT) for health reform, and produced a set of 11 political strategies to promote the health reform effort in the Dominican Republic. These strategies were partially implemented by the OCT, but were insufficient to overcome political obstacles to the reform by late 1997. The conclusion presents six factors that affect the pace and political feasibility of health reform proposals, with examples from the case of the Dominican Republic. PMID:10538715
State governments are influential purchasers of health benefits but have not been studied extensively. In a recent survey of senior benefit managers, we examine the extent to which states have followed the private-sector approach to purchasing health care. We found that states have adopted "industrial purchasing" practices similar to those of large private employers but offer greater choice of carriers and pay a higher percentage of premiums. Unions continue to influence health care purchasing in both the public and private sectors. Double-digit increases in health costs and the current budget crisis may force states to align their purchasing practices with the private sector to cut costs. PMID:15046142
This paper examines the work of the education inspectorates in England and Wales. It specifically addresses the inspectorates' articulation in the Labour Party's general policy shift toward standards-driven reform. The text states that the school inspectorates have been cast as uniquely powerful regulatory agencies within the publicsector and are…
This paper distinguishes two pathways in the various proposals for innovative reforms of publicsector 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…
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…
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
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.
Zoonoses of public health significance may occur in wildlife, livestock or companion animals, and may be detected by the human or animal health sectors. Of particular public health interest are foodborne, arboviral and emerging zoonoses (known/unknown, endemic/exotic). A coordinated One Health approach to the management of zoonoses in NSW uses measures including: mutually agreed intersectoral procedures for detection and response; surveillance and notification systems for defined endemic and exotic diseases; joint meetings and exercises to ensure currency of response plans; and intersectoral communication during a response. This One Health approach is effective and ensures the interests of both the human health and animal health sectors are addressed. PMID:21781617
This article presents findings from three opinion surveys conducted among representative samples of Mexico City residents: the first one immediately prior to the groundbreaking legalization of first-trimester abortion in April 2007, and one and two years after the reform. Bivariate and multivariate analyses were performed to assess changes in opinion concerning abortion and correlates of favorable opinion following reform. In 2009 a clear majority (74 percent) of respondents were in support of the Mexico City law allowing for elective first-trimester abortion, compared with 63 percent in 2008 and 38 percent in 2007. A significant increase in support for extending the law to the rest of Mexico was found: from 51 percent in 2007 to 70 percent in 2008 and 83 percent in 2009. In 2008 the significant independent correlates of support for the Mexico City law were education, infrequent religious service attendance, sex (being male), and political party affiliation; in 2009 they were education beyond high school, infrequent religious service attendance, and ever having been married. PMID:21972670
Wilson, Kate S; García, Sandra G; Díaz Olavarrieta, Claudia; Villalobos-Hernández, Aremis; Rodríguez, Jorge Valencia; Smith, Patricio Sanhueza; Burks, Courtney
This article discusses the empirical study of reform in the human resource management function in the Hong Kong Hospital Authority. It describes the prior management of the hospitals based on the civil service administration model before looking at management reform in general. From this research, the creative tensions between the centrifugal and centripetal forces in the pursuit of 'effectiveness', 'efficiency' and 'economy' are explored in terms of decentralization. A survey of line managers, in eleven Hospital Authority hospitals, revealed the progress of decentralization: a majority of respondents felt that, over the previous five years, managers at their level had been given greater responsibility for human resource management issues. In spite of the widespread perception of increased decentralization, however, it was recognized that there are limits to decentralization. It was the routine administration rather than the policy formulation and interpretation which had been decentralized, and hospitals continued to rely on the Hospital Authority Head of Office for guidance on policy interpretation. Several barriers to the effective decentralization of responsibility for human resource management were identified, including a lack of management skill, knowledge and time, the attitudes of some managers and the tight control of budget. PMID:10351677
Background Continued inequities in coverage, low quality of care, and high out-of-pocket expenses for health services threaten attainment of Millennium Development Goals 4 and 5 in many sub-Saharan African countries. Existing health systems largely rely on input-based supply mechanisms that have a poor track record meeting the reproductive health needs of low-income and underserved segments of national populations. As a result, there is increased interest in and experimentation with results-based mechanisms like supply-side performance incentives to providers and demand-side vouchers that place purchasing power in the hands of low-income consumers to improve uptake of facility services and reduce the burden of out-of-pocket expenditures. This paper describes a reproductive health voucher program that contracts private facilities in Uganda and explores the policy and implementation issues associated with expansion of the program to include publicsector facilities. Methods Data presented here describes the results of interviews of six district health officers and four health facility managers purposefully selected from seven districts with the voucher program in southwestern Uganda. Interviews were transcribed and organized thematically, barriers to seeking RH care were identified, and how to address the barriers in a context where voucher coverage is incomplete as well as opportunities and challenges for expanding the program by involving publicsector facilities were investigated. Results The findings show that access to sexual and reproductive health services in southwestern Uganda is constrained by both facility and individual level factors which can be addressed by inclusion of the public facilities in the program. This will widen the geographical reach of facilities for potential clients, effectively addressing distance related barriers to access of health care services. Further, intensifying ongoing health education, continuous monitoring and evaluation, and integrating the voucher program with other services is likely to address some of the barriers. The publicsector facilities were also seen as being well positioned to provide voucher services because of their countrywide reach, enhanced infrastructure, and referral networks. The voucher program also has the potential to address publicsector constraints such as understaffing and supply shortages. Conclusions Accrediting public facilities has the potential to increase voucher program coverage by reaching a wider pool of poor mothers, shortening distance to service, strengthening linkages between public and private sectors through public-private partnerships and referral systems as well as ensuring the awareness and buy-in of policy makers, which is crucial for mobilization of resources to support the sustainability of the programs. Specifically, identifying policy champions and consulting with key policy sectors is key to the successful inclusion of the publicsector into the voucher program.
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 publicsector (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 publicsectors.
The wide-ranging changes that have occurred in the publicsector 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
Andrew Noblet; Stephen T. T. Teo; John McWilliams; John J. Rodwell
This paper analyzes the process of Korea's recovery from the 1997 financial crisis with several policy implications. The driving force behind the better?than?expected economic recovery was the reform measures introduced by the Korean government in four major areas such as the financial, corporate, labor and publicsectors. Also, Korea's strong export performance helped by the booming U.S. economy provided a
This report summarizes a study of Americans' attitudes toward teaching, educational opportunity, and school reform. Surveys of 2,501 adults nationwide indicate that Americans unequivocally support the guarantee of free public education and consider improvement in fundamental areas of student behavior and academic performance essential. Greater…
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
Lawrence O. Gostin; Peter D. Jacobson; Katherine L. Record; Lorian E. Hardcastle
"Between Public and Private" examines an innovative approach to school district management that has been adopted by a number of urban districts in recent years: a portfolio management model, in which "a central office oversees a portfolio of schools offering diverse organizational and curricular themes, including traditional public schools,…
Bulkley, Katrina E., Ed.; Henig, Jeffrey R., Ed.; Levin, Henry M., Ed.
The public pension scheme has been an important element of the successful model of 'Rhenish Capitalism' (social market economy) in post-war Germany. On the one hand, the promise to guarantee status maintenance during retirement sustained the incentives of the labor market in that it promoted individual effort and mobility. On the other hand, the public pension scheme definitely contributed to
Background: The patient’s personality may be one of the many factors that contribute to the decision to initiate a certain treatment for depression. The aim of this study was to examine whether dispositional optimism and pessimism play a role in the initiation of psychotherapy as the treatment for new-onset depression in previously nondepressed publicsector employees. Methods: This prospective observational
Hasse Karlsson; Kim Kronström; Hermann Nabi; Tuula Oksanen; Paula Salo; Marianna Virtanen; Sakari Suominen; Mika Kivimäki; Jussi Vahtera
This article presents research findings into the effectiveness of an innovative equity fund approach to improving access to publicsector health services for the poor in Kirivong Operational Health District in Cambodia. The operational health district is the lowest organizational level in the Cambodian health system, providing services through health centres and a single referral hospital. An equity fund involves
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 publicsector service delivery across diverse long term care (LTC) and primary care…
Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.
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.
The public healthcare sector in developing countries face many challenges, including weak healthcare systems and under resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Healthcare delivery, access to healthcare and cost containment has the potential for improvement through more efficient healthcare resource management. Global references demonstrate that information technology (IT) has the ability to assist in this
The objective of this study is to find out the contribution of various cultural variables on the organizational commitment. Data were collected from the publicsector units located in the eastern part of India. Analysis of data revealed strong relationship between culture of the organization and commitment of employees. The antecedents of culture were then examined in relation to the
This qualitative study looks at the leadership perceptions and practices of career professionals in the publicsector across three countries of sub-Saharan Africa (Ethiopia, Ghana and Madagascar). All participants were alumni of the Humphrey Fellowship program, a year-long mid-career fellowship in the United States for professional development and…
BACKGROUND: In Uganda, long-lasting insecticidal nets (LLIN) have been predominantly delivered through two publicsector 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
Jan H Kolaczinski; Kate Kolaczinski; Daniel Kyabayinze; Daniel Strachan; Matilda Temperley; Nayantara Wijayanandana; Albert Kilian
This report examines selected publicsector direct job creation schemes that were in operation in 1977-1978 in Canada, Denmark, Norway, the United Kingdom, and the United States. Based on responses to a questionnaire and discussions with officials in the five countries, the information presented in the report is not intended to evaluate any one…
Organisation for Economic Cooperation and Development, Paris (France).
This paper examines the relationship between policy and politics in relation to the development of public-sector primary education through Breton and Gaelic, considering closely the patterns of power through which such provision is delivered. Brittany and Scotland present many similarities as culturally distinctive territories, contained within…
Discusses constitutional limitations on public-sector collective bargaining that incorporates exclusive representation and relates the issue to fundamental tenets of individual liberty and representative government. Illustrates the issue with an Indiana case to be appealed before the U.S. Supreme Court, "Perry Education Association v. Perry Local…
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 publicsector. 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 publicsector. Schools provide an especially rich environment for studying the…
Branch, Gregory F.; Hanushek, Eric A.; Rivkin, Steven G.
The ability of an organisation to recognise the value of new external information, acquire it, assimilate it, transform, and exploit it, namely its absorptive capacity (AC), has been much researched in the context of commercial organisations and even applied to national innovation. This paper considers four key AC-related concepts and their relevance to publicsector organisations with mandates to manage and conserve freshwater ecosystems for the common good. The concepts are the importance of in-house prior related knowledge, the importance of informal knowledge transfer, the need for motivation and intensity of effort, and the importance of gatekeepers. These concepts are used to synthesise guidance for a way forward in respect of such freshwater management and conservation, using the imminent release of a specific scientific conservation planning and management tool in South Africa as a case study. The tool comprises a comprehensive series of maps that depict national freshwater ecosystem priority areas for South Africa. Insights for implementing agencies relate to maintaining an internal science, rather than research capacity; making unpublished and especially tacit knowledge available through informal knowledge transfer; not underestimating the importance of intensity of effort required to create AC, driven by focussed motivation; and the potential use of a gatekeeper at national level (external to the implementing organisations), possibly playing a more general `bridging' role, and multiple internal (organisational) gatekeepers playing the more limited role of `knowledge translators'. The role of AC as a unifying framework is also proposed.
Murray, K.; Roux, D. J.; Nel, J. L.; Driver, A.; Freimund, W.
Several important ethical dilemmas emerge when nurses join a public-sector strike. Such industrial action is commonplace in South Africa and was most notably illustrated by a national wage negotiation in 2010. Media coverage of the proceedings suggested unethical behaviour on the part of nurses, and further exploration is merited. Laws, policies and provisional codes are meant to guide nurses' behaviour during industrial action, while ethical theories can be used to further illuminate the role of nurses in industrial action. There are, however, important aspects to consider before judging whether nurses act unethically when striking. Following Loewy's suggestion that the nature of the work, the proceeding commitment of the nurse to the patient, the prevailing situation when the strike is planned and the person(s) who stand(s) to benefit from the strike be considered, coupled with a consideration of the South African historical socio-political context, important aspects of the ethics of nurses' behaviour in industrial action transpire. PMID:23454981
An analysis of the public health conditions in Ukraine reveals an unsatisfactory medico-demographic situation which is characterized by a low birth rate a relatively high mortality rate, a negative population growth, a reduction of the expected human life...
Background In the rapid scale-up of human immunodeficiency virus (HIV) care and acquired immunodeficiency syndrome (AIDS) treatment, many donors have chosen to channel their funds to non-governmental organizations and other private partners rather than publicsector systems. This approach has reinforced a private sector, vertical approach to addressing the HIV epidemic. As progress on stemming the epidemic has stalled in some areas, there is a growing recognition that overall health system strengthening, including health workforce development, will be essential to meet AIDS treatment goals. Mozambique has experienced an especially dramatic increase in disease-specific support over the last eight years. We explored the perspectives and experiences of key Mozambican publicsector health managers who coordinate, implement, and manage the myriad donor-driven projects and agencies. Methods Over a four-month period, we conducted 41 individual qualitative interviews with key Ministry workers at three levels in the Mozambique national health system, using open-ended semi-structured interview guides. We also reviewed planning documents. Results All respondents emphasized the value and importance of international aid and vertical funding to the health sector and each highlighted program successes that were made possible by recent increased aid flows. However, three serious concerns emerged: 1) difficulties coordinating external resources and challenges to local control over the use of resources channeled to international private organizations; 2) inequalities created within the health system produced by vertical funds channeled to specific services while other sectors remain under-resourced; and 3) the exodus of health workers from the publicsector health system provoked by large disparities in salaries and work. Conclusions The Ministry of Health attempted to coordinate aid by implementing a “sector-wide approach” to bring the partners together in setting priorities, harmonizing planning, and coordinating support. Only 14% of overall health sector funding was channeled through this coordinating process by 2008, however. The vertical approach starved the Ministry of support for its administrative functions. The exodus of health workers from the publicsector to international and private organizations emerged as the issue of greatest concern to the managers and health workers interviewed. Few studies have addressed the growing phenomenon of “internal brain drain” in Africa which proved to be of greater concern to Mozambique’s health managers.
Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between publicsector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas. PMID:24248622
Levy, Jessica K; Curtis, Sian; Zimmer, Catherine; Speizer, Ilene S
In most Westminster governments the essential characteristics of central government audit can be traced to the British Exchequer and Audit Act 1866. The Act was the pinnacle of government finance and accountability reforms implemented in the middle decades of the nineteenth century which were motivated by the need both to control and reduce government spending. The well-recognised Victorian affection for
This report reviews the mathematics program of Miami-Dade public schools in grades 5 through 8 and provides recommendations about how technology might be used to improve learning opportunities for students. The main conclusion of the study and the conceptual foundation for all the conclusions and recommendations is that technology use must be…
Taking advantage of newly available data on a standardized national examination for secondary school students in Thailand, this study attempts to explain the variation in the average performance of students using school and local characteristics. Special emphasis is placed on trying to understand the asymmetric success factors of public and…
Abstract. From the formal point of view, in Romania there is an institutional framework that has looked favourable for operation in at least satisfa ctory conditions for the authorities at the politic al level and at the level of public administration . In fact, th ings are different, and Romanians have to admit tha t the signals from EU authorities
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…
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.…
Both academics and practitioners have disagreed among themselves about whether and to what extent the developed world is witnessing a convergence in the forms of public management. Some of this disagreement may be attributed to the formidable empirical problems facing those who wish to make global or near-global generalizations. To a considerable extent, however, the divergences of view may be
Background: Associations between traffic noise and sleep problems have been detected in experimental studies, but population-level evidence is scarce. Objectives: We studied the relationship between the levels of nighttime traffic noise and sleep disturbances and identified vulnerable population groups. Methods: Noise levels of nighttime–outdoor traffic were modeled based on the traffic intensities in the cities of Helsinki and Vantaa, Finland. In these cities, 7,019 publicsector employees (81% women) responded to postal surveys on sleep and health. We linked modeled outdoor noise levels to the residences of the employees who responded to the postal survey. We used logistic regression models to estimate associations of noise levels with subjectively assessed duration of sleep and symptoms of insomnia (i.e., difficulties falling asleep, waking up frequently during the night, waking up too early in the morning, nonrestorative sleep). We also used stratified models to investigate the possibility of vulnerable subgroups. Results: For the total study population, exposure to levels of nighttime–outside (Lnight, outside) traffic noise > 55 dB was associated with any insomnia symptom ? 2 nights per week [odds ratio (OR) = 1.32; 95% confidence interval (CI): 1.05, 1.65]. Among participants with higher trait anxiety scores, which we hypothesized were a proxy for noise sensitivity, the ORs for any insomnia symptom at exposures to Lnight, outside traffic noises 50.1–55 dB and > 55 dB versus ? 45 dB were 1.34 (95% CI: 1.00, 1.80) and 1.61 (95% CI: 1.07, 2.42), respectively. Conclusions: Nighttime traffic noise levels > 50 dB Lnight, outside was associated with insomnia symptoms among persons with higher scores for trait anxiety. For the total study population, Lnight, outside > 55 dB was positively associated with any symptoms.
Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling.
In 2005, the Task Force on Charter School Quality and Accountability issued "Renewing the Compact," a position statement for the charter school sector that presented recommendations for achieving the goals of growth and quality. This report evaluates the sector's progress on those goals and recommends bold actions to capitalize on its successes…
Ableidinger, Joe; Steiner, Lucy; Spong, Angie; Hassel, Bryan C.
Abstract An urgent priority for European third sector research in the context of the dynamics,of European integration should be to ,examine ,the emergence ,of ‘horizontal’ European policy towards the third, voluntary, nonprofit sector understood as a multi-level process involving nations and supranational institutions. This should involve identifying and conceptualising the parameters, concepts and processes needed to build a relevant policy
This 260-page document from the Australian Productivity Commission details the proceedings of the Microeconomic Reform and the Environment, which took place on September 8, 2000 in Melbourne, Australia. The main body of the report is broken into four main sections, each dealing with a different sector of the environment: the water sector, the electricity sector, the transport sector, and the forest sector. Each section includes a short introduction to the main issues of each sector and the related workshop presentation summary. In some cases, discussions are also given. A short summary and epilogue wrap up Microeconomic Reform and the Environment.
Significant market-oriented reforms carried out in China have brought tremendous changes in the real sector. However, the reform of the financial sector has lagged that of the real sector. The weakness of the financial sector and the alarm of the Asian fi...
This study evaluated the Michigan Department of Education Comprehensive School Reform Demonstration (CSRD) Grant Funded Reform Demonstration Program, which helps raise student achievement in the Detroit Public Schools. The four objectives evaluated were: CSRD schools will demonstrate differences in the classroom learning environment compared to…
Thomas, Regina; Woods, Paul; Hillman, Stephen; Ross, Steven M.
It is generally accepted that the first recorded outbreaks of foot and mouth disease (FMD) in South America occurred around 1870. The disease emerged almost simultaneously in the province of Buenos Aires (Argentina), in the central region of Chile, in Uruguay and in southern Brazil, due to the introduction of livestock from Europe. Argentina set up an agency for the control and eradication of FMD in 1961, Brazil began disease-control activities in Rio Grande do Sul in 1965, Paraguay and Uruguay initiated similar programmes in 1967, Chile in 1970 and Colombia in 1972. A common characteristic was observed in all early national FMD programmes, namely, they were developed, financed, operated and evaluated by the publicsector, without major participation from the private sector, except when buying vaccines and abiding by the regulations. In 1987, the Hemispheric Foot and Mouth Disease Eradication Plan (PHEFA: Plan Hemisférico para la Erradicación de la Fiebre Aftosa) was launched and the private sector played a prominent role in achieving the eradication and control of FMD in several countries. However, this model of co-participation between the public and private sectors has suffered setbacks and a new approach is being developed to find ways in which local structures and activities can be self-sustaining. PMID:15884587
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
Introduction In order to assess the health outcomes of the South African publicsector antiretroviral treatment (ART) programme, it is important to gain a better understanding of the complex relationship between ART and the multidimensional construct quality of life (QoL). Because of the gap between supply and demand, equity issues arise concerning the provisioning of ART.\\u000d\\u000aObjective The aim of
Edwin Wouters; Herman Meulemans; H. C. J. Van Rensburg; J. C. Heunis; Dimitri Mortelmans
An environmental scan project is outlined and discussed using the viable systems model (VSM). A participant\\/observer perspective\\u000a applied futures thinking, systems practice, scenario orientated narratives and risk assessment frameworks to an annual corporate\\u000a planning process involving engagement and communication with senior publicsector executives. Focus was given to improving\\u000a foresight techniques through the innovative use of existing resources and skills.
Henry Ingersoll Bowditch, a Bostonian physician from the mid-19th century, lived a passionate life full of commitment and devotion to various noble causes--he was a champion of public health, an advocate for inclusion of women in medicine and a staunch abolitionist, all unpopular social perspectives at that time in medical and political history. Seemingly difficult personality traits including his stubbornness and moralistic outlook were likely 'adaptive' as he confronted the political reality of major institutional change. His interest in statistical trends and environmental influences and his inductive reasoning led to a deeper understanding of consumption (tuberculosis), the widespread diagnostic use of the stethoscope and thoracocentesis. PMID:22319186
In the last twenty years most African Governments have embarked on health sectorreforms sponsored by international partners. Conceived under New Public Management, the majority of these reforms leverage information technology to decentralise hierarchical structures into more information efficient organizations. The paper illustrates the case study of health management information systems in Kenya in order to better understand how the
Background Obesity and overweight are suggested to increase the risk of occupational injury but longitudinal evidence to confirm this is rare. We sought to evaluate obesity and overweight as risk factors for occupational injuries. Methodology/Principal Findings A total of 69,515 publicsector employees (80% women) responded to a survey in 2000–2002, 2004 or 2008. Body mass index (kg/m2) was derived from self-reported height and weight and was linked to records of subsequent occupational injuries obtained from national registers. Different injury types, locations and events or exposures (the manner in which the injury was produced or inflicted) were analyzed by body mass index category adjusting for baseline socio-demographic characteristics, work characteristics, health-risk behaviors, physical and mental health, insomnia symptoms, and sleep duration. During the mean follow-up of 7.8 years (SD?=?3.2), 18% of the employees (N?=?12,204) recorded at least one occupational injury. Obesity was associated with a higher overall risk of occupational injury; multivariable adjusted hazard ratio (HR) 1.21 (95% CI 1.14–1.27). A relationship was observed for bone fractures (HR?=?1.37; 95% CI: 1.10–1.70), dislocations, sprains and strains (HR?=?1.36; 95% CI: 1.25–1.49), concussions and internal injuries (HR?=?1.26; 95% CI: 1.11–1.44), injuries to lower extremities (HR?=?1.62; 95%: 1.46–1.79) and injuries to whole body or multiple sites (HR?=?1.37; 95%: 1.10–1.70). Furthermore, obesity was associated with a higher risk of injuries caused by slipping, tripping, stumbling and falling (HR?=?1.55; 95% CI: 1.40–1.73), sudden body movement with or without physical stress (HR?=?1.24; 95% CI: 1.10–1.41) and shock, fright, violence, aggression, threat or unexpected presence (HR?=?1.33; 95% CI: 1.03–1.72). The magnitude of the associations between overweight and injuries was smaller, but the associations were generally in the same direction as those of obesity. Conclusions/Significance Obese employees record more occupational injuries than those with recommended healthy weight.
Kouvonen, Anne; Kivimaki, Mika; Oksanen, Tuula; Pentti, Jaana; De Vogli, Roberto; Virtanen, Marianna; Vahtera, Jussi
The paper surveys and illustrates various analytical methods for assisting the capital investment decision process. Attention is limited to capital investments made by firms--referred to collectively as the private sector--and those made by governmental o...
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…
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…
Econometric estimates were used to determine the effects of publicly funded continuous vocational training and retraining in the former East Germany. Results suggest that, despite large public expenditures, no positive effects occurred in the first years after training. (SK)
Who are the targets of welfare reform? How should welfare be reformed? How are the issues of reforming welfare and the national interest in investing in children related, ideologically and strategically? This article sheds light on these questions by discussing the poverty status of female-headed families with children, the impact of public income transfers on reducing the poverty rate of
A study examined the knowledge and job skills required of persons employed in air pollution control (APC)-related occupations in Italy's public service sector. First, Italian legislation on APC and the functions/powers of Italy's public agencies responsible for APC were reviewed. The organization/operation of the public structures involved in…
The debate over constitutional reform has moved to center stage in Taiwan, with a focus on two issues: the choice of presidential versus parliamentary government and a determination of the ultimate role of the National Assembly.
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 publicsector 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 publicsector 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
Gething, Peter W.; Kirui, Viola C.; Alegana, Victor A.; Okiro, Emelda A.; Noor, Abdisalan M.; Snow, Robert W.
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.…
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
This paper presents the findings on the envelope designs and building services provisions of 41 office buildings built from the 1950s to 1990s in the government sector. The thermal performance (in terms of the overall thermal transfer values) of this building stock was surveyed and analysed. General design features, such as appearances and orientations of the buildings, building materials used
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,
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 publicsector 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 publicsector 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.
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.
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…
Fernandez, Sergio; Smith, Craig R.; Wenger, Jeffrey B.
Background: Regular physical activity has been demonstrated to protect against coronary heart disease, Type 2 diabetes mellitus, selected cancers, hypertension, obesity, and other chronic conditions. Therefore, the public health significance of promoting physical activity and preventing inactivity has become a well-established agenda for public health agencies at all levels. Methods: A secondary search of the literature, focusing on existing evidence
This paper analyses the role of public-private partnerships (PPPs) for infrastructure development in the new EU member states and candidate countries in Central and Eastern Europe. We survey projects in transport, water, energy, and telecommunications sectors and then focus on the highway sector. Based on theoretical considerations and extensive fieldwork in Hungary, Poland, Croatia, and the Czech Republic, we find
Andreas Brenck; Thorsten Beckers; Maria Heinrich; Christian von Hirschhausen
The bulletin discusses the impact of both Federal and State laws on publicsector labor relations which differ from those in the private sector in that they are newer, governed by a greater variety of law, and affected by different social and economic for...
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…
This report was undertaken to assess the state of civic capacity for education reform in Philadelphia. It challenges community and civic sectors of the city to put aside individual interests and work together to mobilize resources to pursue the collective good of public school improvement. The report demonstrates that many of the elements…
Gold, Eva; Simon, Elaine; Cucchiara, Maia; Mitchell, Cecily; Riffer, Morgan
Science has a critical role to play in addressing humanity's most important challenges in the twenty-first century. However, the contemporary scientific enterprise has developed in ways that prevent it from reaching maximum effectiveness and detract from the appeal of a research career. To be effective, the methodological and culture reforms discussed in the accompanying essay must be accompanied by fundamental structural reforms that include a renewed vigorous societal investment in science and scientists. PMID:22184420
Science has a critical role to play in addressing humanity's most important challenges in the twenty-first century. However, the contemporary scientific enterprise has developed in ways that prevent it from reaching maximum effectiveness and detract from the appeal of a research career. To be effective, the methodological and culture reforms discussed in the accompanying essay must be accompanied by fundamental structural reforms that include a renewed vigorous societal investment in science and scientists.
This booklet contains four selected conference papers on educational reform and restructuring. In "Can Rational Organization Models Really Reform Anything? A Case Study of Reform in Chicago," Fenwick English describes reform efforts in the Chicago Public Schools and examines the political, social, organizational, and bureaucratic factors that have…
The results achieved during the first eight months of a program to transfer LANDSAT technology to practicing professionals in the private and publicsectors (grass roots) through community colleges and other locally available institutions are reported. The approach offers hands-on interactive analysis training and demonstrations through the use of color desktop computer terminals communicating with a host computer by telephone lines. The features of the terminals and associated training materials are reviewed together with plans for their use in training and demonstration projects.
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
Barata, Martha Macedo de Lima; Kligerman, Débora Cynamon; Minayo-Gomez, Carlos
Market models of education reform predict that the growth of charter schools will infuse competition into the public school sector, forcing traditional public schools to improve the practices they engage in to educate students. Some scholars have criticized these models, arguing that competition from charter schools is unlikely to produce…
University governance reforms are very much a reflection of the broader New Public Management reforms that are focusing on increasing efficiency in public organizations. The article deals with how university reform ideas of a generic nature, emphasizing that universities should be treated and reformed like any other public organizations, are…
Four decades of educational reform efforts from the nineteen sixties have not significantly improved our schools. It is believed that in the equation of educational reform, leadership and power in educational reform have mitigated against educational reform through the misapplicaiton of examination and accountability. A major subset of the field on public administration is accountability. Accountability is widely used in government although the concept is loosely defined. Most often it is used to express public frustration, to call for control, and to transmit a range of political agendas. Any accountability framework originates from the American model of shared powers between independent governmental bodies. It allows for institutions to depend on and accommodate other institutions. Accountability assumes that individuals or agencies may hold accountable for their performance. This assumes that there is a unidirectional flow of power and influence between a controlling partner and a controlled partner. This assumption is false. Individual administrators are exposed to the authority and persuasion within a democratic framework. Educators are also confronted with control mechanisms that are rooted in the organizational and professional standards and disciplinary standards regardless of whether any democratic controls are evoked. Accountability relationships have the potential to become quite complicated. Performance evaluation is significant to every accountability relationship. In the publicsector, the citizens hold government accountable and the idea of performance evaluation is relative at best, however, in education the use of examination for accountability allows for the misapplication of the exam and affects education reform in negative ways.
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.
This paper has two purposes. The first is to draw attention to the multiple ways in which the term public participation is used in development discourse, and to the cross-purpose sorts of discussions that so often ensue. The second is to exhume the functi...
This paper uses mixed methods to examine the impact of New Public Management (NPM) on publicsector nurses’ perceptions of workplace autonomy and, in turn, their job satisfaction. The quantitative findings of this study suggest that nurses’ perception of autonomy does moderate their job satisfaction. The qualitative findings suggest that the implementation of NPM has negatively affected nurses’ experiences of