This article considers some of the effects of health sector reform 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 public sector. 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 public sector, because the public sector 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 public sector, 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
Franco, Lynne Miller; Bennett, Sara; Kanfer, Ruth
Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc. The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health sector reform can positively affect worker motivation. Among others, health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding that reforms may have differential impacts on various cadres of health workers. PMID:11989961
This article considers some of the effects of health sector reform 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
Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie
Although many governments are assuming the responsibility of initiating adaptation policy in relation to climate change, the compatibility of "governance-for-adaptation" with the current paradigms of public administration has generally been overlooked. Over the last several decades, countries around the globe have embraced variants of the philosophy of administration broadly called "New Public Management" (NPM) in an effort to improve administrative efficiencies and the provision of public services. Using evidence from a case study of reforms in the building sector in Norway, and a case study of water and flood risk management in central Mexico, we analyze the implications of the adoption of the tenets of NPM for adaptive capacity. Our cases illustrate that some of the key attributes associated with governance for adaptation--namely, technical and financial capacities; institutional memory, learning and knowledge; and participation and accountability--have been eroded by NPM reforms. Despite improvements in specific operational tasks of the public sector in each case, we show that the success of NPM reforms presumes the existence of core elements of governance that have often been found lacking, including solid institutional frameworks and accountability. Our analysis illustrates the importance of considering both longer-term adaptive capacities and short-term efficiency goals in public sector administration reform. PMID:21229245
This paper analyses changes in university management structures and practices as a response to public sector reforms in Ugandan higher education using Makerere University as a case study. The study uses the organisational learning theory and a review of the higher education literature. Two adaptive responses in the management structures and…
Jensen, Christian; Johansson, Staffan; Löfström, Mikael
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 public sector, 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
Oborn, Eivor; Barrett, Michael; Exworthy, Mark
The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform. PMID:22069793
Stoddard, Christiana; Kuhn, Peter
Beyond some contracted minimum, salaried workers' hours are largely chosen at the worker's discretion and should respond to the strength of contract incentives. Accordingly, we consider the response of teacher hours to accountability and school choice laws introduced in US public schools over the past two decades. Total weekly hours of full-time…
The health care system in Pakistan is beset with numerous problems--structural fragmentation, gender insensitivity, resource scarcity, inefficiency and lack of functional specificity and accessibility. Faced with a precarious economic situation characterized by heavy external debt and faltering productivity, Pakistan's room to maneuver with health sector reform is quite limited. Although the recently announced Devolution Plan provides a window of opportunity, it must go beyond and introduce far-reaching changes in the health and social sectors. Regionalization of health care services in an integrated manner with functional specificity for each level of care is an essential step. Integration of current vertical programs within the framework of a need-based comprehensive primary health care system is another necessary step. Most importantly, fostering a public-private partnership to share the cost of basic primary health care and public health services must be an integral part of any reform. Pakistan must also make the health care system more gender sensitive through appropriate training programs for the service providers along with wide community participation in decision-making processes. Relevant WHO/World Bank/UNDP developed tools could be extremely useful in this respect. The article is based on a critical analysis of secondary data from the public domain as well as from various research projects undertaken by the Aga Khan University. It also draws from the experiences of health sector reform carried out in other countries, particularly those in the Asia-Pacific region. The purpose is to inform and hopefully influence, public policy as the country moves towards devolution. PMID:12174483
In November 2002 the World Bank published a report on the Argentine health sector. The report accurately portrays the complexity and severity of the problems facing the health care system. It stresses that these problems are not purely a product of the country's economic collapse, noting that the system has suffered from long-standing structural problems and inefficiencies. Curiously, the report makes no mention of the leading role played by the World Bank in health reform efforts during the 1990s. This paper demonstrates that these reforms did much to worsen pre-existing weaknesses of the sector. The paper criticises the content of the reform agenda and the manner in which it was produced, arguing that these were reforms in which considerations of public health were less significant than conformity to the wider model of neo-liberal social and economic development prevailing at the time. It also highlights problems of implementing the reform agenda, which reduced the coherency of the reforms. The paper goes on to examine the impact of the crisis, noting links with the preceding reforms. It identifies a number of insights and lessons of potential value to other countries which are pursuing similar policies. PMID:15686819
Organisation for Economic Cooperation and Development, Paris (France).
This report synthesizes the findings from several areas of work undertaken to assess what impact public sector employment has had on both the level and structure of employment. It also examines the impact of the public sector as employer on the labor market from two viewpoints: the level and share of public sector employment and the structure of…
Wilson, George; Roscigno, Vincent J.; Huffman, Matt L.
New "governance" reforms entailing shifts toward privatization have permeated the public sector over the last decade, possibly affecting workplace-based attainments. We examine the consequences of this reform for African American men, who during the civil rights era reached relative parity with whites. We analyze race-based inequities on one…
Gore, Christopher David
In 2007, Uganda had one of the lowest levels of access to electricity in the world. Given the influence of multilateral and bilateral agencies in Uganda; the strong international reputation and domestic influence of its President; the country's historic achievements in public sector and economic reform; and the intimate connection between economic performance, social well-being and access to electricity, the problems with Uganda's electricity sector have proven deeply frustrating and, indeed, puzzling. Following increased scholarly attention to the relationship between political change, policymaking, and public sector reform in sub-Saharan Africa and the developing world generally, this thesis examines the multilevel politics of Uganda's electricity sector reform process. This study contends that explanations for Uganda's electricity sector reform problems generally, and hydroelectric dam construction efforts specifically, must move beyond technical and financial factors. Problems in this sector have also been the result of a model of reform (promoted by the World Bank) that failed adequately to account for the character of political change. Indeed, the model of reform that was promoted and implemented was risky and it was deeply antagonistic to domestic and international civil society organizations. In addition, it was presented as a linear, technical, apolitical exercise. Finally the model was inconsistent with key principles the Bank itself, and public policy literature generally, suggest are needed for success. Based on this analysis, the thesis contends that policymaking and reform must be understood as deeply political processes, which not only define access to services, but also participation in, and exclusion from, national debates. Future approaches to reform and policymaking must anticipate the complex, multilevel, non-linear character of 'second-generation' policy issues like electricity, and the political and institutional capacity needed to increase the potential for success. At the heart of this approach is a need to carefully consider how the character of state-society relations in the country---"governance"---will influence reform processes and outcomes.
Puech, Paloma; Pitcho, Benjamin
The French Labour Code, which provides full protection against moral and sexual harassment, is not applicable to public sector workers. The public hospital is however not exempt from such behaviour, which could go unpunished. Public sector workers are therefore protected by the French General Civil Service Regulations and the penal code. PMID:23865250
The March 2000 pension reform in Japan focused on the long-term financial sustainability of the country's two-tiered public pension system. The government opted for incremental changes in order to maintain pension solvency through 2060. Those changes could reduce future pension funding liability by an estimated one-third. Further, the decision to avoid structural reforms of its pension programs was based on fiscal considerations. Expanding general revenue funding for the first tier from the current share of one-third to cover the entire cost would require increases in the consumption tax that proved to be politically unacceptable. Fully privatizing the second, earnings-related tier would entail transition costs too great to bear at a time of rising budget deficits. In addition, the Japanese public generally supported the sharing of financial burden for public pension programs through a combination of benefit cuts, a raise in the pensionable age, and contribution rate increases. If current cost projections prove to be inaccurate, future pension reviews (scheduled every 5 years) will give the government further opportunity to fine-tune program changes. PMID:11641992
This case study examines why public-sector reform in education often fails to deliver expected performance gains. Longitudinal evidence from a secondary comprehensive located in a former coalfield is used to identify constraints that frustrate government policies. Although the head and senior staff at Norcross School adopted transformational,…
Langer, A.; Nigenda, G.; Catino, J.
Many countries in Latin America and the Caribbean (LAC) are currently reforming their national health sectors and also implementing a comprehensive approach to reproductive health care. Three regional workshops to explore how health sector reform could improve reproductive health services have revealed the inherently complex, competing, and political nature of health sector reform and reproductive health. The objectives of reproductive health care can run parallel to those of health sector reform in that both are concerned with promoting equitable access to high quality care by means of integrated approaches to primary health care, and by the involvement of the public in setting health sector priorities. However, there is a serious risk that health reforms will be driven mainly by financial and/or political considerations and not by the need to improve the quality of health services as a basic human right. With only limited changes to the health systems in many Latin American and Caribbean countries and a handful of examples of positive progress resulting from reforms, the gap between rhetoric and practice remains wide. PMID:10859860
Penny, Alan; Ward, Michael; Read, Tony; Bines, Hazel
In 1998 the Government of Uganda (GoU) began implementing an ambitious reform programme called the Education Strategic Investment Plan (ESIP) in order to effect Universal Primary Education (UPE). This paper offers a perspective on how the GoU has met the challenge of financing education reform, addressed the need to improve the quality of basic…
Economic development and reforms have had profound impacts on China's health care sector. As a result, the health care sector in China is in transition. This report reviews the major changes, and the possible policy response to these changes in China's health care sector. It discusses resource availability in the Chinese health sector, and analyses the trend of household demand for health care goods and services. This study also examines the trade and investment situations in China's health sector and investigates the major forces that are driving the transition in health care and comments on the potential policy responses. PMID:10165043
Kemp, Donna R.; Verlinde, Beverly
This document discusses employee assistance programs (EAPs), programs which have been developed to help employees deal with personal problems that seriously affect job performance. It reviews literature which specifically addresses EAPs in the public sector, noting that there are no exact figures on how many public entities have EAPs. Previous…
The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own. PMID:25878456
India's first generation external sector reforms are a fascinating case study of emergence from a post-Independence socialist-style economy to the world’s largest free market democracy. Part I of this article reviews the Indian license Raj system...
Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V
This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health. PMID:26300038
Aline Coudouel; Stefano Paternostro
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
In Argentina, health sector reforms put particular emphasis on decentralization and self-management of the tax-funded health sector, and the restructuring of the social health insurance during the 1990s. Unlike other countries in the region, there was no comprehensive plan to reform and unify the sector. In order to assess the effects of the reforms on the performance of the health financing system, this study looks at impacts on the three inter-related functions of revenue collection, pooling, and purchasing/provision of health services. Data from various sources are used to illustrate the findings. It was found that the introduction of cost recovery by self-managed hospitals increased their budgets only marginally and competition among social health insurance funds did not reduce fragmentation as expected. Although reforming the Solidarity Redistribution Fund and implementing a single basic package for the insured was an important step towards equity and transparency, the extent of risk pooling is still very limited. This study also provides recommendations regarding strengthening reimbursement mechanisms for public hospitals, and regulating the private sector as approaches to improving the fairness of the health financing system and protecting people from financial hardship as a result of illness. PMID:18378350
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…
Davaki, Konstantina; Mossialos, Elias
Changes in the health care sector in Greece since the pathbreaking introduction of the National Health System (NHS) in 1983 have been sluggish. Twenty years after its inception and a series of attempts to reform it, the NHS remains centralized, fragmented in terms of coverage, and quite far removed from its principles of equity and efficiency. Being part of an idiosyncratic welfare state, the health care system is bound to reflect the particularities of Greek society and economy, namely, clientelism, a weak formal-and a thriving informal-economy, the lack of a strong administrative class, a weak labor movement, and strong organized interests. As a result, several ambitious reform plans have failed repeatedly owing to an array of interrelated economic, political, and social factors that channel potential changes toward the trodden path. This constellation creates unfavorable conditions for the introduction and implementation of major reforms. PMID:15943391
Alwan, Ala'; Hornby, Peter
The authors argue that "health for all" is not achievable in most countries without health sector reform that incorporates a process of coordinated health and human resources development. They examine the situation in countries in the Eastern Mediterranean Region of the World Health Organization. Though advances have been made, further progress is inhibited by the limited adaptation of traditional health service structures and processes in many of these countries. National reform strategies are needed. These require the active participation of health professional associations and academic training institutions as well as health service managers. The paper indicates some of the initiatives required and suggests that the starting point for many countries should be a rigorous appraisal of the current state of human resources development in health. PMID:11884974
Stoddard, Christiana; Kuhn, Peter
Beyond some contracted minimum, salaried workers' hours are largely chosen at the worker's discretion and should respond to the strength of contract incentives. Accordingly, we consider the response of teacher hours to accountability and school choice laws introduced in U.S. public schools over the past two decades. Total weekly hours of full-time…
Zhonghua, Cai; Ye, Wang
In "New Public Management" era, performance measurement has been widely used in managerial practices of public sectors. From the content and features of performance measurement, this paper aims to explore inspirations on Chinese public sector performance measurement, which based on a review of prior literatures including influencial factors, methods and indicators of public sector performance evaluation. In the end, arguments are presented in this paper pointed out the direction of future researches in this field.
Abolhallaje, Masoud; Jafari, Mehdi; Seyedin, Hesam; Salehi, Masoud
Background: Financial management and accounting reform in the public sectors was started in 2000. Moving from cash-based to accrual-based is considered as the key component of these reforms and adjustments in the public sector. Performing this reform in the health system is a part of a bigger reform under the new public management. Objectives: The current study aimed to analyze the movement from cash-based to accrual-based accounting in the health sector in Iran. Patients and Methods: This comparative study was conducted in 2013 to compare financial management and movement from cash-based to accrual-based accounting in health sector in the countries such as the United States, Britain, Canada, Australia, New Zealand, and Iran. Library resources and reputable databases such as Medline, Elsevier, Index Copernicus, DOAJ, EBSCO-CINAHL and SID, and Iranmedex were searched. Fish cards were used to collect the data. Data were compared and analyzed using comparative tables. Results: Developed countries have implemented accrual-based accounting and utilized the valid, reliable and practical information in accrual-based reporting in different areas such as price and tariffs setting, operational budgeting, public accounting, performance evaluation and comparison and evidence based decision making. In Iran, however, only a few public organizations such as the municipalities and the universities of medical sciences use accrual-based accounting, but despite what is required by law, the other public organizations do not use accrual-based accounting. Conclusions: There are advantages in applying accrual-based accounting in the public sector which certainly depends on how this system is implemented in the sector. PMID:25763194
Kelly, Andrew P.
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…
Often health systems functions are identified with service provision within a personal healthcare dimension or a public health framework. This constitutes the healthcare system which is a part of a health system, which views health in its inter-sectoral scope. It is well established that factors which determine health status range much broader than those which are within the realm of the health sector. Many socio-economic and environmental conditions are known to affect health status; liberalization of international trade, global pandemics, natural disasters and humanitarian crises can be detrimental to public health outcomes as can be changes in international cooperation and geopolitical situations, which may have implications for the manner in which health is resourced in a country such as Pakistan. As a roadmap for health systems reform in Pakistan, the Gateway Paper factors these considerations into health policy and planning underscoring the need to develop alternative policy approaches to health within its inter-sectoral scope, redefining targets within the health sector in order to garner support from across various sectors; creating inter-sectoral agencies that concentrate on prevention and health promotion at multiple levels and developing overarching policy and legislation for health promotion. PMID:17595839
Ejughemre, Ufuoma John
The health sector, a foremost service sector in Nigeria, faces a number of challenges; primarily, the persistent under-funding of the health sector by the Nigerian government as evidence reveals low allocations to the health sector and poor health system performance which are reflected in key health indices of the country.Notwithstanding, there is evidence that the private sector could be a key player in delivering health services and impacting health outcomes, including those related to healthcare financing. This underscores the need to optimize the role of private sector in complementing the government’s commitment to financing healthcare delivery and strengthening the health system in Nigeria. There are also concerns about uneven quality and affordability of private-driven health systems, which necessitates reforms aimed at regulation. Accordingly, the argument is that the benefits of leveraging the private sector in complementing the national government in healthcare financing outweigh the challenges, particularly in light of lean public resources and finite donor supports. This article, therefore, highlights the potential for the Nigerian government to scale up healthcare financing by leveraging private resources, innovations and expertise, while working to achieve the universal health coverage. PMID:24596895
R. A. BREALEY; I. A. COOPER; M. A. HABIB
Recent developments, such as privatization and the private finance initiative, have raised the issue of which assets should be owned by the public sector and whether assets have different values in the public and private sectors. In order to answer these questions, we first note that the allocative considerations that usually motivate government intervention need not require the direct provision
Khademian, Anne Meredith
This report looks at recent changes in governance across the public sector to provide context and examples for the National Commission on Governing America's Schools' efforts. The report is presented in six sections. Following a brief introduction in section 1, section 2 provides an overview of the forces that have changed public-sector governance…
Almeida, C; Travassos, C; Porto, S; Labra, M E
Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education. PMID:10707303
Niehaves, Björn; Malsch, Robert
‘Open Innovation’ has been heavily discussed for product innovations; however, an information systems (IS) perspective on ‘process innovation’ has not yet been taken. Analyzing the example of the public sector in Germany, the paper seeks to investigate the factors that hinder and support ‘open process innovation’, a concept we define as the involvement of citizens in business process management (BPM) activities. With the help of a quantitative study (n=358), six factors are examined for their impact on citizen involvement in local government BPM initiatives. The results show that citizen involvement in reform processes is not primarily motivated by the aim of cost reduction, but rather related to legitimacy reasons and the intent to increase employee motivation. Based on these findings, implications for (design) theory and practice are discussed: Instead of detailed collaborative business processes modeling, the key of citizen involvement in public sector BPM lies in communication and mutual understanding.
Edinburgh, University of
and policy makers in public services delivery. The role of accountants and auditors has assumed a marked of service provision? We seek contributions that have an accounting, management, regulatory or policy makingInstitute of Public Sector Accounting Research I·P·S·A·R In Government, Public Services
Joskow, Paul L.
This paper discusses the evolution of wholesale and retail competition in the U.S electricity sector and associated industry restructuring and regulatory reforms. It begins with a discussion of the industry structure and ...
Public Service Research Council, Vienna, VA.
The growth of unionization and the enactment of collective bargaining legislation are considered to be the causes of increased strike activity in the public sector. This paper includes statistical data on the frequency and number of public employee strikes in each state; summarizes the state labor legislation; and presents an average of strikes,…
Tarin, Ehsanullah; Green, Andrew; Omar, Maye; Shaw, Jane
The health sector in the Punjab (Pakistan) faces many problems, and, the government introduced reforms during 1993-2000. This paper explores the policy process for the reforms. A case study method was used and, to assist this, a conceptual framework was developed. Analysis of four initiatives indicated that there were deviations from the government guidelines and that the policy processes used were weak. The progress of different reforms was affected by a variety of factors: the immaturity of the political process and civil society, which together with innate conservatism and resistance to change on the part of the bureaucracy resulted in weak strategic sectoral leadership and a lack of clear purpose underpinning the reforms. It also resulted in weaknesses in preparation of the detail of reforms leading to poor implementation. The study suggests a need for broadening the stakeholders' base, building the capacity of policy-makers in policy analysis and strengthening the institutional basis of policymaking bodies. PMID:19946945
Scanlan, Martin; Tichy, Karen
Conversations about promoting educational reforms that redress educational inequities often ignore private schools as irrelevant. Yet pursuits of inclusivity in private sector schools serve the public interest. This article focuses on how the system of Catholic schools in the Archdiocese of St. Louis has been purposefully striving for 2 decades to…
Promoting Public Policy Reform from Inside and Outside Government Sponsored by SF point legislatures, advocacy organizations, government administrations, philanthropic organizations and Director of Funding the Next Generation Former Director of the SF Department of Children, Youth
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…
Jörg Becker; Björn Niehaves; Felix Müller-Wienbergen; Martin Matzner
\\u000a Although business intelligence (BI) solutions have been a long-standing topic of major interest in private sector, public\\u000a administrations (PA), however, took only first steps towards strategic management. While PA are obliged to implement new public\\u000a management (NPM) approaches, such as new accounting systems or an output-oriented management, to collect management-relevant\\u000a data, there is little support regarding how to employ these
Lim, Teck-Onn; Goh, Adrian; Lim, Yam-Ngo; Mohamad Zaher, Zaki Morad; Suleiman, Abu Bakar
Between 1990 and 2005, dialysis treatment rates in Malaysia increased more than eightfold. Dialysis treatment reached a level comparable to rates in developed countries. This remarkable transformation was brought about in large part by the Malaysian government's large-scale purchase of dialysis services from the highly competitive private sector. This paper traces a series of public- and private-sector reforms that dramatically increased access to dialysis for patients with kidney failure from 13 per million people in the population in 1990 to 119 per million in 2005. Not all developing countries have had uniformly positive experiences with private-sector participation in health care. However, our data suggest that strong participation by the private sector in Malaysia has helped make for a stronger health care system as well as healthier patients. Yet the policy decisions that enabled the private sector to participate fully in providing dialysis have not been repeated with other medical services. PMID:21134922
Niederjohn, Matthew Scott
This paper examines trends in employment and earnings in the U.S. electricity sector during a period of regulatory reform. Econometric models are specified using a large data set of individual employees from the Current Population Survey. OLS earnings estimations find no evidence of an adverse effect on employee earnings during the period of regulatory reform, even after correction for sample selectivity bias using the Heckman two-step approach. In fact, earnings premiums in the electricity sector have increased over the period of regulatory reform. Probit models do find strong evidence that declines in the probability of electricity sector employment, for many occupations, have occurred during the regulatory reform period. These findings deviate significantly from other restructured industries, with the electricity sector being the first industry to show significant employment declines associated with regulatory reform. Using the Blinder-Oaxaca technique, earnings premiums are calculated for electricity sector employees by occupation. These earnings differential variables are found to have a significant negative impact on employment for a number of occupations. Lastly, a longitudinal analysis is used to examine the experiences of electricity sector workers who leave this industry for new employment. This longitudinal procedure allows for analyzing whether electricity sector earnings premiums depict a compensating differential. While the sample size for this analysis is small, an examination of the mean wages of the employees that made an industry change from the electricity sector suggest they continue to receive high earnings in their new positions. These findings suggest that electric utilities, either unable or unwilling to cut employee earnings, have chosen to become more competitive in a deregulated environment through employment actions.
... false Procurement under public sector procedures. 201.22 Section 201.22 Foreign Relations AGENCY FOR INTERNATIONAL...201.22 Procurement under public sector procedures. (a...regional, and international journals, newspapers, etc.,...
Homedes, Núria; Ugalde, Antonio
Human resources are the most important assets of any health system, and health workforce problems have for decades limited the efficiency and quality of Latin America health systems. World Bank-led reforms aimed at increasing equity, efficiency, quality of care and user satisfaction did not attempt to resolve the human resources problems that had been identified in multiple health sector assessments. However, the two most important reform policies – decentralization and privatization – have had a negative impact on the conditions of employment and prompted opposition from organized professionals and unions. In several countries of the region, the workforce became the most important obstacle to successful reform. This article is based on fieldwork and a review of the literature. It discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region. The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. The authors suggest that autochthonous solutions are more likely to succeed than solutions imported from the outside. PMID:15659241
Rigoli, Felix; Dussault, Gilles
The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sector reform has modified critical aspects of the health workforce, including labor conditions, degree of decentralization of management, required skills and the entire system of wages and incentives. Human resources in health, crucial as they are in implementing changes in the delivery system, have had their voice heard in many subtle and open ways – reacting to transformations, supporting, blocking and distorting the proposed ways of action. This work intends to review the evidence on how the individual or collective actions of human resources are shaping the reforms, by spotlighting the reform process, the workforce reactions and the factors determining successful human resources participation. It attempts to provide a more powerful way of predicting the effects and interactions in which different "technical designs" operate when they interact with the human resources they affect. The article describes the dialectic nature of the relationship between the objectives and strategies of the reforms and the objectives and strategies of those who must implement them. PMID:14613523
Background The Government of the Republic of Kenya is in the process of implementing health care reforms. However, poor knowledge about costs of health care services is perceived as a major obstacle towards evidence-based, effective and efficient health care reforms. Against this background, the Ministry of Health of Kenya in cooperation with its development partners conducted a comprehensive costing exercise and subsequently developed the Kenya Health Sector Costing Model in order to fill this data gap. Methods Based on standard methodology of costing of health care services in developing countries, standard questionnaires and analyses were employed in 207 health care facilities representing different trustees (e.g. Government, Faith Based/Nongovernmental, private-for-profit organisations), levels of care and regions (urban, rural). In addition, a total of 1369 patients were randomly selected and asked about their demand-sided costs. A standard step-down costing methodology was applied to calculate the costs per service unit and per diagnosis of the financial year 2006/2007. Results The total costs of essential health care services in Kenya were calculated as 690 million Euros or 18.65 Euro per capita. 54% were incurred by public sector facilities, 17% by Faith Based and other Nongovernmental facilities and 23% in the private sector. Some 6% of the total cost is due to the overall administration provided directly by the Ministry and its decentralised organs. Around 37% of this cost is absorbed by salaries and 22% by drugs and medical supplies. Generally, costs of lower levels of care are lower than of higher levels, but health centres are an exemption. They have higher costs per service unit than district hospitals. Conclusions The results of this study signify that the costs of health care services are quite high compared with the Kenyan domestic product, but a major share are fixed costs so that an increasing coverage does not necessarily increase the health care costs proportionally. Instead, productivity will rise in particular in under-utilized private health care institutions. The results of this study also show that private-for-profit health care facilities are not only the luxurious providers catering exclusively for the rich but also play an important role in the service provision for the poorer population. The study findings also demonstrated a high degree of cost variability across private providers, suggesting differences in quality and efficiencies. PMID:21619567
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…
21st Century Policy Review, 1992
This interview with Percy E. Pollard, Jr., Director of the Cultural and Human Services Program of International Business Machines, discusses new requirements for basic skills and competencies for American workers and considers the role of the private sector in the reforms needed for education and employment training. Women and minorities can take…
Around the world, network utilities (i.e., electricity, natural gas, railway, telecommunications, and water supply industries) are undergoing major structural transformation. A new wave of market liberalization, together with rapid technological changes, has challenged the previously dominant monopoly organization of these industries. A global trend toward deregulation and restructuring is evident in countries at different levels of social and economic development. The challenges of transition from a monopolistic to an open market competitive structure are numerous. Understanding these problems and finding solutions are essential to successful restructuring. In developing countries and economies in transition (i.e., the Eastern Europe and the former Soviet Union), government-owned utilities are often considered to be highly inefficient. The dominant power sector restructuring strategies seek to promote economic efficiency through a gradual introduction of competition into the power sector. Five components of power sector reform are commonly proposed by the World Bank and others for these countries: commercialization, privatization, establishment of an independent regulatory agency, unbundling and gradual introduction of competition in generation and retail markets. The Republic of Georgia, like many economies in transition (e.g., Hungary, Ukraine, and Kazakhstan) has followed this reform model. However, outcomes of the reform have not been as promised. The acute economic problems facing Georgia after it regained independence have compounded problems in the power sector. A review of Georgia's utility reforms reveals that the country has undertaken electricity industry restructuring without giving substantial consideration to the problems that these reforms might have created within the industry or society. The main task of this dissertation is to find the restructuring model, which can best serve economic, social and environmental goals under circumstances similar to those in economies of transition. The dissertation provides a guide for policy makers in the energy sector for implementing power sector reform. At first the dissertation offers a general overview of different models of power sector organization, regulatory frameworks and market arrangements, and the potential impact of reform on social welfare. This knowledge is then applied for analysis of power sector reform in the Republic of Georgia. Social welfare analysis (SWA) is a major analytical tool used in the research for assessing the potential impacts of different power sector organization models on various stakeholders. Through the research it was identified that power industry arrangements in different countries have their particularities; however, after some level of simplification, power sector organization models can fit into one of three broad categories: (1) Government control and regulation of generation and retail segments of the power industry. (2) Full scale competition in the generation segment and retail choice. (3) Partial government control of the generation segment and limited retail choice. For SWA of different power market arrangement scenarios, electricity supply and demand curves had to be derived; for this purpose electricity demand forecasting and power supply evaluation methodologies were developed. This dissertation combines SWA, accepted demand forecasting methods and established power supply evaluation techniques to assess power sector performance under specified policy scenarios relevant to the circumstances of economies in transition such as the Republic of Georgia. Detailed analyses are performed for understanding possible outcomes with the introduction of different reform models. In addition, specific options for incorporating sustainable energy alternatives in the energy planning process are identified and assessed in economic, environmental and social terms. Special attention is given to market-based instruments for promoting sustainable energy options (e.g., renewable portfolio standards, energy conservation and energy efficien
Paris, David C.
Many of the difficulties in educational reform arise because of deep ideological problems concerning education, problems that generally have their roots in liberal democratic theory. This book explores the varied and conflicting themes in public education. Chapters 1 and 2 discusses liberal democratic theory that permits a plurality of…
Kanyongo, Gibbs Y.
The purpose of this article is to discuss Zimbabwe's public education system. First, the article provides a brief look at pre-independence education in Zimbabwe. Second, it discusses some of the reforms that took place in the Zimbabwe education system following independence. Third, it looks at the current structure of Zimbabwe's education system…
Erickson, Paul W.
The King of Jordan's vision for education is resulting in innovative projects for the country. King Abdullah II wants Jordan to develop its human resources through public education to equip the workforce with skills for the future. From King Abdullah II's vision, the Education Reform for a Knowledge Economy (ERfKE) project implemented by the…
Nepal, Rabindra; Jamasb, Tooraj
, Bosnia and Herzegovina, Bulgaria, FYR Macedonia ,Serbia, Romania and Montenegro; Commonwealth of Independent States (CIS) comprising Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine... and Azerbaijan constituted 68.7% and 30.7% of GDP respectively in 2000. See Table A in Appendix I. 3 and order) for countries experiencing drastic systemic changes. Thus, the role of power sector can be perceived to...
Blas, E; Limbambala, M
Zambia underwent a period of health sector reform from 1993 to 1998. The reform attracted substantial support from the World Bank and bilateral donors. While significant achievements were made with respect to decentralization, increased accountability and donor collaboration, the reform stalled in 1998 without having achieved its objectives, largely because of the handling of hospital reform and the civil servants in the health sector. This study was an attempt to analyze this experience with the hospital issue. Service and infrastructure information was collected from all 88 hospitals in the country. Further, information was collected about the social, economic, and political context of the reform. The results show that an historical legacy from the colonial and post-colonial eras has left the country with an expensive and skewed hospital structure that is rapidly deteriorating and very difficult to reform. The referral system is not functioning: higher-level hospitals provide a higher level of care to their immediate catchment populations than is available to the population in general. The reality is thus far from the vision of equity of access to cost-effective quality care. Zambian doctors have either left the country or are concentrated at the highest referral levels in two provinces, leaving the lower levels and most of the country in the hands of expatriate doctors. There are no resources in the government or the private systems to maintain the current hospital infrastructure and things will likely deteriorate unless radical decisions are taken and implemented. The study further shows that the question of hospital reform is a political high-risk zone. If the problems are to be dealt with, the Zambian planners must, together with the politicians, work to create a broad national consensus for understanding the situation, its urgency, and the limited options for forward action. PMID:11772988
Ssengooba, Freddie; Rahman, Syed Azizur; Hongoro, Charles; Rutebemberwa, Elizeus; Mustafa, Ahmed; Kielmann, Tara; McPake, Barbara
Background Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers' responses to the changes in their working environments by taking a 'realistic evaluation' approach. Methods The study findings were generated by triangulating both qualitative and quantitative methods of data collection and analysis among policy technocrats, health managers and groups of health providers. Quantitative surveys were conducted with over 700 individual health workers in both Bangladesh and Uganda and supplemented with qualitative data obtained from focus group discussions and key interviews with professional cadres, health managers and key institutions involved in the design, implementation and evaluation of the reforms of interest. Results The reforms in both countries affected the workforce through various mechanisms. In Bangladesh, the effects of the unification efforts resulted in a power struggle and general mistrust between the two former workforce tracts, family planning and health. However positive effects of the reforms were felt regarding the changes in payment schemes. Ugandan findings show how the workforce responded to a strong and rapidly implemented system of decentralisation where the power of new local authorities was influenced by resource constraints and nepotism in recruitment. On the other hand, closer ties to local authorities provided the opportunity to gain insight into the operational constraints originating from higher levels that health staff were dealing with. Conclusion Findings from the study suggest that a) reform planners should use the proposed dynamic responses model to help design reform objectives that encourage positive responses among health workers b) the role of context has been underestimated and it is necessary to address broader systemic problems before initiating reform processes, c) reform programs need to incorporate active implementation research systems to learn the contextual dynamics and responses as well as have inbuilt program capacity for corrective measures d) health workers are key stakeholders in any reform process and should participate at all stages and e) some effects of reforms on the health workforce operate indirectly through levels of satisfaction voiced by communities utilising the services. PMID:17270042
Von Weizsacker, R K
"Starting from a simple, descriptive model of individual income, an explicit link between the age composition of a population and the personal distribution of incomes is established. Demographic effects on income inequality are derived. Next, a pay-as-you-go financed state pension system is introduced. The resulting government budget constraint entails interrelations between fiscal and demographic variables, causing an additional, indirect demographic impact on the distribution. This is shown not only to change, but in some cases even to reverse the distributional incidence of an aging population. Several policy conflicts arise. The point is re-emphasized by an analysis of the German Pension Reform Act of 1992. The study reveals that the design of the pension formula decisively drives the relation between demographics and inequality." PMID:12319695
GIACAMAN, RITA; ABDUL-RAHIM, HANAN F; WICK, LAURA
Since the signing of the Oslo Peace Accords and the establishment of the Palestinian Authority in 1994, reform activities have targeted various spheres, including the health sector. Several international aid and UN organizations have been involved, as well as local and international non-governmental organizations, with considerable financial and technical investments. Although important achievements have been made, it is not evident that the quality of care has improved or that the most pressing health needs have been addressed, even before the second Palestinian Uprising that began in September 2000. The crisis of the Israeli re-invasion of Palestinian-controlled towns and villages since April 2002 and the attendant collapse of state structures and services have raised the problems to critical levels. This paper attempts to analyze some of the obstacles that have faced reform efforts. In our assessment, those include: ongoing conflict, frail Palestinian quasi-state structures and institutions, multiple and at times inappropriate donor policies and practices in the health sector, and a policy vacuum characterized by the absence of internal Palestinian debate on the type and direction of reform the country needs to take. In the face of all these considerations, it is important that reform efforts be flexible and consider realistically the political and economic contexts of the health system, rather than focus on mere narrow technical, managerial and financial solutions imported from the outside. PMID:12582108
Many new ideas arise at the borders of systems. Academics and educators engage in research and reform of the education system itself, but much that is innovative in today's schools originates outside the classroom, in a burgeoning set of programs and partnerships with the voluntary or community sector, and in the relationships being established by…
To blame the decline in national competitiveness solely on poorly educated, less productive workers is misguided. Despite the growing intensity of corporate criticisms of public education, there is no consensus among economists that schools have caused the productivity crisis. Schools are not critical to economic competitiveness in a global…
As a state legislator, you're well aware of the fiscal pressures that have caused many states to change their pension systems. But you should also be aware of the impact that pension reform has on public education. This brief guide shows you how and why pension programs affect your state's efforts to attract and retain the best teachers. It…
Healy, J; Mckee, M
The success or failure of health sector reform in the countries of Central and Eastern Europe depends, to a large extent, on their health care staff. Commentators have focused on the structures to be put in place, such as mechanisms of financing or changes in ownership of facilities, but less attention has been paid to the role and status of the different groups working in health care services. This paper draws on a study of trends in staffing and working conditions throughout the region. It identifies several key issues including the traditionally lower status and pay of health sector workers compared to the West, the credibility crisis of trade unions, and the under-developed roles of professional associations. In order to implement health sector reforms and to address the deteriorating health status of the population, the health sector workforce has to be restructured and training programmes reoriented towards primary care. Finally, the paper identifies emerging issues such as the erosion of 'workplace welfare' and its adverse effects upon a predominantly female health care workforce. PMID:10176264
Vian, Taryn; Bicknell, William J
Lesotho has been implementing financial management reforms, including performance-based budgeting (PBB) since 2005 in an effort to increase accountability, transparency and effectiveness in governance, yet little is known about how these efforts are affecting the health sector. Supported by several development partners and $24 million in external resources, the PBB reform is intended to strengthen government capacity to manage aid funds directly and to target assistance to pressing social priorities. This study designed and tested a methodology for measuring implementation progress for PBB reform in the hospital sector in Lesotho. We found that despite some efforts on the national level to promote and support reform implementation, staff at the hospital level were largely unaware of the purpose of the reform and had made almost no progress in transforming institutions and systems to fully realize reform goals. Problems can be traced to a complex reform design, inadequate personnel and capacity to implement, professional boundaries between financial and clinical personnel and weak leadership. The Lesotho reform experience suggests that less complex designs for budget reform, better adapted to the context and realities of health sectors in developing countries, may be needed to improve governance. It also highlights the importance of measuring reform implementation at the sectoral level. PMID:23293099
Courtney, Mary; Yacopetti, Jane; James, Catherine; Walsh, Anne; Montgomery, Mary
In a time of health care reform and rapid change, nurse executives need effective leadership skills to be able to respond to a challenging environment, provide quality cost-effective care and promote the professional development of nursing. This research aimed to provide an understanding of nursing executives' roles and professional development needs and obtain concise information for the development of strategies and professional development programs to enhance the effectiveness of the present and future roles of nursing executives. A descriptive cross-sectional postal survey was sent to all public sector Level 4 and 5 nursing executives in Queensland (n = 281), with a response rate of 52.3% (n = 147). Financial management, human resource management and information technologies were identified as the areas where professional development was most needed. Structured educational activities such as short courses or seminars covering information technology, financial and budget management and general business management were identified as the type of activities best suited to nurse executives' needs. The most frequently reported barriers to professional development were difficulties obtaining relief staff, inadequate time, financial cost and inadequate district manager and regional support to enable access to professional development programs. PMID:12002630
Lubben, Marianne; Mayhew, Susannah H.; Collins, Charles; Green, Andrew
It is not clear how policy-making in the field of reproductive health relates to changes associated with programmes for the reform of the health sector in developing countries. There has been little communication between these two areas, yet policy on reproductive health has to be implemented in the context of structural change. This paper examines factors that limit dialogue between the two areas and proposes the following framework for encouraging it: the identification of policy groups and the development of bases for collaborative links between them; the introduction of a common understanding around relevant policy contexts; reaching agreement on compatible aims relating to reproductive health and health sector change; developing causal links between policy content in reproductive health and health sector change as a basis for evidence-based policy-making; and strengthening policy-making structures, systems, skills, and values. PMID:12219159
William P. Wagner; Yvonne Lederer Antonucci
For the past several decades, we have seen organizations on a global scale continue to streamline their business processes enabled by enterprise resource planning (ERP) systems. Despite the recent economic downturn, the public sector represents one of the largest potential areas for new ERP sales. In addition the scale of public sector ERP projects is potentially huge as evidenced by
This monograph was prepared as an initial effort in development of a body of material for training public sector managers. It sets forth the basic principles of grievance arbitration covering discipline in the public sector. Major sections are devoted to the topics of just or proper cause for discipline, due process, the nature of discipline, and…
Infante Durana, Maria Dolores
This dissertation looks into the reasons that pushed European countries to liberalize their electricity industries. The analysis of the political process leading to that decision in the areas pioneers of regulatory reform in this sector (United Kingdom, Sweden and the European Commission) shows that the liberalization of the European power sectors does not conform to the traditional theoretical explanations for regulatory reform that put interests and industry-specific considerations at the forefront of the explanation. The central argument of this dissertation is that, contrary to what most of the literature assumes and the theories predict, the primary impetus for the reforms in European electricity sectors did not come from industrial or economic worries, but rather from a neo-liberal turn to the ideas shared by European intellectual and political elites. The reform followed a political spill-over process by which the liberalization policy was emulated and introduced as a direct result of the international and sectoral diffusion of the new "efficiency regime" and the belief in the economic superiority of free markets over any form of government intervention. As an idea-driven policy, liberalization was not always coherent with the stated goals and, with means and ends that were not always consistent with each other, the reforms were often hampered and their results ambiguous. Liberalization transformed energy policy priorities in member states by adding the promotion and development of market-based mechanisms to the previous two of ensuring that security of supply, was adequate and of achieving ambitious environmental targets. By adding economic efficiency (and its political corollary, low prices) to its policy goals, governments effectively rendered the realization of the other two goals all the more difficult. As a result, liberalization did not entail the expected government disengagement from the affairs of the industry. On the contrary, it became increasingly clear that governments would keep intervening in the market-place as competition forces alone could not bring the expected economic, technical and political benefits in a vital industry which continued to have particular technical and economic attributes as well as a strong capacity to influence other policy areas.
Walt, G; Gilson, L
Policy analysis is an established discipline in the industrialized world, yet its application to developing countries has been limited. The health sector in particular appears to have been neglected. This is surprising because there is a well recognized crisis in health systems, and prescriptions abound of what health policy reforms countries should introduce. However, little attention has been paid to how countries should carry out reforms, much less who is likely to favour or resist such policies. This paper argues that much health policy wrongly focuses attention on the content of reform, and neglects the actors involved in policy reform (at the international, national sub-national levels), the processes contingent on developing and implementing change and the context within which policy is developed. Focus on policy content diverts attention from understanding the processes which explain why desired policy outcomes fail to emerge. The paper is organized in 4 sections. The first sets the scene, demonstrating how the shift from consensus to conflict in health policy established the need for a greater emphasis on policy analysis. The second section explores what is meant by policy analysis. The third investigates what other disciplines have written that help to develop a framework of analysis. And the final section suggests how policy analysis can be used not only to analyze the policy process, but also to plan. PMID:10139469
Garuba, Habibat A; Kohler, Jillian C; Huisman, Anna M
Background Pharmaceuticals are an integral component of health care systems worldwide, thus, regulatory weaknesses in governance of the pharmaceutical system negatively impact health outcomes especially in developing countries . Nigeria is one of a number of countries whose pharmaceutical system has been impacted by corruption and has struggled to curtail the production and trafficking of substandard drugs. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC) underwent an organizational restructuring resulting in reforms to reduce counterfeit drugs and better regulate pharmaceuticals . Despite these changes, there is still room for improvement. This study assessed the perceived level of transparency and potential vulnerability to corruption that exists in four essential areas of Nigeria's pharmaceutical sector: registration, procurement, inspection (divided into inspection of ports and of establishments), and distribution. Methods Standardized questionnaires were adapted from the World Health Organization assessment tool and used in semi-structured interviews with key stakeholders in the public and private pharmaceutical system. The responses to the questions were tallied and converted to scores on a numerical scale where lower scores suggested greater vulnerability to corruption and higher scores suggested lower vulnerability. Results The overall score for Nigeria's pharmaceutical system was 7.4 out of 10, indicating a system that is marginally vulnerable to corruption. The weakest links were the areas of drug registration and inspection of ports. Analysis of the qualitative results revealed that the perceived level of corruption did not always match the qualitative evidence. Conclusion Despite the many reported reforms instituted by NAFDAC, the study findings suggest that facets of the pharmaceutical system in Nigeria remain fairly vulnerable to corruption. The most glaring deficiency seems to be the absence of conflict of 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. PMID:19874613
Kang, Young Taek
This paper seeks to provide a conceptual framework for understanding the topic of public aid to Christian schools in a Reformed Christian perspective. To do so, I need to clarify a Reformed Christian approach in regard to this topic and then review the studies of the issue in legal and educational aspects in the light of the Reformed perspective.…
There is widespread interest within academia to work on public good genetically engineered (GE) projects to the benefit of the poor, especially to use GE-technology to contribute to food security. Not a single product from this work has reached the market. The major cause is GE-regulation, which prevents use of the technology for public good beyond proof-of-concept (Potrykus, I. (2010) Lessons from the Humanitarian Golden Rice project: Regulation prevents development of public good GE-products (these Proceedings)). There is, however, another key problem responsible for the lack of deployment of public good GE-plants: the public sector is incompetent and disinterested for work beyond proof-of-concept, and has neither capability nor funding to develop GE-plant products and introduce them to growers and consumers. The private sector has the expertise for both and in the right circumstances can be ready to support the public sector in public good enterprises. Public-private-partnerships are the best solution so far, to advance exploitation of GE-technology to the benefit of the poor. Public-private-partnerships are viable, however, only, if there is mutual interest from the private sector and initiative and funding from the public sector. PMID:20637908
Shuey, Dean A; Qosaj, Fatime Arenliu; Schouten, Erik J; Zwi, Anthony B
The restoration and development of health care systems in post-conflict situations and complex emergencies are attracting attention. Kosovo is unique in being a post-conflict situation, in a former socialist country, with an unclear political future, under temporary UN administration. The World Health Organization (WHO) led a process of developing a health policy framework for the emergency period that included elements of health sector reform, a somewhat controversial initiative. Reform elements of the policy were consistent with normative health policies in much of eastern and central Europe. There was tension between the need to have a policy in place rapidly and the desire to be participatory. Policy to deal with emergency situations that is not available at the time required is of limited value. Although there was some tension between relief and development agendas, the policy process did direct significant resources and effort in directions that contributed to longer-term reform and development. A policy framework does not ensure compliance with policy unless issues of authority, mandate, and leadership are clear. A rapidly developed health policy framework at the onset of an emergency is desirable. Policy developers should be experienced, seen as being neutral and be relatively independent of any specific donor or interest group. WHO is well situated to play this role if it meets certain conditions. PMID:12595129
Yingyi Qian; Chenggang Xu
China's thirteen years of reforms (1979-1991) have achieved an average GNP annual growth rate of 8.6%. What makes China's reforms from those of Eastern Europe and the Soviet Union is the sustained entry and expansion of the non-state sector. We argue that the organization structure of the economy matters. Unlike their unitary hierarchical structure based on the functional or specialization
Hill, Peter S; Dodd, Rebecca; Dashdorj, Khurelmaa
Since its transition to democracy, Mongolia has undergone a series of reforms, both at national level and in the health sector. This paper examines the pace and scope of these reforms, the ways in which they have impacted on sexual and reproductive health services and their implications for the health workforce. Formerly pro-natalist, Mongolia has made significant advances in contraceptive use, women's education and reductions in maternal mortality. However, rising adolescent pregnancy and sexually transmitted infections, and persisting high levels of abortion, remain challenges. The implementation of the National Reproductive Health Programme has targeted skills development, outreach and the provision of resources. Innovative adolescent-friendly health services have engaged urban youth, and the development of family group practices has created incentives to provide primary medical care for marginalised communities, including sexual and reproductive health services. The Health Sector Strategic Masterplan offers a platform for coordinated development in health, but is threatened by a lack of consensus in both government and donor communities, competing health priorities and the politicisation of emerging debates on fertility and abortion. With previous gains in sexual and reproductive health vulnerable to political change, these tensions risk the exacerbation of existing disparities and the development by default of a two-tiered health care system. PMID:16713883
_Public Policy for the Private Sector_ is a quarterly journal published by the World Bank's Finance, Private Sector, and Infrastructure Network (FPSI). Recently, new documents concerning Finance, Water, and Post-Privatization Performance have been added to this ongoing collection of policy and case study notes.
Alexander Schellong; Johann Wolfgang Goethe
Customer Relationship Management has been well discussed as a holistic concept for the private sector to start, maintain and optimize relationships to make customers more loyal\\/profitable - in sum to improve the relationship with the consumers. Many companies have invested into the customer driven CRM concept but research indicates varying outcomes. Recent publications, mainly driven by the private sector rather
Bulletin of the American Society for Information Science, 1981
This chart profiles public/private controversies and the current status of these aspects of the information sector: electronic mail, sensing satellites, transborder data flows, government printing, trade information, merger of computers and communications, and small business administration. (SW)
Leiserson, Gregory Quick
This thesis investigates the influence of retiree health and pension policies on the retirement decisions of public sector employees. Chapter one documents the central role of eligibility for subsidized retiree health ...
BESHEARS, JOHN; CHOI, JAMES J.; LAIBSON, DAVID; MADRIAN, BRIGITTE C.
We describe the pension plan features of the states and the largest cities and counties in the U.S. Unlike in the private sector, defined benefit (DB) pensions are still the norm in the public sector. However, a few jurisdictions have shifted toward defined contribution (DC) plans as their primary savings plan, and fiscal pressures are likely to generate more movement in this direction. Holding fixed a public employee’s work and salary history, we show that DB retirement income replacement ratios vary greatly across jurisdictions. This creates large variation in workers’ need to save for retirement in other accounts. There is also substantial heterogeneity across jurisdictions in the savings generated in primary DC plans because of differences in the level of mandatory employer and employee contributions. One notable difference between public and private sector DC plans is that public sector primary DC plans are characterized by required employee or employer contributions (or both), whereas private sector plans largely feature voluntary employee contributions that are supplemented by an employer match. We conclude by applying lessons from savings behavior in private sector savings plans to the design of public sector plans. PMID:21789032
Purpose: The purpose of this paper is to discuss the role of principals in light of public management reforms taking place in the German educational system and in reference to the empirical patterns uncovered by the papers contained in the Special Issue. Policy makers have created new expectations and new technologies that seem to suggest to…
Lopez, Thomas R.; Balzer, David M.
The expression "site-based management" (SBM) has become part of the rhetoric of reform of U.S. public schools. The United States has been involved in school reform efforts for many years now, including attempts at SBM. The case of the Toledo (Ohio) public schools serves as a prime example of an urban school district that, like many others, shows…
Monahan, Amy B.
There is significant interest in reforming retirement plans for public school employees, particularly in light of current market conditions. This paper presents an overview of the various types of state regulation of public pension plans that affect possibilities for reform. Several states have legal protections that effectively prevent a state…
Yang, Y Tony; Nichols, Len M
Obesity is a particularly vexing public health challenge, since it not only underlies much disease and health spending but also largely stems from repeated personal behavioral choices. The newly enacted comprehensive health reform law contains a number of provisions to address obesity. For example, insurance companies are required to provide coverage for preventive-health services, which include obesity screening and nutritional counseling. In addition, employers will soon be able to offer premium discounts to workers who participate in wellness programs that emphasize behavioral choices. These policies presume that government intervention to reduce obesity is necessary and justified. Some people, however, argue that individuals have a compelling interest to pursue their own health and happiness as they see fit, and therefore any government intervention in these areas is an unwarranted intrusion into privacy and one's freedom to eat, drink, and exercise as much or as little as one wants. This paper clarifies the overlapping individual, employer, and social interest in each person's health generally to avoid obesity and its myriad costs in particular. The paper also explores recent evidence on the impact of government interventions on obesity through case studies on food labeling and employer-based anti-obesity interventions. Our analysis suggests a positive role for government intervention to reduce and prevent obesity. At the same time, we discuss criteria that can be used to draw lines between government, employer, and individual responsibility for health, and to derive principles that should guide and limit government interventions on obesity as health reform's various elements (e.g., exchanges, insurance market reforms) are implemented in the coming years. PMID:21871035
In this dissertation, I study the performance impact of information technology (IT) investments in the public sector. IT has been one of the key assets in public administration since the early MIS era. Even though the information systems (IS) discipline has witnessed a considerable amount of research efforts on the subject of IT business value for…
A model for monitoring the Web site development process in the public sector is proposed and tested empirically with a sample of local government Web sites. Four factors in the matrix of the framework--publicity, local service, differentiation and participation--together with two dimensions of attracting and delivering were proved to be important…
Clark, Robert L; Mitchell, Olivia S
Economic theory predicts that employer-provided retiree health insurance (RHI) benefits have a crowd-out effect on household wealth accumulation, not dissimilar to the effects reported elsewhere for employer pensions, Social Security, and Medicare. Nevertheless, we are unaware of any similar research on the impacts of retiree health insurance per se. Accordingly, the present paper utilizes a unique data file on respondents to the Health and Retirement Study, to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still quite prevalent. Key findings include the following: Most full-time public sector employees anticipate having employer-provided health insurance coverage in retirement, unlike most private sector workers.Public sector employees covered by RHI had substantially less wealth than similar private sector employees without RHI. In our data, Federal workers had about $82,000 (18%) less net wealth than private sector employees lacking RHI; state/local workers with RHI accumulated about $69,000 (or 15%) less net wealth than their uninsured private sector counterparts.After controlling on socioeconomic status and differences in pension coverage, net household wealth for Federal employees was $116,000 less than workers without RHI and the result is statistically significant; the state/local difference was not. PMID:25479891
This paper explores the changing institutional context of health service delivery in rural Tanzania through an anthropological analysis of the kinds of healing strategies pursued by men and women when they are ill. In some rural districts popular dissatisfaction with state medical provision is not manifested in a rejection of the allopathic medicine with which it is associated, but in increased reliance on an emerging informal sector of private medical provision. Although this sector provides a valued and accessible service to certain categories of clients it delivers poor quality treatment, serving to reinforce the cyclical relationship between poverty and ill health. Despite the best intentions of major public sector reforms neither government nor other agencies are able to meet rural demand for health services. Reliance on the parallel market for medical provision is likely to continue, at least in the short term, with negative consequences for health. PMID:11128625
Alper, M. E.
Approximately four years ago the Jet Propulsion Laboratory, under NASA sponsorship, began to devote some of its resources to examining ways to transfer space technology to the civil sector. As experience accumulated under this program, certain principles basic to success in technology transfer became apparent. An adequate definition of each problem must be developed before any substantial effort is expended on a solution. In most instances, a source of funds other than the potential user is required to support the problem definition phase of the work. Sensitivity to the user's concerns and effective interpersonal communications between the user and technical personnel are essential to success.
China's healthcare system is experiencing significant growth from expanded government-backed insurance, greater public-sector spending on hospitals, and the introduction of private insurance and for-profit clinics. An incremental reform process has sought to develop market incentives for medical innovation and liberalize physician compensation and hospital finance while continuing to keep basic care affordable to a large population that pays for many components of care out-of-pocket. Additional changes presently under consideration by policymakers are likely to further restructure insurance and the delivery of care and will alter competitive dynamics in major healthcare industries, notably pharmaceuticals, medical devices, and diagnostic testing. This article describes the institutional history of China's healthcare system and identifies dilemmas emerging as the country negotiates divisions between public and private in healthcare. Building on this analysis, the article considers opportunities for public-private partnerships and greater systems integration to reconcile otherwise incommensurable approaches to rewarding innovation and improving access. The article concludes with observations on the public function of health insurance and its significance to further development of China's healthcare system. PMID:24052932
Newbrander, W; Parker, D
Major changes in the public/private mix of health services are occurring in many countries. These changes may be analysed by examining the financing and provision of services and subsidization of the purchase of the factors of production. The public sector and not-for-profit and for-profit elements of the private sector must be viewed as separate entities in such analyses due to their differing objectives, motives and form of operation. The issues to be dealt with by countries in finding the public/private mix which is appropriate for their health system and achieves their objectives include efficiency, quality, regulation, equity and consumer choice and satisfaction. The recommendations for action for countries include: promoting collaboration between private and public sectors; testing different public/private mix models; identifying appropriate expansion paths for private sector services; improving information for policy and planning decisions; enhancing management capacity; and, reviewing programme and project support. International agencies also have a role in this process by supporting countries through the provision of technical assistance, financial aid, promoting policy reviews, and facilitating the sharing of information and experiences among countries concerning these public/private mix issues. PMID:10120538
Gómez, Elsa Gómez
Gender equity is increasingly being acknowledged as an essential aspect of sustainable development and more specifically, of health development. The Pan American Health Organization's Program for Women, Health, and Development has been piloting for a year now a project known as Equidad de género en las políticas de reforma del sector de salud, whose objective is to promote gender equity in the health sector reform efforts in the Region. The first stage of the project is being conducted in Chile and Peru, along with some activities throughout the Region. The core of the project is the production and use of information as a tool for introducing changes geared toward achieving greater gender equity in health, particularly in connection with malefemale disparities that are unnecessary, avoidable, and unfair in health status, access to health care, and participation in decision-making within the health system. We expect that in three years the project will have brought about changes in the production of information and knowledge, advocacy, and information dissemination, as well as in the development, appropriation, and identification of intersectoral mechanisms that will make it possible for key figures in government and civil society to work together in setting and surveying policy on gender equity in health. PMID:12162842
This study seeks an explanation for the neglect of state building in Russia. The major hypothesis is that dependence on external rent leads to the weakness of the state. Three intervening variables---transaction costs, bargaining power of the state, and discount rates---are posited to explain variance on the dependent variable, the weakness of the state. Based on the exploration of three dimensions of energy sector reform, the dissertation argues that in the short run resource rents may be the only reliable and adequate source of finance for the Russian government. The division of resource rents among the many claimants (state vs. business, state vs. society, Moscow vs. regions, and Russia vs. foreign companies), it submits, will pose a stringent test of the viability of democratic governance in Russia. The dissertation concludes that some evidence indicates that Russia has in fact met the characteristics of the rentier state. The greater reliance on a large resource sector for revenue has led to high transaction costs of tax collection, weak bargaining power of the state, and high discount rates of government officials in Russia.
McMahon, Mary; Limerick, Brigid; Cranston, Neil; Andersen, Cheryl
Purpose: This paper aims to document women's reflections on their careers over a ten-year period to provide quantitative baseline data on which to frame follow-up in-depth interviews. The participants work in the public service in Queensland (Australia) and had been recommended for, and participated in, women in management (WIM) courses conducted…
This paper reviews New York City Mayor Michael Bloomberg's education reform agenda, "Children first", in the light of organizational theory. I argue that this reform agenda reflects both coercive and mimetic isomorphism, as Bloomberg uses mayoral control to apply business concepts and practices to New York City's public school system. Through…
Reville, S. Paul, Ed.
In the last decade, the Boston Public Schools has undergone critical reforms that have been of intense interest to school leaders and policymakers throughout the country. Under the leadership of superintendent Thomas Payzant, the Boston schools implemented extensive reform strategies that yielded notable results. Fittingly, at the end of Payzant's…
Wang, Jia; Xie, Yu
Situated in China’s market transition, this study examines the relationship between economic sector and a worker’s happiness in post-reform urban China. Using datasets from the Chinese General Social Surveys 2003, 2006 and 2008, we find that workers in the state sector enjoy a subjective premium in well-being – reporting significantly higher levels of happiness than their counterparts in the private sector. We also find that during a period when a large wave of workers moved from the state sector to the private sector, those remaining in the state sector reported being significantly happier than did former state sector workers who had moved, whether the move was voluntary or involuntary. We attribute the higher level of reported happiness in the state sector than in the private sector to the disparity by sector in the provision of social welfare benefits. Those who made voluntary state-to-private moves experienced a trade-off in enjoying higher payoffs while losing job security, whereas involuntary mobiles experienced downward mobility and suffered a long-term psychological penalty. PMID:26188448
Sung Ho Ha; Min Jung Lee
In response to environmental change, public sectors have begun to focus on their customers and customer services. Most of the public sector organisations, however, have made little progress in making themselves more customer-friendly, when compared with the private sector. Thus to improve the quality of service for public sector clients, this study devised a framework of Service Quality Improvement in
Schmandt, J. (editor)
The NASA Meal System was developed with three simple concepts in mind: (1) nutritious, conventional foods are packaged in single-serving units and assembled into complete meals; (2) the meals have an extended shelf-life and can be transported and stored without need for refrigeration or freezing; (3) preparation of the meal by the consumer is an easy task which is accomplished in ten minutes or less. The meal system was tested in 1975 and 1976 by different groups of elderly individuals. NASA and the LBJ School of Public Affairs sponsored a national conference to report on the demonstration of the meal system for the elderly and to explore potential uses of the system for social services, institutional feeding programs, disaster relief, and international aid. The proceedings of the conference and how different groups assessed the potential of the meal system are reported.
Conrad, Cynthia; Coleman, Charles
Teaching Chinese students in an American university can be both challenging and rewarding. Cultural and language differences can lead to some superficial confusion and interpretational problems. However, the vast differences in the ways Chinese students view the role of the public sector, as compared to the US, can mean that the instructors and…
Berkovich, Izhak; Foldes, Vincent Jonathan
Purpose: The purpose of this article is to address the involvement of third sector organizations in state public education in Israel, with emphasis on the decision-making processes affecting the geographic distribution of service provision. Design/methodology/approach: A collective case study approach was used to investigate non-governmental…
BRIAN A. CROMWELL
to test whether state and federal grant This paper explores maintenance prac- policies induce local governments to sub- tices in the local public sector and their re- stitute new investment for the mainte- lationship to state and federal grant pol- nance of existing capital. Using a new data icies. If state and federal grant policies set on the maintenance policies
Chouinard, Jill Anne
In the original paper, it was argued that while there is an array of methods and methodologies available, their use is delimited by the culture of accountability that prevails in public sector institutions, a fact that is particularly problematic given the complexity and diversity of evaluation contexts today. This short rejoinder, to responses…
Indiana Univ., Bloomington. Midwest Center for Public Sector Labor Relations.
In the face of a high degree of legislative activity concerning public sector labor relations in the Midwest, this guide was prepared to familiarize practitioners with such legislation enacted as of May 1, 1975, in Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. This legislation concerns state employees, fire fighters, municipal…
The understanding of expert knowledge as shared, distributed and contextualised has gained ground. The case description in this article focuses on developing expert knowledge in a situation in which both knowledge needs and the definition of expertise fields changed radically in the public sector within a social crisis. The article examines an…
Goldman, Janice J., 1953-
Educational reform has become a central concern of public policy debates at both the state and federal level. The policy trend both nationally and locally is towards uniform standards in education, with testing as the ...
Costa, Nilson do Rosário; Siqueira, Sandra Venâncio; Uhr, Deborah; Silva, Paulo Fagundes da; Molinaro, Alex Alexandre
This study examines the relationships between Brazilian psychiatric reform, the adoption of the Centers for Psychosocial Care (CAPS) and the development of the Unified Health System (SUS). The adherence of municipal governments was a variable determinant for the spread of reform, especially due to the continental scale and fragmentation of the Brazilian federation. The article demonstrates the institutional stability of psychiatric reform in Brazil over two decades. The institutional nature of the decision-making process in the public arena has permitted the implementation of new organizational formats through imitation and financial incentives. The psychiatric reform was successful in defending the advantages of CAPS in relation to the asylum and hospital model dominant in past decades. The inductive policies, strengthened and upheld by Law 10.216/2001, transformed the agenda of psychiatric reform, limited to pioneering cities in a national public policy. PMID:22124901
Bray, Judy; Medler, Alex
Denver is currently in the national education spotlight, largely because of its willingness to try a unique combination of major education reforms not seen in other large urban school districts. While many observers hold these reforms in high regard, a steep road lies ahead. Current student results are unacceptable by all measures. The time is…
Jihong Ding; Minglai Zhu
This paper evaluates Chinese public health insurance reform enforced since 1998 in terms of its welfare effects. We evaluate\\u000a China health insurance reform since 1998 using the China Health and Nutrition Surveys (CHNS) data with relevant econometric\\u000a models. The results of empirical studies show that the public health insurance status has significant impact on medical service\\u000a utilization and expenditure. The
Welford, W.H. (Olwine, Connelly, Chase, O'Donnell and Weyher, Washington, DC (United States)); Elston, P.J. (Long Lake Energy Corp., New York, NY (United States))
This article examines the reasons that it is likely that the 102nd Congress will pass legislation that will reform the Public Utilities Holding Company Act of 1935. The impetus provided by the Persian Gulf War, public opinion, the National Energy Plan and the National Independent Energy Producers (NIEP) is examined. Several proposals of the NIEP to guard against market abuses in the reforms are presented.
Carpenter, Jacqueline; Doverspike, Dennis; Miguel, Rosanna F.
According to public service motivation theory, individuals with a strong public service orientation are attracted to government jobs. This proposition was investigated in three studies by measuring public sector motivation at a pre-entry level as an individual difference variable affecting perceptions of fit and organizational attraction. Results…
Kapro?, Danuta; Stephan, Werner
The involvement of the public in educational reform processes in modern democratic societies primarily serves the purpose of politically legitimizing the reform agenda. This study examines the rationales implicitly or explicitly submitted to the public to explain why educational reforms in the two countries should be endorsed. Although differences in the political culture caution against a hasty comparison of the two case studies, a number of politico-economic similarities allow for a valid juxtaposition. In Poland the context of socio-political and economic renewal prompted the reformers to emphasize the human-capital model which heightened public awareness and participation in the debate surrounding the reform. Public involvement in Saskatchewan was negatively affected for mainly two reasons. First, the government evidently manipulated public input by various means and thereby appears to have predetermined the outcome. Second, the rationale for the reform, based on a free-market model, tightened the linkage between the needs of the labour market and the mandate of the schools. As a result, public interest and participation was greatly diminished.
In 1992, Congress enacted the HOPE VI program to overhaul the nation's public housing policy. The reform legislation was prompted by a report commissioned by Congress that deemed two-thirds of all public housing "severely distressed." Since the landmark public housing policy was enacted in 1992, the Department of Housing and Urban Development…
Oliff, Monique; Mayaud, Philippe; Brugha, Ruairí; Semakafu, Ave Maria
Universal access to comprehensive reproductive health services, integrated into a well-functioning health system, remains an unfulfilled objective in many countries. In 2000-2001, in Tanzania, in-depth interviews were conducted with central level stakeholders and focus group discussions held with health management staff in three regional and nine district health offices, to assess progress in the integration of reproductive health services. Respondents at all levels reported stalled integration and lack of synchronisation in the planning and management of key services. This was attributed to fear of loss of power and resources among national level managers, uncertainty as to continuation of donor support and lack of linkages with the Health Sector Reform Secretariat. Among reproductive health programmes, sexually transmitted infection (STI) control alone retained its vertical planning, management and implementation structures. District-level respondents expressed frustration in their efforts to coordinate STI service delivery with other, more integrated programmes. They reported contradictory directives and poor communication channels with higher levels of the Ministry of Health; lack of technical skills at district level to undertake supervision of integrated services; low morale due to low salaries; and lack of district autonomy in decision-making. Integration requires a coherent policy environment. The uncoordinated and conflicting agendas of donors, on whom Tanzania is too heavily reliant, is a major obstacle. PMID:12800702
Vergara I, Marcos
Currently, there is no discussion on the need to improve and strengthen the institutional health care modality of FONASA (MAI), the health care system used by the public services net and by most of the population, despite the widely known and long lasting problems such as waiting lists, hospital debt with suppliers, lack of specialists and increasing services purchase transference to the private sector, etc. In a dichotomous sectorial context, such as the one of health?s social security in Chile (the state on one side and the market on the other), points of view are polarized and stances tend to seek refuge within themselves. As a consequence, to protect the public solution is commonly associated with protecting the ?status quo?, creating an environment that is reluctant to change. The author proposes a solution based on three basic core ideas, which, if proven effective, can strengthen each other if combined properly. These are: network financing management, governance of health care services in MAI and investments and human resources in networked self-managed institutions. The proposal of these core ideas was done introducing a reality testing that minimizes the politic complexity of their implementation. PMID:25860366
Sullivan, G; Young, A S; Fortney, S; Tillipman, D; Murata, D; Koegel, P
PARTNERS is the Los Angeles County Department of Mental Health's capitated managed care treatment program. To explore the context in which public sector managed care reforms are occurring and to understand the obstacles to implementing such programs, qualitative data were collected from administrators, case managers, and clients. Administrators were found to need assistance in negotiating managed care contracts and in tracking costs. Case managers, although concerned about increased clinical demands, enjoyed the flexibility and creativity their new roles allowed. Clients were satisfied with their increased independence, even though many had to change their site of care. Beyond considering these concerns, the range of community stakeholders who may be affected by such interventions must be addressed. PMID:11338327
Indiana Univ., Bloomington. Midwest Center for Public Sector Labor Relations.
The purpose of this guide is to answer common questions about public sector labor relations with special emphasis on how this sector differs from the private sector. A beginning section offers general information defining and explaining public sector labor relations. A segment on labor relations law details legislation and the function of…
Going public represents a new style of presidential leadership in which the president sells his programs directly to the American public. Several scholars have argued that presidents need to go to the public more often and make skillful use of public rhetoric to galvanize public support for their policy agenda. This article examines President Clinton's public rhetoric and his failed strategy of going public to rally support for his health care reform proposal during 1993-1994. It concludes with a discussion of factors that help explain President Clinton's failure to rally public support for the Health Security Act of 1993 and secure its passage in the Congress. PMID:15189794
Anuskiewicz, T.; Johnston, J.; Zimmerman, R. R.
Current activities of the program to accelerate specific applications of space related technology in major public sector problem areas are summarized for the period 1 June 1971 through 30 November 1971. An overview of NASA technology, technology applications, and supporting activities are presented. Specific technology applications in biomedicine are reported including cancer detection, treatment and research; cardiovascular diseases, diagnosis, and treatment; medical instrumentation; kidney function disorders, treatment, and research; and rehabilitation medicine.
Background: India’s health sector witnessed some major policy changes in 1990s that aimed at making health services more accessible to the population. Methods: In this paper, I tried to present some preliminary results of the significant changes that occurred between 1995/6 and 2004, especially in relation to the question of access to healthcare for the poor and rural population using data from 52nd (1995–6) and 60th round (2004) of National Sample Survey Organization on ‘morbidity and healthcare’. Results: The analysis suggests that overall utilization of healthcare services have declined and the odds of not seeking care due to financial inability has further increased among the poor and rural population during the period of reforms. Results of the multivariate logit regression model indicate that the non-poor, middle and above educated people were having greater likelihood of using services from private health care provider. Conclusion: Interestingly, poor and rural residents were more likely to have used healthcare from public facilities in 2004 than in 1995–6, suggesting that the shift from private to public sector is encouraging, provided they receive good quality health care services at public facilities and do not face catastrophic health expenditures. PMID:24757689
McBride, Genevieve G.
Analysis of the Wisconsin woman suffrage campaign of 1910-1920 suggests that public relations belonged not only to political or business practices, but was equally a process by which the masses achieved their own best interests in nineteenth and early twentieth century social reform movements. Woman suffragists were led by women, and the public…
Don Little's Catalytic Reforming deals exclusively with reforming. With the increasing need for unleaded gasoline, the importance of this volume has escalated since it combines various related aspects of reforming technology into a single publication. For those with no practical knowledge of catalytic reforming, the chemical reactions, flow schemes and how the cat reformer fits into the overall refinery process will be of interest. Contents include: Catalytic reforming in refinery processing: How catalytic reformers work - chemical reactions; Process design; The catalyst, process variables and unit operation; Commercial processes; BTX operation; Feed preparation; naphtha hydrotreating and catalytic reforming; Index.
The debate about the public-private mix for health care has been dominated by rhetoric and the failure to evaluate the characteristics of the outcomes of public and private health care systems and to relate these to policy targets. After a brief analysis of the competing, liberal (conservative) and collectivist (socialist), objectives, the nature of the private health care sector in Britain is described and it is shown that growth has faltered due to cost containment problems. This outcome is the product of characteristics of the private health care system, paralleled precisely in the NHS: asymmetry information, monopoly power, moral hazard and third party pays. The final section discusses briefly some remedies for the inefficient and inequitable outcomes which are seen in all health care markets and it is argued that competition within public and private health care systems may enable each system type to achieve its own particular objectives more efficiently. PMID:3749949
Evers, Williamson M., Ed.; Izumi, Lance T., Ed.; Riley, Pamela A., Ed.
This book presents a collection of recent articles on the problems in today's schools, why school and students are underperforming, exploring a range of topics and explaining why some reforms in education are destined to fail while others have been proven to work. The first section, "Teaching Approaches," presents articles on progressive…
Liu, Su; Yam, Carrie H K; Huang, Olivia H Y; Griffiths, Sian M
How to provide better primary care and achieve the right level of public-private balance in doing so is at the centre of many healthcare reforms around the world. In a healthcare system like Hong Kong, where inpatient services are largely funded through general taxation and ambulatory services out of pocket, the family doctor model of primary care is underdeveloped. Since 2008, the Government has taken forward various initiatives to promote primary care and encourage more use of private services. However, little is known in Hong Kong or elsewhere about consumers' willingness to pay (WTP) for private services when care is available in the public sector. This study assessed willingness of the Hong Kong elderly to pay for specific primary care and preventive services in the private sector, through a cross-sectional in-person questionnaire survey and focus group discussions among respondents. The survey revealed that the WTP for private services in general was low among the elderly; particularly, reported WTP for chronic conditions and preventive care both fell below the current market prices. Sub-group analysis showed higher WTP among healthier and more affluent elderly. Among other things, concerns over affordability and uncertainty (of price and quality) in the private sector were associated with this low level of WTP. These results suggest that most elderly, who are heavy users of public health services but with limited income, may not use more private services without seeing significant reduction in price. Financial incentives for consumers alone may not be enough to promote primary care or public-private partnership. Public education on the value of prevention and primary care, as well as supply-side interventions should both be considered. Hong Kong's policy-making process of the initiative studied here may also provide lessons for other countries with ongoing healthcare reforms. PMID:23161587
Cockcroft, Anne; Andersson, Neil; Milne, Deborah; Hossain, Md Zakir; Karim, Enamul
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 findings to examine the changes in public opinions, use and experience of health services in the period of the HPSP. Methods We carried out three household surveys (1999, 2000 and 2003) of a stratified random sample of 217 rural sites and 30 urban sites. Each site comprised 100–120 contiguous households. Each survey included interviews with 25,000 household respondents and managers of health facilities serving the sites, and gender-stratified focus groups in each site. We measured: household ratings of government health services; reported use of services in the preceding month; unmet need for health care; user reports of waiting times, payments, explanations of condition, availability of prescribed medicines, and satisfaction with service providers. Results Public rating of government health services as "good" fell from 37% to 10% and the proportion using government treatment services fell from 13% to 10%. Unmet need increased from 3% to 9% of households. The proportion of visits to government facilities fell from 17% to 13%, while the proportion to unqualified practitioners rose from 52% to 60%. Satisfaction with service providers' behaviour dropped from 66% to 56%. Users were more satisfied when waiting time was shorter, prescribed medicines were available, and they received explanations of their condition. Conclusion Services have retracted despite increased investment and the public now prefer unqualified practitioners over government services. Public opinion of government health services has deteriorated and the reforms have not specifically helped the poorest people. User satisfaction could be increased if government doctors improved their interaction with patients and if waiting times were reduced by better management of facilities. PMID:17324263
Tsigilis, Nikolaos; Zachopoulou, Evridiki; Grammatikopoulos, Vasilios
The purpose of the present study was to examine perceived levels of burnout and job satisfaction of Greek early educators, across public and private sector. One hundred and seventy eight childhood educators participated in the study. 108 were working in the public sector, 67 in private sector, whereas three did not respond. Participants were…
Lau, Alan W.; Pavett, Cynthia M.
This study compared high level managerial jobs in public and private sectors. Results indicate that managers in the public sector perform the same kind of activities as managers in the private sector in terms of complexity of job content and roles and in terms of job characteristics. (Author)
I. Dincer; M. M. Hussain; I. Al-Zaharnah
In this paper, we deal with the analysis of energy and exergy utilization in the public and private sector of Saudi Arabia by considering the energy and exergy flows for the years between 1990 and 2001. Energy and exergy analyses for the public and private sector are undertaken to study the energy and exergy efficiencies. These sectoral efficiencies are then
Axelrod, D A; Millman, D; Abecassis, M M
The Health Care Reform (HCR) legislation passed by Congress in 2010 will have significant impact on transplant centers, patients and health care professionals. The Act seeks to expand coverage, limit the growth in health care costs and reform the delivery and insurance systems. In Part I of this two part series, we provide an overview and perspective of changes in private health insurance resulting from HCR. Under the plan, all Americans will be required to purchase coverage through their employer or via an improved individual/small group market. This legislation limits abusive practices such as limitations on preexisting conditions, lifetime and annual coverage limitations and dropping of beneficiaries if they become sick. The legislation will also limit high-cost plans and regulate premium increases. Private sector reforms are likely to benefit our patients by increasing the number of patients with access to transplant services, since the use of 'preexisting' conditions will be eliminated. However without a concomitant increase in the organ supply, longer waiting times and greater use of marginal organs are likely to increase the cost of transplant. Furthermore, transplant providers will receive reduced reimbursement as a result of market consolidation and the growing power of large transplant networks. PMID:20825383
John R. Logan; Yiping Fang; Zhanxin Zhang
Housing reform in China has proceeded on two tracks: privatization of public housing and development of a new private housing sector. During this period of transition, rents have remained relatively low in the remaining public housing, and purchase prices offered to occupants of public housing have been well below market prices. Although these rents and prices are partly based on
Food Price Subsidies and Nutrition: Evidence from State Reforms to India's Public Distribution food price subsidies affect household nutrition using a dramatic expansion of the availability. These results differ from recent studies suggesting that food subsidies have little effect on nutrition
National Center on Performance Incentives, 2008
In "Market-Based Pay Reform for Public School Teachers"--a paper presented at the National Center on Performance Incentives research to policy conference in February--Michael Podgursky, professor of economics at the University of Missouri, examines the effects and unintended consequences of the current compensation system for teachers in the U.S.…
Ruifa Hu; Yaqing Cai; Kevin Z. Chen; Ynogwei Cui; Jikun Huang
The top down public agricultural extension system in China and its early reforms during the 1990’s has left millions of farmers without access to extension services. An inclusive agricultural extension system was introduced in 2005 to better meet the diverse technology needs of small farmers. Three key features of the experiment are 1) inclusion of all farmers as target beneficiaries,
Clowes, George A.
Recent concerns over the efficacy of vouchers arise largely from a failure to distinguish between different types of school choice efforts: targeted vouchers, aimed at rescuing children from failing schools, and universal vouchers, aimed at systemic reform of the public school system. It is unreasonable to expect a targeted voucher program to…
Jenson, Jeffrey M.; Howard, Matthew O.
Cyclic fluctuations in juvenile justice policy and their relationship to policy, practice, and youth crime are examined. This analysis suggests that overall crime rates are independent of prevailing juvenile justice policies. These findings support targeted prevention efforts including policy reforms, public education efforts, and social practice…
Titles I and III of the Public Utility Regulatory Policies Act of 1978 (PURPA) are examined with a focus on the economic bases and implications of retail sales by electric and natural gas utilities. Title I outlines the requirements and procedures for setting retail electricity rates. Six ratemaking standards and the various arguments in favor of rate reform are examined.
Smoley, Eugene, Jr.
This document discusses the desirability of creating a synergistic business/education relationship. The most pressing problems of urban education and education reform are not conceptual or analytic, but managerial. Dysfunctional public education will affect business in the future because the products of the education system will enter the work…
Kim, Ki Su
Statism is a political economy that prevails in many East Asian countries. This paper explores its negative role in South Korea's education reform since the restoration of civilian democracy in 1993. It takes note of South Koreans' aberrant use of the terms "public education" and "private education" and the frame of reference for policy discourses…
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…
Him, Miki Suzuki; Ho?gör, Ay?e Gündüz
In this article, we examine how socioeconomically disadvantaged women are affected by health sector reform and family planning policy changes in Turkey through a case study of Kurdish women's struggles for birth control. In Turkey, a family planning program became relatively marginalized in primary health care services as a result of health sector reform as well as a shift of population policy toward a moderately pronatal approach. We argue that an emerging health care system would leave disadvantaged women unable to benefit from contraceptives and would perpetuate reproductive health inequalities between women in the country. PMID:24134209
Agasisti, Tommaso; Dal Bianco, Antonio
In this article, we analyse the effects of teaching reforms in Italy. These were introduced in 1999, and changed the entire organization of university courses, where the Bachelor-Master (BA-MA) structure was adopted. The first step is to define the production process of higher education (HE). This process consists of several inputs (professors,…
Haws, J M; McKenzie, M; Mehta, M; Pollack, A E
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
Selway, Joel Sawat
How do changes in electoral rules affect the nature of public policy outcomes? The current evidence supporting institutional theories that answer this question stems almost entirely from quantitative cross-country studies, the data of which contain very little within-unit variation. Indeed, while there are many country-level accounts of how changes in electoral rules affect such phenomena as the number of parties or voter turnout, there are few studies of how electoral reform affects public policy outcomes. This article contributes to this latter endeavor by providing a detailed analysis of electoral reform and the public policy process in Thailand through an examination of the 1997 electoral reforms. Specifically, the author examines four aspects of policy-making: policy formulation, policy platforms, policy content, and policy outcomes. The article finds that candidates in the pre-1997 era campaigned on broad, generic platforms; parties had no independent means of technical policy expertise; the government targeted health resources to narrow geographic areas; and health was underprovided in Thai society. Conversely, candidates in the post-1997 era relied more on a strong, detailed national health policy; parties created mechanisms to formulate health policy independently; the government allocated health resources broadly to the entire nation through the introduction of a universal health care system, and health outcomes improved. The author attributes these changes in the policy process to the 1997 electoral reform, which increased both constituency breadth (the proportion of the population to which politicians were accountable) and majoritarianism. PMID:21591306
Drezner, Jeffrey Alan
Understanding why government officials behave in certain ways under particular circumstances is an important theme in political science. This research explores the design of policies and incentives targeted at public sector officials, in particular the use of market based policy tools in a non-market environment, and the influence of that organizational environment on the effectiveness of the policy. The research examines the case of Department of Defense (DoD) facility energy management. DoD energy policy includes a provision for the retention of savings generated by conservation activities: two-thirds of the savings is retained at the installation generating the savings, half to used for further investment in energy conservation, and half to be used for general morale, welfare, and recreation activities. This policy creates a financial incentive for installation energy managers to establish higher quality and more active conservation programs. A formal written survey of installation energy managers within DoD was conducted, providing data to test hypotheses regarding policy effectiveness and factors affecting policy implementation. Additionally, two detailed implementation case studies were conducted in order to gain further insights. Results suggest that policy design needs to account for the environment within which the policy will be implemented, particularly organizational culture and standard operating procedures. The retention of savings policy failed to achieve its intended outcome---retention of savings for re-investment in energy conservation---because the role required of the financial management community was outside its normal mode of operation and interests and the budget process for allocating resources did not include a mechanism for retention of savings. The policy design did not adequately address these start-up barriers to implementation. This analysis has shown that in order for retention of savings, or similar policies based on market-type mechanisms, to be effective in the public sector context, the required cultural changes and appropriate implementing mechanisms must be provided for in the policy design.
Kirk, Megan; Tomm-Bonde, Laura; Schreiber, Rita
More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to public health in its emphasis on the economic, legal, political and cultural factors that influence health. With public health renewal underway across Canada, and despite overwhelming support in the public health community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear. In this paper, we present the historical understanding of health promotion in Canada, namely highlighting the contributions from the Lalonde Report, Alma Ata Declaration, the Ottawa Charter for Health Promotion and the more recent population health movement. We discuss public health renewal, using the province of British Columbia in Canada as an example. We identify the potential threats to health promotion in public health renewal as it unfolds. PMID:24534261
Roy, Anish Kumar
To date the public sector role in facilitating the transition to a sustainable energy future has been envisaged mainly from a regulatory perspective. In such a role, the public sector provides the push factors---enforcing regulations and providing incentives---to correct market imperfections that impede energy transitions. An alternative and complementary role of the public sector that is now gaining increasing attention is that of catalyzing energy transitions through public sector energy management initiatives. This dissertation offers a conceptual framework to rationalize such a role for the public sector by combining recent theories of sustainable energy transition and public management. In particular, the framework identifies innovative public management strategies (such as performance contracting and procurement) for effectively implementing sustainable energy projects in government facilities. The dissertation evaluates a model of sustainable public sector energy management for promoting energy efficiency in Malaysia. The public sector in Malaysia can be a major player in leading and catalyzing energy efficiency efforts as it is not only the largest and one of the most influential energy consumers, but it also plays a central role in setting national development strategy. The dissertation makes several recommendations on how a public sector energy management strategy can be implemented in Malaysia. The US Federal Energy Management Program (FEMP) is used as a practical model. The analysis, however, shows that in applying the FEMP model to the Malaysian context, there are a number of limitations that will have to be taken into consideration to enable a public sector energy management strategy to be effectively implemented. Overall the analysis of this dissertation contributes to a rethinking of the public sector role in sustainable energy development that can strengthen the sector's credibility both in terms of governance and institutional performance. In addition, it links theory with practice by offering a strategy that can effectively address critical issues arising from the energy-development-policy nexus of the sustainable energy development debate.
Fox, D. M.
Standard interpretations of the history of public health in New York City in the twentieth century describe either the decline or the growth of the importance accorded to public health activities. To the contrary, public health has, paradoxically, both declined in salience and attracted increasing resources. This article describes the politics of public health in New York City since the 1920s. First it describes events in the history of public health in the context of events in the economy and in city, state, and national politics. Then it proposes three descriptive models for arraying the data about public health politics: accretion, reform, and crisis. Next it describes how the politics of AIDS in New York City in the 1980s was a consequence of the history that produced these three political styles. Finally, it argues that the three political styles are generalizable to the history of public health throughout the United States in the twentieth century. PMID:1814059
Reform Judaism, the branch of Judaism most liberal in religious practice and most committed to adapting to the realities of modern America, has recently abandoned its opposition to Jewish day schools and has thereby signalled its acceptance of an alternative to public education. When the ancestors of these Reform Jews came to America in the middle…
Environmental economists recommend the use of taxes and fiscal changes as market economy instruments for environmental policy. The purpose of such measures is to reduce or to avoid market failure due to negative external effects. Normally, taxes are fiscal income sources whereas environmental taxes serve as an incentive to change consumer behavior. In this paper, the effects of an ecological tax reform in the traffic sector on a selected German household will be illustrated on the basis of a theoretical welfare approach. The basic idea used for an ecological tax reform is first to reduce those household activities which produce greenhouse gas emissions, then to use the earned tax revenue to compensate the household, so that the household budget is unchanged to a large degree. In this work, direct monetary compensation models are compared to the idea of the indirect utility compensation. Direct monetary compensation gives every household a flat amount of money (lump-sum transfer) so the individual has the choice to decide which sort of transportation he prefers.
Rossi, T; Murillo Fort, C; Puente Karolys, J C
This paper deals with corruption and the lack of transparency in public sector purchases as well as with the main instruments to obtain adequate results in purchase negotiation.Firstly, we discuss how corruption causes concern to national governments, international organizations, academic centers, non-governmental organizations and society in general. The consequences of corruption in Argentina and other Latin American countries are highlighted, especially the effect of corruption on economic growth and the way it creates economic inefficiency and inequality.Secondly, the database created by the Subsecretary of Strategic Management of the Autonomous Government of the City of Buenos Aires is analyzed. The central purpose of this study is to evaluate the impact of the Administrative Reform of 1998 on the prices of 24 products acquired by 13 general acute care hospitals from 1998-1999. The weighted prices, the number of units purchased and the total number of contracts given in this period, as well as the products with the greatest utilization rate, are analyzed. Multivariante analysis was used to identify hospitals with appropriate activity and efficient budget administration (activity and negotiation indicators). Price development was analyzed using the regression technique (ordinary least squares), which demonstrated an 8% reduction in prices for the year 1999. The contribution of each hospital to this variation is presented using dummy variables. Thus, six of the 13 hospitals significantly contributed to the decrease in prices. Of these six, three hospitals also contributed to reduction in price dispersion. The results obtained allow us to conclude that, if public hospitals have adequate purchase negotiation instruments and a uniform legal framework, they can achieve a good level of activity. Furthermore, public hospitals can contribute to reductions in price and price dispersion, at the same time as improving efficiency in the assignation and utilization of resources. PMID:11841761
Rubinstein, Saul A.; McCarthy, John E.
For most of the past decade the policy debate over improving U.S. public education has centered on teacher quality. In this debate, teachers and their unions have often been seen as the problem, not part of the solution. Further, current discourse often assumes that conflicting interests between teacher unions and administration is inevitable.…
Din, Siraj ud; Khan, Bakhtiar; Rehman, Rashid; Bibi, Zainab
The purpose of this paper is to gain an insight into the conflict management in public and private sector universities in Khyber Pakhtunkhwa, Pakistan. To achieve the earlier mentioned purpose, survey method was used with the help of questionnaire. In this research, impact of university type (public and private sector) was examined on the conflict…
Van Wart, Montgomery; And Others
This handbook is intended to assist trainers, design specialists, training managers, technical trainers, and other members of the public sector who conduct training on an occasional basis. The following topics are covered: understanding human resource development (HRD) and its role in the public sector--expanding the scope and significance of HRD…
Al cia Adser; Carles Boix
To account for the strong and positive correlation found betweentrade openness and the size of the public sector, scholars havedeveloped theoretical explanations in which politics have remainedconspicuously absent in two ways. First, why some economies are moreopen than others has been (implicitly) attributed to parametersexogenous to the political decisions of domestic actors. Second, thepresence of a sizable public sector has
The paper compares private and public sector developments relating to radon mitigation in the U.S. In response to elevated radon levels in many U.S. houses, the Federal and State governments and the private sector have undertaken many varied mitigation and public information effo...
The monograph deals with disparities between public and private sector employment conditions and practices which affect the recruitment and retention of personnel. The emphasis is on state agencies because the disparities are most evident at that level of public sector employment...
William P. Wagner; Yvonne Lederer Antonucci
While large-scale ERP deployments have been prevalent in the private-sector, there have been few attempts to deploy them in the public sector. This paper describes the first large-scale, public-sector ERP implementation, which integrates systems for over 50 different agencies in the state of Pennsylvania government. Over 20 individuals were interviewed during three years to identify and describe issues, success factors,
The Center for Public Integrity conducted a year-long investigation of the decision-making processes of the U.S. government during its work on health care reform. The results suggest that health care reform has become the most heavily lobbied legislative initiative in recent U.S. history. In 1993 and 1994, hundreds of special interests spent over $100 million to influence the outcome of this public policy issue. In Part II, the authors describe some of these special interests, including the insurance industry, both the largest companies and those that make up the Health Insurance Association of America; doctors, hospitals, and other health care providers; the pharmaceutical industry; businesses of all sizes; and the tobacco industry. PMID:8575865
Piotti, B; Macome, E
It has been predicted that major introduction of information communication technology (ICT) for health care organisations (HCO) over the next 10 years will be used to achieve the universal coverage and improve the quality of health care delivered to people. Which is the best strategy on ICT transfer, adoption and adaptation for the local Mozambican HCO? This paper argues that a sociotechnical approach of ICT development can help policy makers and health managers to address the technology transfer in a better and more appropriate way to their social context and to the public health reforms in progress. The urgency of health care demands (e.g. AIDS epidemic) and the institutional changes implemented by the Government and the local Ministry of Health (MOH), open a dynamic process of re-organisation inside the health institutions in the next years. This process needs to be monitored and initiatives planned, which places pressure on the evolution of health information system (HIS). The increase in the use of ICT can be an ally for health managers. The emergence of the open source software (OSS) and the recent ICT market trends towards networking may also enable local HCO to better face and solve the long process of health care standardisation, which usually prepares and accompanies any introduction of ICT. On the other side, the "big bang" introduction of electronic packages, devices and software applications may be an obstacle framing and anchoring local HCO to external settings, "modern" and universal models. Thus, a uniform step-by-step implementation of hospital-based health information system is desirable. PMID:16807083
Zhong, Lijin; Mol, Arthur P. J.; Fu, Tao
During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China’s water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China.
Shan, Ming; Chan, Albert P C; Le, Yun; Hu, Yi
Response strategy is a key for preventing widespread corruption vulnerabilities in the public construction sector. Although several studies have been devoted to this area, the effectiveness of response strategies has seldom been evaluated in China. This study aims to fill this gap by investigating the effectiveness of response strategies for corruption vulnerabilities through a survey in the Chinese public construction sector. Survey data obtained from selected experts involved in the Chinese public construction sector were analyzed by factor analysis and partial least squares-structural equation modeling. Analysis results showed that four response strategies of leadership, rules and regulations, training, and sanctions, only achieved an acceptable level in preventing corruption vulnerabilities in the Chinese public construction sector. This study contributes to knowledge by improving the understanding of the effectiveness of response strategies for corruption vulnerabilities in the public construction sector of developing countries. PMID:24894336
Ruifa Hu; Yaqing Cai; Kevin Z. Chen; Yongwei Cui; Jikun Huang
The top-down public agricultural extension system in China and its early commercialization reforms during the 1990s have left millions of farmers without access to extension services. A pilot inclusive agricultural extension system was introduced in 2005 to better meet the diverse needs of small-scale farmers. Three key features of the experiment are (1) inclusion of all farmers as target beneficiaries,
urban parks to reform corrupted city dwellers into the good society. Public health, the primary virtue machines with which to reform a corrupted society, making it into something more idealistic. Nature
Rosenberg, Sarah; Silva, Elena
Over the past decade, teachers have seen changes in both their conditions of employment--from pay to retirement benefits--and their practice. Far too often, these policies have been made by people who talk "about" teachers, rather than talking "to" them. Last fall, Education Sector surveyed a nationally representative random sample of more than…
Outsourcing was one process of privatisation used in the Victorian public health sector in the 1990s. However it was used to varying degrees and across a variety of different services. This paper attempts to answer the questions: Why have managers outsourced? What have managers considered when they have decided to outsource? The research was carried out in a rural hospital and a metropolitan network in Victoria. The key findings highlight the factors that decision makers considered to be important and those that led to negative outcomes. Economic factors, such as frequency of exchange, length of relationships between the parties, and information availability, were often ignored. However, other factors such as outcome measurability, technology, risk, labour market characteristics and goal conflict, and political factors such as relative power of management over labour were often perceived as important in the decision-making process. Negative outcomes from outsourcing were due to the short length of relationships and accompanying difficulties with trust, commitment and loyalty; poor quality; and excessive monitoring and the measurement of outcomes. PMID:17266498
Consultation of the DfE's Green Paper, "Support and Aspiration: A New Approach to Special Educational Needs," provoked considerable debate among public and private sector professionals, parents and young people over the planned special educational needs reform. Since then, publication of the Children and Families Bill in 2013…
Hargrove, D S; Fox, J C; Goldman, C R
The labor intensive public mental health system needs to encourage trainees in mental health professions to consider careers in the public sector. Recent evidence is that younger professionals are choosing other career paths following their training. This paper suggests that the availability of relevant training opportunities, positive role models, financial support while in training, and a supportive group of peers are important components of training for public sector careers. PMID:2055005
Fronstin, Paul; Helman, Ruth
PUBLIC SUPPORT FOR HEALTH REFORM: Findings from the 2009 Health Confidence Survey--the 12th annual HCS--indicate that Americans have already formed strong opinions regarding various aspects of health reform, even before details have been released regarding various key factors. These issues include health insurance market reform, the availability of a public plan option, mandates on employers and individuals, subsidized coverage for the low-income population, changes to the tax treatment of job-based health benefits, and regulatory oversight of health care. These opinions may change as details surface, especially as they concern financing options. In the absence of such details, the 2009 HCS finds generally strong support for the concepts of health reform options that are currently on the table. U.S. HEALTH SYSTEM GETS POOR MARKS, BUT SO DOES A MAJOR OVERHAUL: A majority rate the nation's health care system as fair (30 percent) or poor (29 percent). Only a small minority rate it excellent (6 percent) or very good (10 percent). While 14 percent of Americans think the health care system needs a major overhaul, 51 percent agree with the statement "there are some good things about our health care system, but major changes are needed." NATIONAL HEALTH PLAN ELEMENTS RATED HIGHLY: Between 68 percent and 88 percent of Americans either strongly or somewhat support health reform ideas such as national health plans, a public plan option, guaranteed issue, expansion of Medicare and Medicaid, and employer and individual mandates. MIXED REACTION TO HEALTH BENEFITS TAX CAP: Reaction to capping the current tax exclusion of employment-based health benefits is mixed. Nearly one-half of Americans (47 percent) would switch to a lower-cost plan if the tax exclusion were capped, 38 percent would stay on their current plan and pay the additional taxes, and 9 percent don't know. CONTINUED FAITH IN EMPLOYMENT-BASED BENEFITS, BUT DOUBTS ON AFFORDABILITY: Individuals with employment-based health benefits are confident that employers will continue to offer such benefits. They are much less confident that they would be able to afford coverage on their own, even if employers gave them the money they currently spend on health benefits. However, were employers to stop offering coverage, respondents report that they are likely to purchase it on their own. RISING HEALTH COSTS HURTING FAMILY FINANCES: Those experiencing health cost increases tend to say these increases have negatively affected their household finances. In particular, they indicate that increased health care costs have resulted in a decrease in contributions to a retirement plan (32 percent) and other savings (53 percent) and in difficulty paying for basic necessities (29 percent) and other bills (37 percent). COSTS ALSO AFFECTING HEALTH CARE USE: Many consumers report they are changing the way they use the health care system in response to rising health care costs. Roughly 80 percent of those with higher out-of-pocket expenses say these increased costs have led them to try to take better care of themselves and choose generic drugs more often. One-quarter also say they did not fill or skipped does of their prescribed medications in response to increased costs. PMID:19580218
Mark Hart; Helena Lenihan
This paper aims to contribute to the debate about the role of the public sector in stimulating greater use of private sector equity for business start-up and growth in two ways. First, to examine the extent to which the provision of public sector equity finance enables individual firms to raise additional funds in the private sector market place. Second, to
Alikhasi, Narges; Khadivi, Reza; Kheyri, Maryam
Background: Improving the utilization rate of antenatal care is a critical strategy for achieving the reproductive health goals in Iran. The aim of this study was to assess the utilization rate of antenatal care (ANC) by women after health sector reform (HSR) interventions in rural areas of Islamic Republic of Iran (IR Iran). Materials and Methods: This is a retrospective cross-sectional study. The data were gathered by cluster sampling from 400 motherhood records of mothers whose last pregnancies had been terminated in the first 3 months of 2013. Data were collected from 21 rural health centers of Isfahan district during the year 2013. The utilization rate of ANC by mothers was assessed by the number of visits they had, the time of the first ANC visit, the occurrence of pregnancy- or delivery-related complications, and the number of postpartum visits. Results: The mean time of the first ANC was 9 ± 5.23th week of gestational age. For 69.3% of pregnant women, the first ANC was before the 12th week. Overall, the frequency of ANC visits ranged from 2 to 21, with the average of 10.6 ± 3.23 visits. 93.8% of the utilized ANC visits were adequate. 99.8% of the deliveries took place in the hospital. 99% of mothers had at least one visit in the postpartum period. 4% of the mothers had suffered from pregnancy-related complications. Conclusion: It seems that IR Iran has achieved to one of the important objectives by its reform in health care access, that is, more ANC for pregnant women. PMID:25558259
Ramesh, M; Wu, Xun
Declining access to health care and rapidly rising health expenditures are a matter of grave public concern in China. After decades of efforts to reduce its involvement, the Chinese government is currently in the process of reforming the sector through increase in public expenditures and expansion of health insurance. The objective of this paper is to assess the potential of the reform direction in light of international experiences with similar reforms. It argues--on the basis of examination of reform experiences in Korea, Singapore and Thailand--that financing reforms without parallel measures to improve the provision system, especially how providers are paid, are unlikely to address the problems and may actually aggravate them. If the financing reforms are to succeed, it is vital for China to reform the incentives that guide the providers' behaviour. PMID:19419809
Hamid, Saima; Malik, Asmat Ullah; Kamran, Irum; Ramzan, Musarat
Background Many low and middle income countries lack the human resources needed to deliver essential health interventions. A health care system with a limited number of nurses cannot function effectively. Although the recommended nurse to doctor ratio is 4:1, the ratio in Pakistan is reversed, with 2.7 doctors to one nurse. Methods A qualitative study using narrative analysis was undertaken in public and private tertiary care hospitals in Pakistan to examine and compare job satisfaction among nurses and understand the factors affecting their work climate. Interactive interviews were conducted with nurses working with inpatients and outpatients. Results All of the respondents had joined the profession by choice and were supported by their families in their decision to pursue their career, but now indicated that they were dissatisfied with their jobs. Three types of narratives were identified, namely, “Working in the spirit of serving humanity”, “Working against all odds”, and “Working in a functional system and facing pressures of increased accountability”. Nurses working in a public sector hospital are represented in the first two narrative types, whereas the third represents those working in a private sector hospital. The first narrative represents nurses who were new in the profession and despite hard working conditions were performing their duties. The second narrative represents nurses working in the public sector with limited resources, and the third narrative is a representation of nurses who were working hard and stressed out despite a well functioning system. Conclusion The study shows that the presence of a well trained health workforce is vital, and that certain aspects of its organization are key, including numbers (available quantity), skill mix (health team balance), distribution (urban/rural), and working conditions (compensation, nonfinancial incentives, and workplace safety). This study has identified the need to reform policies for retaining the nursing workforce. Simple measures requiring better management practices could substantially improve the working environment and hence retention of nurses. PMID:24453494
Craglia, Massimo; Friis-Christensen, Anders; Ostländer, Nicole; Perego, Andrea
INSPIRE is a European Directive aiming to establish a EU-wide spatial data infrastructure to give cross-border access to information that can be used to support EU environmental policies, as well as other policies and activities having an impact on the environment. In order to ensure cross-border interoperability of data infrastructures operated by EU Member States, INSPIRE sets out a framework based on common specifications for metadata, data, network services, data and service sharing, monitoring and reporting. The implementation of INSPIRE has reached important milestones: the INSPIRE Geoportal was launched in 2011 providing a single access point for the discovery of INSPIRE data and services across EU Member States (currently, about 300K), while all the technical specifications for the interoperability of data across the 34 INSPIRE themes were adopted at the end of 2013. During this period a number of EU and international initiatives has been launched, concerning cross-domain interoperability and (Linked) Open Data. In particular, the EU Open Data Portal, launched in December 2012, made provisions to access government and scientific data from EU institutions and bodies, and the EU ISA Programme (Interoperability Solutions for European Public Administrations) promotes cross-sector interoperability by sharing and re-using EU-wide and national standards and components. Moreover, the Research Data Alliance (RDA), an initiative jointly funded by the European Commission, the US National Science Foundation and the Australian Research Council, was launched in March 2013 to promote scientific data sharing and interoperability. The Joint Research Centre of the European Commission (JRC), besides being the technical coordinator of the implementation of INSPIRE, is also actively involved in the initiatives promoting cross-sector re-use in INSPIRE, and sustainable approaches to address the evolution of technologies - in particular, how to support Linked Data in INSPIRE and the use of global persistent identifiers. It is evident that government and scientific data infrastructures are currently facing a number of issues that have already been addressed in INSPIRE. Sharing experiences and competencies will avoid re-inventing the wheel, and help promoting the cross-domain adoption of consistent solutions. Actually, one of the lessons learnt from INSPIRE and the initiatives in which JRC is involved, is that government and research data are not two separate worlds. Government data are commonly used as a basis to create scientific data, and vice-versa. Consequently, it is fundamental to adopt a consistent approach to address interoperability and data management issues shared by both government and scientific data. The presentation illustrates some of the lessons learnt during the implementation of INSPIRE and in work on data and service interoperability coordinated with European and international initiatives. We describe a number of critical interoperability issues and barriers affecting both scientific and government data, concerning, e.g., data terminologies, quality and licensing, and propose how these problems could be effectively addressed by a closer collaboration of the government and scientific communities, and the sharing of experiences and practices.
Ruger, Jennifer Prah; Kress, Daniel
The government of Morocco approved two reforms in 2005 to expand health insurance coverage. The first is a payroll-based mandatory health insurance plan for public-and formal private–sector employees to extend coverage from the current 16 percent of the population to 30 percent. The second creates a publicly financed fund to cover services for the poor. Both reforms aim to improve access to high-quality care and reduce disparities in access and financing between income groups and between rural and urban dwellers. In this paper we analyze these reforms: the pre-reform debate, benefits covered, financing, administration, and oversight. We also examine prospects and future challenges for implementing the reforms. PMID:17630444
We describe in detail seven distinct areas in both public and private sectors in which a real-time computer-aided dispatch system is applicable to the allocation of scarce resources. Characteristics of a real-time ...
Chen, Li; Dai, Yaohua; Zhang, Yanfeng; Wu, Qiong; Rudan, Diana; Safti?, Vanja; van Velthoven, Michelle H.M.M.T.; Su, Jianqiang; Tan, Zangwen; Scherpbier, Robert W.
Aim To evaluate the quality of antenatal care (ANC) in Hebei Province and compare it between the public and private sector and within the public sector. Methods We conducted a Maternal, Newborn and Child Health Household Survey in 2010 using a two-stage sampling procedure and included 1079 mothers. The quality of ANC was assessed on the basis of the number of ANC visits, the time of the first ANC visit, 16 different ANC procedures, owning a maternal health care booklet, and the type of service provider. Results Almost all women (98%) received ANC services at least once, 80% at least four times, and 54% at least five times. About half of the women (46%) visited ANC facility within their first trimester. Neither public nor private sector provided all 16 standardized services, but significantly more women in public sector received ANC procedures. Most women received ANC in county or higher-level hospitals (75%) and very few in township hospitals (8%). Significantly fewer women were weighed and tested for HIV/AIDS in township than in county or higher-level hospitals. Conclusion The quality of ANC in Hebei was poorer than required by China’s national and World Health Organization norms. Although the public sector performed better than the private sector, the utilization and quality of care of ANC services in this sector varied and women generally visited county or higher-level health facilities. PMID:23630142
Woody, Elisabeth L.
This article examines heterosexist assumptions and the role of homophobia in students' experiences in California's public "Single Gender Academies," in an effort to include issues of sexuality in current discourses on adolescent gender identity and public school reform. Interviews with students, conducted as part of the most comprehensive research…
Davida Becker; Claudia Díaz-Olavarrieta; Clara Juárez; Sandra G. García; Patricio Sanhueza; Cynthia C. Harper
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
Sari, N; Langenbrunner, J C
What do consumers pay for pharmaceuticals in a transition economy, and who is hit hardest? Kazakhstan is in the midst of emerging from a Soviet Union state to a market economy. It has seen a significant dip in Gross Domestic Product and available revenues for health as a result. New sources of revenues, such as out-of-pocket payments, both formal and informal, have become widespread. In this paper we use the results of a 1996 Living Standards survey jointly sponsored by the World Bank and the Kazakhstan Government to examine patterns of prescribed pharmaceutical spending. We use a two-part regression model that is utilized to adjust for the skewness of non-spenders and heavy utilizers. Results suggest that upper-income groups spend more in absolute terms, but low-income groups pay a higher share of their income for pharmaceuticals. Pharmaceutical expenditure is positively related to poor health status, chronic illness and rural area residence. Our estimates suggest that on average people in rural areas spend 16% more than people in urban areas. The analysis shows that certain types of illnesses impose significant out-of-pocket burden for consumers - gynaecologic as well as intestinal and cardiac. The findings can be used for developing and designing a new 10-year World Bank-financed programme for restructuring the health sector. They also suggest the need for prioritizing rural care, as well as covering pharmaceuticals for specific types of care interventions and certain demographic groups. PMID:11739368
Perks, Carol; Toole, Michael J; Phouthonsy, Khamla
The Lao People's Democratic Republic (Lao PDR) is classified by the World Bank as a low-income country under stress. Development partners have sought to utilize effective aid instruments to help countries classified in this way achieve the Millennium Development Goals; these aid instruments include sector-wide approaches (SWAps) that support decentralized district health systems and seek to avoid fragmentation and duplication. In Asia and the Pacific, only Bangladesh, Papua New Guinea and the Solomon Islands have adopted SWAps. Since 1991, a comprehensive primary health care programme in the remote Sayaboury Province of Lao PDR has focused on strengthening district health management, improving access to health facilities and responding to the most common causes of mortality and morbidity among women and children. Between 1996 and 2003, health-facility utilization tripled, and the proportion of households that have access to a facility increased to 92% compared with only 61% nationally. By 2003, infant and child mortality rates were less than one-third of the national rates. The maternal mortality ratio decreased by 50% despite comprehensive emergency obstetric care not being available in most district hospitals. These trends were achieved with an investment of approximately 4 million US dollars over 12 years (equivalent to US 1.00 US dollars per person per year). However, this project did not overcome weaknesses in some national disease-control programmes, especially the expanded programme on immunization, that require strong central management. In Lao PDR, which is not yet committed to using SWAps, tools developed in Sayaboury could help other district health offices assume greater planning responsibilities in the recently decentralized system. Development partners should balance their support for centrally managed disease-specific programmes with assistance to horizontally integrated primary health care at the district level. PMID:16501731
Perks, Carol; Toole, Michael J.; Phouthonsy, Khamla
The Lao People's Democratic Republic (Lao PDR) is classified by the World Bank as a low-income country under stress. Development partners have sought to utilize effective aid instruments to help countries classified in this way achieve the Millennium Development Goals; these aid instruments include sector-wide approaches (SWAps) that support decentralized district health systems and seek to avoid fragmentation and duplication. In Asia and the Pacific, only Bangladesh, Papua New Guinea and the Solomon Islands have adopted SWAps. Since 1991, a comprehensive primary health care programme in the remote Sayaboury Province of Lao PDR has focused on strengthening district health management, improving access to health facilities and responding to the most common causes of mortality and morbidity among women and children. Between 1996 and 2003, health-facility utilization tripled, and the proportion of households that have access to a facility increased to 92% compared with only 61% nationally. By 2003, infant and child mortality rates were less than one-third of the national rates. The maternal mortality ratio decreased by 50% despite comprehensive emergency obstetric care not being available in most district hospitals. These trends were achieved with an investment of approximately 4 million US dollars over 12 years (equivalent to US 1.00 US dollars per person per year). However, this project did not overcome weaknesses in some national disease-control programmes, especially the expanded programme on immunization, that require strong central management. In Lao PDR, which is not yet committed to using SWAps, tools developed in Sayaboury could help other district health offices assume greater planning responsibilities in the recently decentralized system. Development partners should balance their support for centrally managed disease-specific programmes with assistance to horizontally integrated primary health care at the district level. PMID:16501731
Reza Gharoie Ahangar; Ali Alijani Rooshan
Extensive globalization and competition has produced economic environment that are more turbulent and volatile than ever before (Parry and Thomson, 2003). Breath taking changes are making it difficult for the business organizations to survive and thrive in a highly competitive world and banking industry is no exception. Around the world the service sector of the economy is going through a
Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh
Background & objectives: Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Methods: Data from National Sample Survey 60th Round on Morbidity and Health Care were analyzed by mean consumption expenditure quintiles. Indicators were devised to document inequities in the dimensions of horizontal and vertical inequity; and redistribution of public subsidy. Concentration index (CI), and equity ratio in conjunction with concentration curve were computed to measure inequity. Results: Reporting of morbidity and hospitalization rate had a pro-rich distribution in all three States indicating poor utilization of health services by low income households. Nearly 57 and 60 per cent households from poorest income quintile in Haryana and Punjab, respectively faced catastrophic OOP hospitalization expenditure at 10 per cent threshold. Lower prevalence of catastrophic expenditure was recorded in higher income groups. Public sector also incurred high costs for hospitalization in selected three States. Medicines constituted 19 to 47 per cent of hospitalization expenditure and 59 to 86 per cent OPD expenditure borne OOP by households in public sector. Public sector hospitalizations had a pro-poor distribution in Haryana, Punjab and Chandigarh. Interpretation & conclusions: Our analysis indicates that public sector health service utilization needs to be improved. OOP health care expenditures at public sector institutions should to be curtailed to improve utilization of poorer segments of population. Greater availability of medicines in public sector and regulation of their prices provide a unique opportunity to reduce public sector OOP expenditure. PMID:23041735
Bachman, Charles A.
While private sector organizations have implemented enterprise resource planning (ERP) systems since the mid 1990s, ERP implementations within the public sector lagged by several years. This research conducted a mixed method, comparative assessment of post "go-live" ERP implementations between public and private sector organization. Based on a…
Background There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the public sector. Methods Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist ‘dual practice’, that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. Results Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel ‘needed’ and ‘relevant’. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. Conclusions The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the public sector. Policy recommendations center around boosting public sector resources and building trust of the public sector through including health workers more in decision-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 public sector to increase retention. PMID:23281664
OECD Publishing (NJ1), 2006
Public bodies hold a range of information and content ranging from demographic, economic and meteorological data to art works, historical documents and books. Given the availability of information and communication technologies (ICTs) public sector information can play an important role in producing innovative value-added services and goods.…
Performance measurement in the public sector is largely based on objective metrics, which may be subject to gaming behaviour. This paper investigates a novel subjective performance evaluation system where independent inspectors visit schools at very short notice, publicly disclose their findings and sanction schools rated fail. First, I…
Al-Shehab, Ali Jasem
With the diminishing model of the welfare state, public education in Kuwait is facing the challenges of the competition of private schools, while the private sector has always struggled against the monopolistic power of the public schools that educate a broad spectrum of K-12 students. This article presents estimates of the effect of private…
Cheema, Jehanzeb R.
The education system in Qatar comprises of both private schools, which receive money through student fees, and public schools, which are fully government-funded. In the mid-2000s, Qatar started its transition towards an independent school model with the aim of eventually converting all public schools into government-supported independent schools. The idea was to give public schools more autonomy in terms of hiring decisions, adoption of curriculum and textbooks, and budget spending, enabling them to emulate some of the private schools' strategies for turning out successful students. This study examines evidence from the 2006-2012 administrations of the Program for International Student Assessment (PISA) in Qatar in order to evaluate whether or not recent educational reform efforts in this country have succeeded in bridging the literacy divide between private and public schools. The results, presented in a number of detailed tables and discussed in the last part of the article, indicate that there is a significant difference in key literacy skills between the two types of schools. Private schools were found to outperform their public counterparts in areas such as mathematics, reading and science, both before and after controlling for important student-level differences, and this gap has evidently persisted from 2006 to 2012.
Sims, Ronald R.
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)
Lunt, Neil; Exworthy, Mark; Hanefeld, Johanna; Smith, Richard D
Many public health systems in high- and middle-income countries are under increasing financial pressures as a result of ageing populations, a rise in chronic and non-communicable diseases and shrinking public resources. At the same time the rise in patient mobility and concomitant market in medical tourism provides opportunities for additional income. This is especially the case where public sector hospitals have a reputation as global centres of excellence. Yet, this requires public sector entrepreneurship which, given the unique features of the public sector, means a change to professional culture. This paper examines how and under what conditions public sector entrepreneurship develops, drawing on the example of international patients in the UK NHS. It reports on a subset of data from a wider study of UK medical tourism, and explores inward flows and NHS responses through the lens of public entrepreneurship. Interviews in the English NHS were conducted with managers of Foundation Trusts with interest in international patient work. Data is from seven Foundation Trusts, based on indepth, semi-structured interviews with a range of NHS managers, and three other key stakeholders (n = 16). Interviews were analysed using a framework on entrepreneurship developed from academic literature. Empirical findings showed that Trust managers were actively pursuing a strategy of expanding international patient activity. Respondents emphasised that this was in the context of the current financial climate for the NHS. International patients were seen as a possible route to ameliorating pressure on stretched NHS resources. The analysis of interviews revealed that public entrepreneurial behaviour requires an organisational managerial or political context in order to develop, such as currently in the UK. Public sector workers engaged in this process develop entrepreneurship - melding political, commercial and stakeholder insights - as a coping mechanism to health system constraints. PMID:24833318
The statutory health insurance reform law of 1993 had a serious impact on the management of university hospitals. Firstly, the phase of strict budget caps, new in and out patient services could only be introduced when compensated with the elimination of other services. Most universities have mastered this challenge. In the second phase, an entirely new system of hospital fees will be introduced. This will lead to a high degree of uncertainty on the financial situation of the university hospitals. The new regulation on hospital fees only insufficiently takes into consideration tertiary care hospitals. A severe loss of income has to be reckoned with. The funding of current subsidies for medical research, training, construction projects and big-ticket equipment is threatened by the fiscal budget crisis due to the current recession and the heavy financial burdens of the German reunification. Therefore fundamental reforms with regard to the statutory form, the form of ownership, the responsibilities of the university hospital, the organization of management and decision processes, the public service law and investment financing are all unavoidable. PMID:7676746
Clark, Steven E
Psychological science has come to play an increasingly important role in the legal system by informing the court through expert testimony and by shaping public policy. In recent years, psychological research has driven a movement to reform the procedures that police use to obtain eyewitness identification evidence. This reform movement has been based in part on an argument suggesting that recommended procedures reduce the risk of false identifications with little or no reduction in the rate of correct identifications. A review of the empirical literature, however, challenges this no-cost view. With only one exception, changes in eyewitness identification procedures that reduce the risk of false identification of the innocent also reduce the likelihood of correct identification of the guilty. The implication that criminals may escape prosecution as a result of procedures implemented to protect the innocent makes policy decisions far more complicated than they would otherwise be under the no-cost view. These costs (correct identifications lost) and benefits (false identifications avoided) are discussed in terms of probative value and expected utility. PMID:26168461
Hurlburt, Michael; Horwitz, Sarah McCue
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 public sector 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 public sector service systems. PMID:21197565
Perkins, R; Barnett, P; Powell, M
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
Fornia, William B
Public pension plans will continue to search for cost-sharing retiree health care solutions and may shift to a defined contribution emphasis. Fiduciary responsibility will be highlighted in view of controversial plan changes, government budgetary constraints, scrutinized investment return assumptions, potential labor shortages and increased shareholder activism. PMID:12800307
Kezar, Andrianna; Tierney, William G.
Recently, the Center for Higher Education Policy Analysis at the University of Southern California conducted a national study of public higher education governing board performance. 130 board members, presidents, coordinating board officials, governors, legislators, and education department staff were interviewed about ways to improve performance…
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 public sector 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-public sector facilities were excluded from main analyses. The densities and characteristics of the public sector 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 public sector 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 public sector 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. PMID:24467776
Gass, Eric; Bezold, Maureen P
Public health agencies are facing a convergence of forces that require a reexamination of the existing paradigm. The need to replace an aging workforce with a new generation that possesses a different worldview, in the context of budget austerity, will be challenging. In addition, the uncertainty of health care reform poses a challenge for public health leadership. This "perfect storm" provides the opportunity for the social work paradigm to come in and fill the void. PMID:24074132
Jackson, Janese Marie
Given the perils of today's dynamic and resource-constrained environment, intellectual capital has become a source of competitive advantage for public sector organizations. Composed of three elements--organizational knowledge, innovative capability, and organizational commitment--intellectual capital is an asset that cannot simply be bought or…
Golden, John M
While society debates whether and how to use public funds to support work on human embryonic stem cells (hESCs), many scientific groups and businesses debate a different question - the extent to which patents that cover such stem cells should be permitted to limit or to tax their research. The Wisconsin Alumni Research Foundation (WARF), a non-profit foundation that manages intellectual property generated by researchers at the University of Wisconsin at Madison, owns three patents that have been at the heart of the latter controversy The story of WARF's patents and the controversy they have fostered highlights not only continuing tensions between proprietary and nonproprietary approaches to developing science and technology, but also an at least partly reassuring capacity of public and private sectors to deal with those tensions in a way that can render them substantially manageable, and frequently more manageable as a technology matures. More particularly, the cumulative story of WARF's patents features three leitmotifs that suggest how an attentive and engaged public sector might commonly succeed in working with public and private sector actors to achieve workable balances between proprietary rights and more general social interests: (1) right holders' decisions to pursue less than full rights assertion or enforcement; (2) the ability of government and other public sector actors to help bring about such decisions through co-option or pressure; and (3) the frequent availability or development of technological alternatives that limit research bottlenecks. PMID:20579254
Johnston, Lee M; Finegood, Diane T
Over the past few decades, cross-sector partnerships with the private sector have become an increasingly accepted practice in public health, particularly in efforts to address infectious diseases in low- and middle-income countries. Now these partnerships are becoming a popular tool in efforts to reduce and prevent obesity and the epidemic of noncommunicable diseases. Partnering with businesses presents a means to acquire resources, as well as opportunities to influence the private sector toward more healthful practices. Yet even though collaboration is a core principle of public health practice, public-private or nonprofit-private partnerships present risks and challenges that warrant specific consideration. In this article, we review the role of public health partnerships with the private sector, with a focus on efforts to address obesity and noncommunicable diseases in high-income settings. We identify key challenges-including goal alignment and conflict of interest-and consider how changes to partnership practice might address these. PMID:25581149
Martin, David P.
IT governance has become an important topic as both public and private organizations struggle to meet the challenge of aligning complex IT systems with operational needs. Without effective IT governance, organizations fail to gain strategic benefits that come by the proper strategic alignment of IT resources with the larger organizational mission.…
Describes how environmental education can help achieve the goals of public education reform. Focuses on reform in curriculum, instruction, and assessment and considers school reform in various types of school settings. (DDR)
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.
Linda Gordon, a respected historian of US welfare policy, attempts to "refine the story we tell about welfare by contextualizing it in a way not yet done by historians--relating it to the New Deal relief and public works which were so visible at the time of welfare's birth." Gordon examines the promises and contradictions of New Deal relief programs to offer a valuable historical context for current debates on the public sector and the role of government.
Juma Hemed Lungo
Two Open Source Software (OSS) projects in Tanzania are discussed as exemplar efforts for the adaptation and use of OSS in public sector. The projects investigated in this Action Research Study were from the Health and Education Sectors. The two projects are of important in that, they use two different approaches of embracing OSS where the Health Sector project uses
George Blick; Thomas R. Gulledge; Rainer A. Sommer
We present our experiences in defining and documenting business process requirements for a large-scale public sector 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
Rasdi, Roziah Mohd; Garavan, Thomas N.; Ismail, Maimunah
Purpose: The purpose of this paper is to investigate how managerial level moderates the relationships between networking behaviours and career success (objective and subjective) in the context of a public sector organisation in Malaysia. Design/methodology/approach: The study utilised a cross-sectional design and investigated these relationships…
Kubala, James Joseph
A quantitative and qualitative study examined three leadership strategies found in performance-based management (human resource, scientific management and political strategies used in public sector management); a framework by which performance measurement (PM) supports leadership strategies; and how the strategies impact PM. It examined leadership…
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…
Coleman, David W.
Information Technology (IT) provides public sector organizations the capability to provide real increases in organizational effectiveness by aiding in the efficient exchange of information. Adoption of advanced IT such as service oriented environments, Web 2.0, and bespoke systems such as Enterprise Resource Planning (ERP) promises to markedly…
Sharif, Raed M.
Although there appears to be a broad recognition of the key role that Public Sector Information (PSI) can play in the development of societies, there are still significant gaps in our understanding of how PSI is actually being utilized and of its wider societal value, especially in developing countries. The overarching goal of this dissertation…
A lack of management capacity has been identified as the key stumbling block to the transformation and reconceptualization of the public sector in South Africa into a more effective, efficient, and responsive system of health delivery. As part of the overall management development process, this research aimed to identify the skills important for public sector health management and to evaluate managers' self-assessed proficiency in each of these skills. A cross-sectional survey using a self-administered questionnaire was conducted among hospital managers in the South African public health sector. Respondents were asked to rate the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Self-assessment of levels of competency showed that managers felt most competent in strategic planning, people management, and self-management, and relatively less competent in the task-related skills and their ability to deliver healthcare. People management, self-management, and task-related skills were rated as being most important, followed by strategic management and health delivery skills, respectively. The largest differences between mean importance rating and mean skill rating were for people management skills, task-related and self-management skills. These findings reflect the reality of the local health service environment and the needs of health managers and will be useful in the conceptualization, design, and delivery of health management programs aimed at enhancing current and future management and leadership capacity in the public health sector in South Africa. PMID:18708881
Jewson, Nick; Felstead, Alan; Green, Francis
This article examines what has happened to training in public sector organisations in the UK in a period of austerity. It draws on individual-level data collected over the period 2000-2012 and establishment-level data collected from employer surveys carried out between 2005 and 2012. To understand these data further, 75 qualitative interviews with…
At first glance, public-sector labor unions are just one of many types of organizations that participate in the political process. However, these unions differ significantly from other interest groups made up of individual citizens or non-labor organizations. Because their members' interests are tied to government policy, these unions are more…
Khan, Shahrukh Rafi
Examines the relationship between a public-sector teacher salary structure based on qualifications and experience and teacher effectiveness in rural Pakistan. Findings raise questions regarding the rationality of the salary structure's assumed positive association between teacher monetary incentives, teacher cognitive skills, and student academic…
Zumrah, Abdul Rahim
Purpose: The purpose of this study is to highlight the importance role of transfer of training as a mediator in the relationship between training and service quality. Design/methodology/approach: The data of this study were collected from three sources: the employees of public sector organizations in Malaysia who participated in a Basic Financial…
of ICTs in the public sector has long been touted for its potential to transform the institutions here takes aim at examining ICT use that crosses these scales of influence and accountability. We to understand and sup- port cooperative work in myriad settings (e.g., [3, 6, 22]). Most often, the contexts
Stephen Mutula; Tumelo Kalaote
Purpose – The purpose of this paper is to review use of open source software in the public sector in Botswana and South Africa. South Africa is Botswana's neighbor and both countries are leading economies in Africa. Design\\/methodology\\/approach – The paper draws on a survey that was carried out in information communication technology (ICT)-intensive government ministries in Botswana in May
Dill, Jeffrey S.
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,…
Leslie, Laurel K.; Lambros, Katina M.; Aarons, Gregory A.; Haine, Rachel A.; Hough, Richard L.
This study investigates rates and predictors of school-based services (SBSs) for 390 youth meeting criteria for Attention Deficit Hyperactivity Disorder and served in the San Diego public sectors. Only 60% of youth had received an Attention Deficit Hyperactivity Disorder diagnosis; these youth were younger, male, Caucasian (versus Latino), and…
Rasdi, Roziah Mohd; Ismail, Maimunah; Uli, Jegak; Noah, Sidek Mohd
Purpose: The purpose of this paper is to develop a theoretical framework for measuring public sector 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…
Examined the effects of a flexible working hours schedule on the arrival and departure times of 162 public sector employees. Results indicated that workers, when scheduling their own workday, deviate only moderately from their preflexitime arrival/departure times; and they tend to develop relatively stable arrival/departure patterns. (Author/RC)
Richard T. Cober; Douglas J. Brown; Alana J. Blumental; Dennis Doverspike; Paul E. Levy
Organizational use of Internet recruiting has dramatically increased in the last five years. However, there has been little research to guide the development of organizational employment Web pages. This paper first outlines the reasons why public sector organizations should consider focusing more energy on developing their own employment Web sites to supplement other recruiting activities. We then present a model
Hamlin, Robert G.; Patel, Taran
Purpose: This paper aims to report the results of a replication study of perceived managerial and leadership effectiveness within a Romanian public sector hospital, and to discuss the extent to which they are similar to and different from findings from equivalent studies carried out in two British NHS Trust hospitals. Design/methodology/approach:…
Jascourt, Hugh D.
Introduces two articles that (1) supply the union and management perspectives of the Supreme Court decision in "Ellis vs. Brotherhood of Railway, Airline and Steamship Clerks" and (2) discuss how this decision affects the public sector in the area of education. (MLF)
The potential for public private sector partnerships is likely to grow. However, despite a number of high profile success stories, promoting partnerships has proved more difficult than many assumed. This paper argues that such partnerships need to be viewed in the framework of an innovation system and a development scenario where networks of agro-enterprises and intermediary organisations will underpin rural
Patrick, Walter K; Cadman, Edwin C
Globalisation of economies, diseases and disasters with poverty, emerging infectious diseases, ageing and chronic conditions, violence and terrorism has begun to change the face of public health and medical education. Escalating costs of care and increasing poverty have brought urgency to professional training to improve efficiency, cut costs and maintain gains in life expectancy and morbidity reduction. Technology, genetics research and designer drugs have dramatically changed medical practice. Creatively, educational institutions have adopted the use of: (1) New educational and communication technologies: internet and health informatics; (2) Problem based learning approaches; Integrated Practice and Theory Curricula; Research and Problem Solving methodologies and (3) Partnership and networking of institutions to synergise new trends (e.g. core competencies). Less desirably, changes are inadequate in key areas, e.g., Health Economics, Poverty and Health Development, Disaster Management & Bioterrorism and Ethics. Institutions have begun to adjust and develop new programs of study to meet challenges of emerging diseases, design methodologies to better understand complex social and economic determinants of disease, assess the effects of violence and address cost containment strategies in health. Besides redesigning instruction, professional schools need to conduct research to assess the impact of health reform. Such studies will serve as sentinels for the public's health, and provide key indicators for improvements in training, service provision and policy. PMID:12597516
Daniels, Norman; Flores, Walter; Pannarunothai, Supasit; Ndumbe, Peter N.; Bryant, John H.; Ngulube, T. J.; Wang, Yuankun
The Benchmarks of Fairness instrument is an evidence-based policy tool developed in generic form in 2000 for evaluating the effects of health-system reforms on equity, efficiency and accountability. By integrating measures of these effects on the central goal of fairness, the approach fills a gap that has hampered reform efforts for more than two decades. Over the past three years, projects in developing countries on three continents have adapted the generic version of these benchmarks for use at both national and subnational levels. Interdisciplinary teams of managers, providers, academics and advocates agree on the relevant criteria for assessing components of fairness and, depending on which aspects of reform they wish to evaluate, select appropriate indicators that rely on accessible information; they also agree on scoring rules for evaluating the diverse changes in the indicators. In contrast to a comprehensive index that aggregates all measured changes into a single evaluation or rank, the pattern of changes revealed by the benchmarks is used to inform policy deliberation aboutwhich aspects of the reforms have been successfully implemented, and it also allows for improvements to be made in the reforms. This approach permits useful evidence about reform to be gathered in settings where existing information is underused and where there is a weak information infrastructure. Brief descriptions of early results from Cameroon, Ecuador, Guatemala, Thailand and Zambia demonstrate that the method can produce results that are useful for policy and reveal the variety of purposes to which the approach can be put. Collaboration across sites can yield a catalogue of indicators that will facilitate further work. PMID:16175828
Sappington, Thomas W; Ostlie, Kenneth R; Difonzo, Christina; Hibbard, Bruce E; Krupke, Christian H; Porter, Patrick; Pueppke, Steven; Shields, Elson J; Tollefson, Jon J
Public-sector scientists have a mandate to independently evaluate agricultural products available to American farmers on the open market, whereas the companies that sell the products must protect their intellectual property. However, as a consequence of the latter concern, public scientists currently are prohibited by industry-imposed restrictions from conducting research on commercialized transgenic seed without permission of the company. Industry acknowledged the seriousness of the problem after public warnings by a large group of entomologists to EPA and scientific advisory panels that the assumption of independence of public-sector studies on these products is no longer valid under current restrictions. Both industry and public scientists are working to find an amicable, mutually-acceptable solution. Recently, the American Seed Trade Association brokered a draft set of principles designed to protect the legitimate property rights of companies while allowing public scientists independence to conduct most types of research on their commercialized products without the need for case-by-case agreements. While there are a number of potential pitfalls in implementation of the principles across companies, this effort represents a major step forward, and there is reason for optimism that this approach can be made to work to the benefit of industry, public scientists, and the American public. PMID:21865871
Background Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. Methods The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. Conclusions The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system where church-run health facilities are vital in the provision of health care in rural areas and where patients tend to prefer these services. In order to ensure equity in distribution of qualified health workers in Tanzania, a national regulation and legislation of the pension schemes is required. PMID:22480347
Eckes, Thomas; Ellis, Melanie; Kalnberzina, Vita; Pizorn, Karmen; Springer, Claude; Szollas, Krisztina; Tsagari, Constance
Contributions from seven European countries pinpoint major projects, problems, and prospects of reforming public 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…
Tommelein, Iris D.
Implementation of Lean Concepts for Public Sector Engineering Design and Construction: A Case Study Proceedings IGLC `98 IMPLEMENTATION OF LEAN CONCEPTS FOR PUBLIC SECTOR ENGINEERING DESIGN AND CONSTRUCTION: A CASE STUDY John A. Kuprenas1 ABSTRACT This work details the implementation of lean thinking concepts
Hussain, Rana; Ali, Sajid
This article tries to respond to a basic question: "can in-service teachers of public sectors in Pakistan be reformed?" The authors' response to this question is: "yes, public teachers can be reformed, if contextual possibilities are exploited efficiently". Although a straightforward and simplistic response to the question, this was felt necessary…
Logan, John R; Fang, Yiping; Zhang, Zhanxin
Housing reform in China has proceeded on two tracks: privatization of public housing and development of a new private housing sector. During this period of transition, rents have remained relatively low in the remaining public housing, and purchase prices offered to occupants of public housing have been well below market prices. Although these rents and prices are partly based on known formulas, there is considerable variability in how much people pay for similar apartments. This study uses 2000 Census data to estimate the housing subsidy received by the remaining renters in the public sector and purchasers of public housing, based on private sector prices for housing of comparable quality and size. The paper also analyzes variation in the estimated discount from market prices that these people receive. The findings show that the biggest winners in China's transition from socialist housing allocation are those who were favored in the previous system, based on such factors as residence status, education and occupation. PMID:24163494
Sharma, Abhishek; Kaplan, Warren A; Chokshi, Maulik; Hasan Farooqui, Habib; Zodpey, Sanjay P
Objective Haemophilus influenzae type b (Hib) vaccine has been available in India's private sector market since 1997. It was not until 14 December 2011 that the Government of India initiated the phased public sector introduction of a Hib (and DPT, diphtheria, pertussis, tetanus)-containing pentavalent vaccine. Our objective was to investigate the state-specific coverage and behaviour of Hib vaccine in India when it was available only in the private sector market but not in the public sector. This baseline information can act as a guide to determine how much coverage the public sector rollout of pentavalent vaccine (scheduled April 2015) will need to bear in order to achieve complete coverage. Setting 16 of 29 states in India, 2009–2012. Design Retrospective descriptive secondary data analysis. Data (1) Annual sales of Hib vaccines, by volume, from private sector hospitals and retail pharmacies collected by IMS Health and (2) national household surveys. Outcome measures State-specific Hib vaccine coverage (%) and its associations with state-specific socioeconomic status. Results The overall private sector Hib vaccine coverage among the 2009–2012 birth cohort was low (4%) and varied widely among the studied Indian states (minimum 0.3%; maximum 4.6%). We found that private sector Hib vaccine coverage depends on urban areas with good access to the private sector, parent's purchasing capacity and private paediatricians’ prescribing practices. Per capita gross domestic product is a key explanatory variable. The annual Hib vaccine uptake and the 2009–2012 coverage levels were several times higher in the capital/metropolitan cities than the rest of the state, suggesting inequity in access to Hib vaccine delivered by the private sector. Conclusions If India has to achieve high and equitable Hib vaccine coverage levels, nationwide public sector introduction of the pentavalent vaccine is needed. However, the role of private sector in universal Hib vaccine coverage is undefined as yet but it should not be neglected as a useful complement to public sector services. PMID:25712822
Slifkin, R T; Clark, S J; Strandhoy, S E; Konrad, T R
This report uses county-level immunization data generated by state public health agencies to explore the rural-urban variation in the delivery of childhood immunizations in the public sector. Public health department-documented immunization coverage rates for 1995 were obtained from 882 counties in 11 states east of the Mississippi River. To assess the possible association between public health department immunization coverage rates and county rurality, descriptive statistics were calculated. A multiple regression model then was estimated. In all states except West Virginia, nonmetropolitan counties averaged higher completion rates than metropolitan counties. Consistent with the descriptive statistics, in the regression analysis nonmetropolitan counties had average immunization rates 2.47 percentage points higher than metropolitan counties, even when controlling for county socioeconomic characteristics. For the 11 states in the analysis, rural children immunized in the public sector had higher completion rates compared with urban children. These data reflect the dependence of rural families on the public health system and the potential for successful health care delivery through public clinics. As new health care systems are brought into rural areas, the success of this existing avenue for care must not be overlooked. PMID:10177155
Andersen, Mette Rye; Storm, Hans H
The importance of cancer- and other disease registries for planning, management and evaluation of healthcare systems has been shown repeatedly during the last 50 years. Complete and unbiased population-level analyses on routinely collected, individual data concerning health and personal characteristics can address significant concerns about risk factors for cancer and provide sound evidence about public health and the effectiveness of healthcare systems. The existence of quality controlled and comprehensive data in registries, allowed to be used for quality control, research and public health purposes are taken as granted by most health professionals and researchers. However, the current revision of the European Union (EU) data protection framework suggests a harmonisation of requirements for confidentiality and individual consent to data processing, likely at the expense of proper use of registry data in the health sector. Consequences of excessive confidentiality rules that may lead to missed data linkages have been simulated. The simulations provide one possible explanation for observed heterogeneity among some cancer incidence data. Further, public health, quality control and epidemiological research on large populations can no longer provide evidence for health interventions, if requirements for consent renders research impossible or where attempts to obtain consent from each data subject generates biased results. Health professionals should engage in the on-going debate on the Commission's proposal for a General Data Protection Regulation. The nature and use of registry data in public health research must be explained and known to policy-makers and the public. Use of cancer registry data and other epidemiological activity will terminate abruptly if an unnecessarily strict EU data protection regulation is adopted. Research based interventions, as well as the international recognised standing of cancer registries and register-based research institutions in Europe are at stake. PMID:24120502
Mehrolhassani, Mohammad Hossein; Emami, Mozhgan
Background: Change theories provide an opportunity for organizational managers to plan, monitor and evaluate changes using a framework which enable them, among others, to show a fast response to environmental fluctuations and to predict the changing patterns of individuals and technology. The current study aimed to explore whether the change in the public accounting system of the Iranian health sector has followed Kurt Lewin’s change theory or not. Methods: This study which adopted a mixed methodology approach, qualitative and quantitative methods, was conducted in 2012. In the first phase of the study, 41 participants using purposive sampling and in the second phase, 32 affiliated units of Kerman University of Medical Sciences (KUMS) were selected as the study sample. Also, in phase one, we used face-to-face in-depth interviews (6 participants) and the quote method (35 participants) for data collection. We used a thematic framework analysis for analyzing data. In phase two, a questionnaire with a ten-point Likert scale was designed and then, data were analyzed using descriptive indicators, principal component and factorial analyses. Results: The results of phase one yielded a model consisting of four categories of superstructure, apparent infrastructure, hidden infrastructure and common factors. By linking all factors, totally, 12 components based on the quantitative results showed that the state of all components were not satisfactory at KUMS (5.06±2.16). Leadership and management; and technology components played the lowest and the greatest roles in implementing the accrual accounting system respectively. Conclusion: The results showed that the unfreezing stage did not occur well and the components were immature, mainly because the emphasis was placed on superstructure components rather than the components of hidden infrastructure. The study suggests that a road map should be developed in the financial system based on Kurt Lewin’s change theory and the model presented in this paper underpins the change management in any organizations. PMID:24596885
Pascucci, Stefano; De Magistris, Tiziana
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…
McDaniel, Thomas R.
The 1980s reform movement has been top-down, with national commissions, state laws, bully-pulpit speakers, and buzzwords like "accountability" and "excellence." A new reform agenda will probably focus on human and social needs, rather than economic and military-industrial preoccupations. President George Bush represents the kinder, gentler…
Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report. PMID:21155425
In 2001, Colquitt developed an Organizational Justice Scale that intended to measure procedural, distributive, interpersonal, and informational justice. The dimensionality of the scale has been tested in subsequent studies with diverging results. Given the fact that contextual differences may account for more variation across research sites than individual differences, the deviating research findings may be due to context. This study examined the dimensionality of Colquitt's Organizational Justice Scale in a new context: the public health sector. The procedural and informational justice dimensions were highly correlated, but confirmatory factor analysis showed that a four-factor solution provided a better fit than a three-factor solution. All fit indices for the four-factor model were consistent with a good model. There was, however, evidence of a potential omitted factor, procedural-voice justice, which has also been found in a previous examination of the measure in the public sector. PMID:25871568
Okurame, David E
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
Mission-directed public-sector research facilities are experiencing increasingly severe budget environments while seeing expanding missions and responsibilities. In an effort to identify research leveraging methodologies an information search was conducted in conjunction with some efforts to find the proper links to systems engineering fundamentals. The result is an initial model for use in a preconcept/phase-1 engineering design organization, with a goal of improving the organizations performance.
Crick Lund; Sharon Kleintjes; Ritsuko Kakuma; Alan J. Flisher
Background There is growing recognition that mental health is an important public health issue in South Africa. Yet mental health services\\u000a remain chronically under-resourced. The aim of this study was to document levels of current public sector mental health service\\u000a provision in South Africa and compare services across provinces, in relation to current national policy and legislation.\\u000a \\u000a \\u000a \\u000a \\u000a Methods A survey was conducted
Edwards, R L; Eadie, D C
The current economic climate has been particularly hard on non-profit and public human services organizations, frequently resulting in managing organizational decline. The authors believe that the dominant concern should be with fostering organizational growth. To this end, they suggest that nonprofit board members and executives, as well as public sector leaders, need to concern themselves with the concurrent management of two agendas: Running the Shop and Meeting the Change Challenge. This can be done effectively through the use of strategic issue management, which is a set of techniques that represents a blend of traditional strategic management and change management approaches. PMID:10138340
Huong, Dang Boi; Phuong, Nguyen Khanh; Bales, Sarah; Jiaying, Chen; Lucas, Henry; Segall, Malcolm
China and Vietnam have adopted market reforms in the health sector in the context of market economic reforms. Vietnam has developed a large private health sector, while in China commercialization has occurred mainly in the formal public sector, where user fees are now the main source of facility finance. As a result, the integrity of China's planned health service has been disrupted, especially in poor rural areas. In Vietnam the government has been an important financer of public health facilities and the pre-reform health service is largely intact, although user fees finance an increasing share of facility expenditure. Over-servicing of patients to generate revenue occurs in both countries, but more seriously in China. In both countries government health expenditure has declined as a share of total health expenditure and total government expenditure, while out-of-pocket health spending has become the main form of health finance. This has particularly affected the rural poor, deterring them from accessing health care. Assistance for the poor to meet public-sector user fees is more beneficial and widespread in Vietnam than China. China is now criticizing the degree of commercialization of its health system and considers its health reforms "basically unsuccessful." Market reforms that stimulate growth in the economy are not appropriate to reform of social sectors such as health. PMID:17844934
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 public sector 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 public sector 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. PMID:23347433
Zarifis, George K.
This article reflects on the findings of the Research voor Beleid (RvB) study for the second phase of the assessment of the "Impact of ongoing reforms in education and training on adult learning sector" (2010), with particular focus on adult participation in education in three EU Member States in south-eastern Europe (Bulgaria, Cyprus and Greece).…
India embarked on a strategy of economic reforms in the wake of a serious balance-ofpayments crisis in 1991. A central plank of the reforms was reform in the financial sector and, with banks being the mainstay of financial intermediation, the banking sector. The objective of the banking sector reforms was to promote a diversified, efficient and competitive financial system with
Wagstaff, Adam; Yu, Shengchao
This paper combines differences-in-differences with propensity score matching to estimate the impacts of a health reform project in China that combined supply-side interventions aimed at improving the effectiveness and quality of care with demand-side measures aimed at expanding health insurance and providing financial support to the very poor. Data from household, village and facility surveys suggest the project reduced out-of-pocket spending, and the incidence of catastrophic spending and impoverishment through health expenses. Little impact is detected on the use of services, and while the evidence points to the project reducing sickness days, the evidence on health outcomes is mixed. PMID:17112613
As an employer, the public sector 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…
In November 1993, Democratic US Representative Ron Wyden held a hearing on the cost of the contraceptive implant Norplant. Its US distributor, Wyeth-Ayerst, informed the US House Subcommittee on Regulation, Business Opportunities and Technology that it would offer the public sector a discounted price for Norplant 5 years after it had been on the US market. Public funds contributed to the development of Norplant. USAID provided $17.2 million of the $41.3 million that the Population Council spent on developing Norplant. Wyeth provided the Council levonorgestrel, the drug used in Norplant, thereby holding the right to market Norplant in the US and Canada. USAID buys Norplant from the distributor for all other countries for $23, while Wyeth sells Norplant in a package of insertion and educational materials for $365. This large gap infuriates groups providing family planning services to low-income women. Medicaid pays for Norplant and its insertion for the poorest women. Wealthier women either pay for Norplant themselves, or their health insurance pays for it. This leaves low-income women with no access to Norplant. Wyeth has formed the Norplant Foundation to provide Norplant to low-income women whom Medicaid will not cover. It also trains most providers in insertion and removal procedures. The law requires Wyeth to reimburse qualified public health clinics 15% of costs. The reason Wyeth does not yet give the public sector a discounted price is that it wants Norplant to become firmly entrenched in the private sector first. Other panelists commented on how Norplant's success may encourage other companies to return to contraception research. Liability and political controversy are still concerns, however. Another panelist expressed concern that consumers have become too dependent on pharmaceutical companies and their commercial interests. PMID:12318533
Garland, James C.
As president of Miami University of Ohio from 1996 until 2006, James C. Garland redefined the public institution as a "semi-private" university by implementing the same tuition for both in-state and out-of-state students. Students from Ohio with need received large scholarships--but those who could afford to pay more did so. The reform, which…
Chapman, Michael S.
, and sustainability and green building practices. OHSU has been vocal and active in the health reform conversation health care reform and reduced public funding. OHSU laid the groundwork for success in 2007 by adoptingthe next five years OhSU is moving into a new era. Our work will be defined by health reform
Curtis, Valerie A; Garbrah-Aidoo, Nana; Scott, Beth
Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public-Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646
Nepal, Rabindra; Jamasb, Tooraj
and Argentina and the hydroelectricity-rich Brazil will be used where permitted by the context. Secondly, this paper aims to fill in the existing gap in the literature regarding a comprehensive study of the power sector reform processes in Nepal over the years... ) The objective of the Hydropower Development Policy of 1992 was to promote and facilitate hydropower development allowing for state, joint sector (public-private) and private sector development of hydroelectricity projects through licensees. The policy...
In the changing market environment of livestock products, the delivery of animal health services is emerging as an important priority area for enhancing the competitiveness of poor livestock producers. At the same time, governments are continuing to face serious budgetary difficulties and are finding it difficult to expand the reach of these services or improve service quality. In this context of a changing environment and dwindling public resources, this paper revisits the economic framework that has thus far guided thinking about public and private sector roles in the provision of animal health services and examines the ongoing debate on livestock service delivery for the poor. The paper highlights the importance of strong institutions and appropriate legislation for regulating behaviour and enforcing contracts and re-emphasises the idea, which is supported by economic theory, that there is a need for task sharing between the public and private sectors. The paper further emphasizes the need for: a) integrating the debate on livestock service delivery with the larger debate on political economy and institutional development, and b) ensuring service access in poor marginal areas by working through membership organisations, self-help groups and civil society organisations, and by promoting the use of para-professionals and community-based animal health delivery systems. PMID:15200085
Taylor, Lori L.; Springer, Matthew G.
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…
Tulchinsky, T H; Varavikova, E A
OBJECTIVES. This paper reviews Russia's health crisis, financing, and organization and public health reform needs. METHODS. The structure, policy, supply of services, and health status indicators of Russia's health system are examined. RESULTS. Longevity is declining; mortality rates from cardiovascular diseases and trauma are high and rising; maternal and infant mortality are high. Vaccine-preventable diseases have reappeared in epidemic form. Nutrition status is problematic. CONCLUSIONS. The crisis relates to Russia's economic transition, but it also goes deep into the former Soviet health system. The epidemiologic transition from a predominance of infectious to noninfectious diseases was addressed by increasing the quantity of services. The health system lacked mechanisms for epidemiologic or economic analysis and accountability to the public. Policy and funding favored hospitals over ambulatory care and individual routine checkups over community-oriented preventive approaches. Reform since 1991 has centered on national health insurance and decentralized management of services. A national health strategy to address fundamental public health problems is recommended. PMID:8604754
Public Agenda, 2012
This is a report on how community stakeholders, including parents, teachers, community leaders and advocates, think about current efforts by Chicago Public Schools (CPS) to "turn around" Chicago's lowest-performing schools, and their expectations for future school reform actions. It was prepared by Public Agenda, with support from…
Background The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Methods Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N?=?165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€?=?MYR4). Results A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P?=?0.003). Higher costs were expended as disease severity increased (ANOVA, P?=?0.022) and for patients requiring surgeries (ANOVA, P?0.001). Providers generally spent most on consumables while patients spent most on transportation. Conclusions Cost of providing dental treatment for periodontitis patients at public sector specialist settings were substantial and comparable with some non-communicable diseases. These findings provide basis for identifying potential cost-reducing strategies, estimating economic burden of periodontitis management and performing economic evaluation of the specialist periodontal programme. PMID:24884465
Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini
Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01). Age and education level of health care providers don’t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi. PMID:24479088
Di Loreto, G; Felicioli, G
The Istituto Nazionale della Previdenza Sociale (Inps) is one of the biggest Public Sector organizations in Italy; about 30.000 people work in his structures. Fifteen years ago, Inps launched a long term project with the objective to create a complex and efficient safety and health at work organization. Italian law contemplates a specific kind of physician working on safety and health at work, called "Medico competente", and 85 Inps's physicians work also as "Medico competente". This work describes how IT improved coordination and efficiency in this occupational health's management system. PMID:21086694
Wermund, E. G.
Mapping of land resources and environmental geology was initiated in Texas toward better communication of geology to the public policy sector. Relevant mapping parameters have included terrain, substrate, active processes, economic resources, and hydrology as well as physical, chemical, and biologic properties. Land resources maps and reports have been prepared for public agencies and published for technical and nontechnical readers; sales of these articles are one indicator of public policy transfer. Single lectures or participation in symposia and colloquia for scientific societies have been valuable only for peer review or as a means to sharpen communicative skills. The most successful mechanisms of public policy transfer have been (1) in-state workshops and short courses for elected officials, Governmental employees, and interested citizens; (2) legislative testimonies; (3) active participation on interagency committees; (4) reviews and comments on planning statements; and (5) a temporary loan of personnel to another agency. Areas where these methods successfully have impacted public policy are reflected in the present quality of Section 208, Section 701, and coastal zone management planning; applications for surface-mining permits; and environmental impact statement records in Texas.
National Center for Family Literacy, Louisville, KY.
This guide provides the information family literacy programs, practitioners, and friends need to understand the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) and its ramifications. It also addresses how to advocate on behalf of family literacy and to adapt programs to meet welfare reform requirements, while…
National Center for Family Literacy, Louisville, KY.
In 1997, the National Center for Family Literacy convened four state policymakers for an audioconference to discuss five issues related to family literacy and its role as a welfare reform strategy. First, with regard to the value of family literacy, policymakers saw literacy as the key to employment and job retention. Second, family literacy was a…
Crowson, Robert L.; Boyd, William Lowe
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,…
Hangartner, Judith; Svaton, Carla Jana
This article discusses insights from an ethnographic study of local governance practices in the Canton of Bern, Switzerland, under changing policy conditions. Recent reforms introduced and strengthened the position of head teachers, enhanced the responsibility of the municipalities and introduced new quality management procedures in local…
Background Countries in the Asia Pacific region have made great progress in the fight against malaria; several are rapidly approaching elimination. However, malaria control programmes operating in elimination settings face substantial challenges, particularly around mobile migrant populations, access to remote areas and the diversity of vectors with varying biting and breeding behaviours. These challenges can be addressed through subnational collaborations with commercial partners, such as mining or plantation companies, that can conduct or support malaria control activities to cover employees. Such partnerships can be a useful tool for accessing high-risk populations and supporting malaria elimination goals. Methods This observational qualitative case study employed semi-structured key informant interviews to describe partnerships between the Malaysian Malaria Control Programme (MCP), and private palm oil, rubber and acacia plantations in the state of Sabah. Semi-structured interview guides were used to examine resource commitments, incentives, challenges, and successes of the collaborations. Results Interviews with workers from private plantations and the state of Sabah MCP indicated that partnerships with the commercial sector had contributed to decreases in incidence at plantation sites since 1991. Several plantations contribute financial and human resources toward malaria control efforts and all plantations frequently communicate with the MCP to help monitor the malaria situation on-site. Management of partnerships between private corporations and government entities can be challenging, as prioritization of malaria control may change with annual profits or arrival of new management. Conclusions Partnering with the commercial sector has been an essential operational strategy to support malaria elimination in Sabah. The successes of these partnerships rely on a common understanding that elimination will be a mutually beneficial outcome for employers and the general public. Best practices included consistent communication, developing government-staffed subsector offices for malaria control on-site, engaging commercial plantations to provide financial and human resources for malaria control activities, and the development of new worker screening programmes. The successes and challenges associated with partnerships between the public and commercial sector can serve as an example for other malaria-eliminating countries with large plantation sectors, and may also be applied to other sectors that employ migrant workers or have commercial enterprises in hard to reach areas. PMID:24443824
Stephen Mutula; Justus M. Wamukoya
Sound management of information contained in records and other information systems in the public sector is the sine qua non of democratic governance. For effective access to government held information, Freedom of Information (FOI) legislations impose significant duties and responsibilities on public authorities to give access to information. FOI legislation is premised on the principle that effective records management enables
Zumrah, Abdul Rahim
Purpose: This study aims to investigate the relationships among perceived organizational support (POS), transfer of training outcomes to the workplace and service quality in the context of public sector organizations in Malaysia. Design/methodology/approach: The data for this study have been collected from three sources, the employees of public…
Vermont, University of
policies has been a long standing consideration within public management theory, research and practice (Mc will be in a better position to adaptively manage the wicked problems surrounding the accountability and performanceThe Innovation Journal: The Public Sector Innovation Journal, Volume 16(1), 2011, article 3
Clive M. J. Warren
Purpose – The purpose of this paper is to describe the current climate change predictions and the likely consequences for building assets, and therefore the delivery of public services, in the face of extreme weather events. Public sector asset managers need to mitigate and prepare for future events. However, current practice, as illustrated by the literature, shows that little risk
Sammons, Morgan T.
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…
Garnick, Deborah W.; Lee, Margaret T.; Horgan, Constance M.; Acevedo, Andrea
The Washington Circle (WC), 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 public sector and feasible to calculate in the public sector using data collected for administrative purposes by state and local substance abuse and/or mental health agencies. Working collaboratively, twelve states specified revised measures and six 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
Waitzkin, Howard; Yager, Joel; Santos, Richard
Relatively little research has clarified how executives of for-profit healthcare organisations frame their own motivations and behaviour, or how government officials frame their interactions with executives. Because managed care has provided an organisational structure for health services in many countries, we focused our study on executives and government officials who were administering public sector managed care services. Emphasising theoretically the economic versus non-economic motivations that guide economic behaviour, we extended a long-term research project on public sector Medicaid managed care (MMC) in the United States. Our method involved in-depth, structured interviews with chief executive officers of managed care organisations, as well as high-ranking officials of state government. Data analysis involved iterative interpretation of interview data. We found that the rate of profit, which proved relatively low in the MMC programme, occupied a limited place in executives' self-described motivations and in state officials' descriptions of corporation-government interactions. Non-economic motivations included a strong orientation toward corporate social responsibility and a creed in which market processes advanced human wellbeing. Such patterns contradict some of the given wisdom about how corporate executives and government officials construct their reality. PMID:21707659
Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana
This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector 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
Office of Personnel Management, Washington, DC.
This document summarizes the discussions held at a conference of public sector 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…
Background Regulation of the pharmaceutical sector is a challenging task for most governments in the developing countries. In Tanzania, this task falls under the Food and Drugs Authority and the Pharmacy Council. In 2010, the Pharmacy Council spearheaded policy reforms in the pharmaceutical sector aimed at taking over the control of the regulation of the business of pharmacy from the Tanzania Food and Drugs Authority. This study provides a critical analysis of these reforms. Methods The study employed a qualitative case-study design. Data was collected through in-depth interviews, focus group discussions and document reviews. Data was analyzed thematically using a policy triangle framework. The analysis was done manually. Results The reforms adopted an incremental model of public policy-making and the process was characterized by lobbying for political support, negotiations and bargaining between the interest groups. These negotiations were largely centred on vested interests and not on the impact of the reforms on the efficiency of pharmaceutical regulations in the country. Stakeholders from the micro and meso levels were minimally involved in the policy reforms. Conclusion Recent pharmaceutical regulation reforms in Tanzania were overshadowed by vested interests, displacing a critical analysis of optimal policy options that have the potential to increase efficiency in the regulation of the business of pharmacy. Politics influenced decision-making at different levels of the reform process. PMID:23849334
Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P < 0.01). Discordance between what motivational factors health workers considered important and their perceptions of actual presence of these factors were also highest in Uttar Pradesh in the public sector, where all 17 items had greater discordance for public sector workers than for workers in the private sector (P < 0.001). Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-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. PMID:21108833
Kamarudin, M. K.; Yahya, Z.; Harun, R.; Jaapar, A.
In Malaysia, the government agencies that handle the management of historical buildings are finding themselves facing a shortage of funds to provide the necessary work on digitalising management works. Due to the rising cost of management, which also covers maintenance and infrastructure works, there is a need for a paradigm shift from public sector to private sector provision on infrastructure and management works. Therefore the government agencies need to find the suitable mechanism to encourage private sector especially the private property and developers to take part in it. This scenario has encouraged the authorities to look new ways of entering into partnership and collaboration with the private sector to secure the continuity of provision and funding. The paper first reviews the different approach to facilitate off-site local management system of historical buildings and then examines options for both private and public funding in digitalising the historical buildings management works by interviewing government officer, conservator and member of nongovernment agencies. It then explores how the current system of management may adopt the shift to avoid any vulnerability and threat to the existing historical buildings. This paper concludes with a short summary of key issues in management works of historical buildings and recommendations.
Kolstad, Julie Riise; Lindkvist, Ida
Motivational crowding-out theory establishes that the effectiveness of financial incentive schemes, like pay-for-performance, crucially depends on the underlying social preferences of health workers. In this paper we study the extent to which heterogeneity in the strength and structure of social preferences is related to career choices by testing whether preferences vary systematically between Tanzanian health worker students who prefer to work in the private for-profit health sector and those who prefer to work in the public health sector. Despite its important policy implications, this issue has received little attention to date. By combining data from a questionnaire and an economic experiment, we find that students who prefer to work in the public health sector have stronger pro-social preferences than those who prefer to work in the private for-profit sector. PMID:22763126
Rispel, Laetitia C.; Angelides, George
Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ? R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape Province (rural). In that financial year, a total of 5369 registered nurses could have been employed in lieu of nursing agency expenditure. Conclusions The study findings should inform workforce planning in South Africa. There is a need for uniform policies and improved management of commercial nursing agencies in the public health sector. PMID:25537936
Roubos, Ilse; Ewen, Margaret; Mantel-Teeuwisse, Aukje K; Leufkens, Hubertus GM; Laing, Richard O
Abstract Objective To investigate potential differences in the availability of medicines for chronic and acute conditions in low- and middle-income countries. Methods Data on the availability of 30 commonly-surveyed medicines – 15 for acute and 15 for chronic conditions – were obtained from facility-based surveys conducted in 40 developing countries. Results were aggregated by World Bank country income group and World Health Organization region. Findings The availability of medicines for both acute and chronic conditions was suboptimal across countries, particularly in the public sector. Generic medicines for chronic conditions were significantly less available than generic medicines for acute conditions in both the public sector (36.0% availability versus 53.5%; P?=?0.001) and the private sector (54.7% versus 66.2%; P?=?0.007). Antiasthmatics, antiepileptics and antidepressants, followed by antihypertensives, were the drivers of the observed differences. An inverse association was found between country income level and the availability gap between groups of medicines, particularly in the public sector. In low- and lower-middle income countries, drugs for acute conditions were 33.9% and 12.9% more available, respectively, in the public sector than medicines for chronic conditions. Differences in availability were smaller in the private sector than in the public sector in all country income groups. Conclusion Current disease patterns do not explain the significant gaps observed in the availability of medicines for chronic and acute conditions. Measures are needed to better respond to the epidemiological transition towards chronic conditions in developing countries alongside current efforts to scale up treatment for communicable diseases. PMID:21673857
L'Abbé, M; Schermel, A; Minaker, L; Kelly, B; Lee, A; Vandevijvere, S; Twohig, P; Barquera, S; Friel, S; Hawkes, C; Kumanyika, S; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Rayner, M; Sacks, G; Sanders, D; Snowdon, W; Swinburn, B; Walker, C
This paper outlines a step-wise framework for monitoring foods and beverages provided or sold in publicly funded institutions. The focus is on foods in schools, but the framework can also be applied to foods provided or sold in other publicly funded institutions. Data collection and evaluation within this monitoring framework will consist of two components. In component I, information on existing food or nutrition policies and/or programmes within settings would be compiled. Currently, nutrition standards and voluntary guidelines associated with such policies/programmes vary widely globally. This paper, which provides a comprehensive review of such standards and guidelines, will facilitate institutional learnings for those jurisdictions that have not yet established them or are undergoing review of existing ones. In component II, the quality of foods provided or sold in public sector settings is evaluated relative to existing national or sub-national nutrition standards or voluntary guidelines. Where there are no (or only poor) standards or guidelines available, the nutritional quality of foods can be evaluated relative to standards of a similar jurisdiction or other appropriate standards. Measurement indicators are proposed (within 'minimal', 'expanded' and 'optimal' approaches) that can be used to monitor progress over time in meeting policy objectives, and facilitate comparisons between countries. PMID:24074214
Mukherjee, Sudeshna Basu; Ray, Anjali
Background: The present study was firstly aimed to find out the nature of stressful life events arising out of the innovative challenges in modernized organizations; and secondly, it tried to identify the relationship between innovative work behavior of managers and the levels of stress arising out of stressful events in modernized organizations (public and private) in West Bengal. Materials and Methods: Data was collected from a sample of 200 managers, by using 3 tools (General Information Schedule, Life Event Inventory and Innovative Work Behavior Scale) through a face-to-face interview. Responses were subjected to both quantitative and qualitative analyses. The data was statistically treated for ‘t’ and ANOVA. Results: Data highlighted the fact that the qualitative profile of stressful events in the lives of managers expressed specificity in terms of their organizational type (public- and private-sector modernized organizations), and levels of stress from stressful life events were significantly higher among the modernized private-sector managers than those among public-sector managers. The prevalence of innovative work behavior was moderately higher among managers of private-sector modernized organizations than their counterparts in public-sector organizations. The trends of innovative work behavior of the managers indicated much variability due to interaction of their level of perceived stressful challenges for innovation and the global forces of change that have unleashed dynamic, systematic and higher expectation level from them. PMID:21180486
Cawich, Shamir O; Harding, Hyacinth E; Crandon, Ivor W; McGaw, Clarence D; Barnett, Alan T; Tennant, Ingrid; Evans, Necia R; Martin, Allie C; Simpson, Lindberg K; Johnson, Peter
The barriers to health care delivery in developing nations are many: underfunding, limited support services, scarce resources, suboptimal health care worker attitudes, and deficient health care policies are some of the challenges. The literature contains little information about health care leadership in developing nations. This discursive paper examines the impact of leadership on the delivery of operating room (OR) services in public sector hospitals in Jamaica.Delivery of OR services in Jamaica is hindered by many unique cultural, financial, political, and environmental barriers. We identify six leadership goals adapted to this environment to achieve change. Effective leadership must adapt to the environment. Delivery of OR services in Jamaica may be improved by addressing leadership training, workplace safety, interpersonal communication, and work environment and by revising existing policies. Additionally, there should be regular practice audits and quality control surveys. PMID:24355903
Berke, J. G.
The organization and functions of an interdisciplinary team for the application of aerospace generated technology to the solution of discrete technological problems within the public sector are presented. The interdisciplinary group formed at Stanford Research Institute, California is discussed. The functions of the group are to develop and conduct a program not only optimizing the match between public sector technological problems in criminalistics, transportation, and the postal services and potential solutions found in the aerospace data base, but ensuring that appropriate solutions are acutally utilized. The work accomplished during the period from July 1, 1970 to June 30, 1971 is reported.
Hochrainer-Stigler, Stefan; Mechler, Reinhard; Pflug, Georg; Williges, Keith
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 public sector 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 public sector'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.
The embezzlement and corruption scandal surrounding the director of a local Massachusetts housing authority in late 2011 spurred a heated public debate about governance and efficiency in the state-funded public housing ...
Background The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences. Methods Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture. Results Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information. Conclusions Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors. PMID:21619572
Smith, Ralph F
Although Dickens is still known as having been a highly visible supporter of England's well-known nineteenth-century sanitary movement, he became, in fact, deeply troubled by many of this movement's fundamental tenets, as evidenced by journal narratives on fever that he edited and wrote in the mid-nineteenth century. Rather than water and sewer engineering works and a sanitary regime policed by government agencies as envisaged by Edwin Chadwick and other sanitary reformers, Dickens's view by 1855 was that only a massive erasure of the existing social and political systems and their replacement by an utterly new infrastructure would suffice. PMID:26095845
Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W
Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has resulted in significant increases in geographic access although several areas of the country need further improvements. This information is key to future planning and with this paper we have released the digital spatial database in the public domain to assist the Kenyan Government and its partners in the health sector. PMID:19267903
Julian V Roberts
Objective: One justification for a statutory ban on physical punishment is that passage of such legislation changes public attitudes towards the use of this form of parental discipline. The experience in Sweden is often cited as an example of legislation which changed public opinion. The aim of this brief article is to review the public opinion findings in Sweden in
Background Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. Although there have been several studies of job satisfaction among nurses in South Africa, these are limited because they relate to studies of individual organizations or regions, use small samples or are dated. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. Methods This was a cross-sectional survey of professional nurses conducted throughout South Africa using a pretested and self-administered questionnaire. Univariate and bivariate statistical models were used to evaluate levels of satisfaction with various facets of work and to elicit the differences in satisfaction levels between different groups of nurses. A total of 569 professional nurses participated in the study. Results Private-sector nurses were generally satisfied, while public-sector nurses were generally dissatisfied. Public-sector nurses were most dissatisfied with their pay, the workload and the resources available to them. They were satisfied only with the social context of the work. Private-sector nurses were dissatisfied only with their pay and career development opportunities. Professional nurses in the more rural provinces, those intending to change sectors and those more likely not to be in their current positions within the next five years were also more likely to be dissatisfied with all facets of their work. Conclusion This study highlighted the overall dissatisfaction among South African nurses and confirmed the disparity between the levels of job satisfaction between the public and private sectors. Health managers should address those factors that affect job satisfaction, and therefore retention, of nurses in South Africa. Improving the work environment so that it provides a context congruent with the aspirations and values systems of nurses is more likely to increase the satisfaction of nurses and consequently have a positive effect on individual, organizational and health outcomes. PMID:19232120
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 public sector 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 public sector 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 public sector 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 public sector 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 public sector into the voucher program. PMID:24139603
District of Columbia Public Schools: While Early Reform Efforts Tackle Critical Management Issues, a District-Wide Strategic Education Plan Would Help Guide Long-Term Efforts. Testimony before the Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia, Committee on Homeland Security and Governmental Affairs, U.S. Senate. GAO-08-549T
Ashby, Cornelia M.
In response to long-standing problems with student academic performance, the condition of school facilities, and the overall management of the D.C. public school system, the D.C. Council approved the Public Education Reform Amendment Act of 2007 (Reform Act). The Reform Act made major changes to the operations and governance of the D.C. public…
Robelen, Erik W.
Kicked off the week of April 10, 2006 with a big plug on "The Oprah Winfrey Show," a new campaign spearheaded by the Bill & Melinda Gates Foundation is aiming to drum up public action to address what its organizers see as a crisis in America's public high schools. The Stand Up campaign comes as high schools have emerged as a focus of public-policy…
Boskin, Michael J.
Providing pre-college teachers with an analysis of tax reform is the primary goal of this publication. The present tax system is both inefficient and inequitable. Three goals of tax reform proposals are detailed: (1) fairness--the dimensions of horizontal equity, or equal treatment of equals however defined, and vertical equity, reflecting the…
Branch, Gregory F.; Hanushek, Eric A.; Rivkin, Steven G.
Although much has been written about the importance of leadership in the determination of organizational success, there is little quantitative evidence due to the difficulty of separating the impact of leaders from other organizational components--particularly in the public sector. Schools provide an especially rich environment for studying the…
Branch, Gregory F.; Hanushek, Eric A.; Rivkin, Steven G.
Although much has been written about the importance of leadership in the determination of organizational success, there is little quantitative evidence due to the difficulty of separating the impact of leaders from other organizational components--particularly in the public sector. Schools provide an especially rich environment for studying the…
Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.
There is a growing need for geropsychologists who are specialists in practice, research, education, and advocacy for older adults. The combined USF/Tampa VA geropsychology fellowship program focuses on the training of three post-doctoral Fellows each year in public sector service delivery across diverse long term care (LTC) and primary care…
Brown, Mary Maureen; Brudney, Jeffrey L.
The effectiveness of information technology in promoting the learning organization in the public sector was examined using responses of 314 police officers. Three factors that threatened the capability of information technology to support knowledge workers in learning organizations were found: asymmetrical decision parameters, ill-structured…
Drake, Brett; Jonson-Reid, Melissa; Sapokaite, Lina
Objective: This study uses administrative data to track the first rereports of maltreatment in a low-income, urban child welfare population (n = 4957) while controlling for other public service involvement. Service system involvement is explored across the following sectors: Child Welfare, Income Maintenance, Special Education, Juvenile Court, and…
Hamlin, Robert G.; Sage, Lesley
This paper describes an empirical study of mentor and mentee behaviors deemed critical for developing healthy mentoring relationships and effective mentoring during the "start up" and "on going" stages of a formal mentoring scheme within a major UK public sector organization. Several identified behavioral categories (criteria) of mentoring…
Oh, Jeong Rok
The purpose of this study was to explore the relationship between organizational justice and career satisfaction of employees in the public sector of South Korea. Specifically, this study aimed to investigate the impact of three different dimensions (distributive, procedural, and interactional justice) of organizational justice on career…
Luechinger, Simon; Meier, Stephan; Stutzer, Alois
High unemployment rates entail substantial costs to the working population in terms of reduced subjective well-being. This paper studies the importance of individual economic security, in particular job security, by exploiting sector-specific institutional differences in the exposure to economic shocks. Public servants have stricter dismissal…
Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.
The water sector is dependent on effective institutions and organisations, and, therefore, on strong competences at the individual level. In this paper we describe competence formation and competence needs in a case study of the Directorate General of Water Resources (DGWR) in the Ministry of Public Works in Indonesia. A framework is introduced for the water sector comprising three aggregate competences for technical issues, management, and governance, and a meta-competence for continuous learning and innovation. The four competences are further organised in a T-shaped competence profile. Though DGWR professionals have a firmly "technical" orientation, both surveys and interviews reveal a strong perceived requirement for other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. Further, a discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that can be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With low competence in these fields, it is difficult for professionals to communicate and collaborate effectively in a multidisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this is partially compensated by the attention to continuous learning and innovation. The exposure to a different culture and learning format is experienced as fundamentally formative.
As prison populations soar at unprecedented rates, the need for high quality education behind bars has never been greater. Prison education programs are the vehicle for reform and may be the solution to curtailing an ever-growing prison population. Yet, as the public sector increasingly contracts with the private sector for prison management,…
In many urban districts, the public education landscape is being transformed as private-sector providers such as educational management organizations, charter management organizations, and partner support organizations partner with or run district schools. While some private-sector providers' visions for school reform have remained static…
Bulkley, Katrina E., Ed.; Henig, Jeffrey R., Ed.; Levin, Henry M., Ed.
"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,…
Meyerson, Martin; Zemsky, Robert
A study examined the impact of public policy on education and training in the private sector. During the study, the following research activities were completed: a statistical examination of the scope and nature of firm-supplied training, 20 case studies of the training supplied by large firms representing a diverse set of industries across the…
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 public sector 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 public sector 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 public sector 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 public sector 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. PMID:23768178
Hare, Kristoffer Borbjerg; Vinther, Jesper Høeg; Lohmander, L Stefan; Thorlund, Jonas Bloch
Objectives A recent study reported a large increase in the number of meniscal procedures from 2000 to 2011 in Denmark. We examined the nation-wide distribution of meniscal procedures performed in the private and public sector in Denmark since different incentives may be present and the use of these procedures may differ from region to region. Setting We included data on all patients who underwent an arthroscopic meniscal procedure performed in the public or private sector in Denmark. Participants Data were retrieved from the Danish National Patient Register on patients who underwent arthroscopic meniscus surgery as a primary or secondary procedure in the years 2000 to 2011. Hospital identification codes enabled linkage of performed procedures to specific hospitals. Primary and secondary outcome measures Yearly incidence of meniscal procedures per 100?000 inhabitants was calculated with 95% CIs for public and private procedures for each region. Results Incidence of meniscal procedures increased at private and at public hospitals. The private sector accounted for the largest relative and absolute increase, rising from an incidence of 1 in 2000 to 98 in 2011. In 2011, the incidence of meniscal procedures was three times higher in the Capital Region than in Region Zealand. Conclusions Our study identified a large increase in the use of meniscal procedures in the public and private sector in Denmark. The increase was particularly conspicuous in the private sector as its proportion of procedures performed increased from 1% to 32%. Substantial regional differences were present in the incidence and trend over time of meniscal procedures. PMID:25712820
Lance D. Fusarelli
In their search for magic bullets to fix failing schools, policymakers seldom directly address powerful ecological factors impacting schooling. This article identifies several major demographic, societal, economic, and educational changes and trends in U.S. society over the past several years; analyzes their impact on schoolchildren; and offers a series of policy recommendations for public sector reform initiatives that show promise
Tsai, Wehn-Jyuan; Liu, Jin-Tan; Chou, Shin-Yi; Thornton, Robert
Between 1968 and 1973 the Taiwanese government undertook the most extensive expansion on record of the public junior high school system in Taiwan. This study analyzes the effects of the 1968 education reform and subsequent high school expansion on gender disparities in employment generally, as well in different sectors and classes of employment.…
Fuhrman, Susan H., Ed.; O'Day, Jennifer A., Ed.
This book offers a variety of incentive approaches to school reform, through the perspectives of noted experts in education policy, practice, and research, as well as respected thinkers from the public and private sectors. The intended audience includes policymakers at the national, state, and district levels; teacher educators and other education…
Abrantes Pego, Raquel; Almeida, Celia
This study focuses on the role of public health experts in the contemporary health sector reform process. The authors discuss the issue based on the case of Brazil and Mexico, where a group of public health specialists have oriented their participation to influence the conflict concerning health policy reform in the respective countries. One approach has been to develop a new cognitive framework for technical health sector reform projects viewed as policy proposals with technical content. The purpose is to demonstrate how these specialists have managed to influence the national debate over health sector reform when the technical and scientific discussion leaves the academic sphere and reaches the social and political realm. The authors contend that this occurs because such technical and scientific knowledge has been postulated (independently of its intrinsic value) as a political and ideological alternative platform for sustaining a health sector reform proposal which, once transformed into a policy project, has served to aggregate certain political and social forces. PMID:12118305
Ezebilo, Eugene E; Animasaun, Emmanuel D
In most developing countries public-private sector partnership is becoming increasingly applied in household waste management service delivery especially in urban areas to reduce cost and improve effectiveness. This paper reports a study of householders' perceptions of public-private sector partnership in provision of household waste management services in Ilorin, south-west Nigeria. A multistage random sampling technique was used to select 224 households for the study. The data generated from the survey were analysed using a binary logit model. The results show that most of the respondents were of the opinion that the public-private partnership has not been able to improve household waste management services. Time taken to visit solid waste collection point, income and marital status negatively influenced their perceptions, while activities of sanitary inspectors, occupation and gender had positive influence. The public-private partnership will be more effective and sustainable if the public sector could pay more attention to performance monitoring and accountability. PMID:22452959
Levy, Jessica K; Curtis, Sian; Zimmer, Catherine; Speizer, Ilene S
Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between public sector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas. PMID:24248622
...criteria. The resulting recommendations will be reported to FEMA leadership. The purpose of the public meetings is to describe, update...alteration at http://www.regulations.gov, including any personal information provided. You may want to read the Privacy...
...criteria. The resulting recommendations will be reported to FEMA leadership. The purpose of the public meetings is to describe, update...alteration at http://www.regulations.gov, including any personal information provided. You may want to read the Privacy...
Mol, Arthur P. J.; Fu, Tao
During the past decades, the traditional state monopoly in urban water management has been debated heavily, resulting in different forms and degrees of private sector involvement across the globe. Since the 1990s, China has also started experiments with new modes of urban water service management and governance in which the private sector is involved. It is premature to conclude whether the various forms of private sector involvement will successfully overcome the major problems (capital shortage, inefficient operation, and service quality) in China’s water sector. But at the same time, private sector involvement in water provisioning and waste water treatments seems to have become mainstream in transitional China. PMID:18256780
Murray, K; Roux, D J; Nel, J L; Driver, A; Freimund, W
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 public sector 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. PMID:21431779
Murray, K.; Roux, D. J.; Nel, J. L.; Driver, A.; Freimund, W.
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 public sector 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.
Mahmood, Kutub; Pelkowski, Sonia; Atherly, Deborah; Sitrin, Robert D; Donnelly, John J
In anticipation of the successful eradication of wild polio virus, alternative vaccination strategies for public-sector markets of low-resource countries are extremely important, but are still under development. Following polio eradication, inactivated polio vaccine (IPV) would be the only polio vaccine available, and would be needed for early childhood immunization for several years, as maintenance of herd immunity will be important for sustaining polio eradication. Low-cost combination vaccines containing IPV could provide reliable and continuous immunization in the post-polio eradication period. Combination vaccines can potentially simplify complex pediatric routine immunization schedules, improve compliance, and reduce costs. Hexavalent vaccines containing Diphtheria (D), Tetanus (T), whole cell pertussis (wP), Hepatitis B (HBV), Haemophilus b (Hib) and the three IPV serotype antigens have been considered as the ultimate combination vaccine for routine immunization. This product review evaluates potential hexavalent vaccine candidates by composition, probable time to market, expected cost of goods, presentation, and technical feasibility and offers suggestions for development of low-cost hexavalent combination vaccines. Because there are significant technical challenges facing wP-based hexavalent vaccine development, this review also discusses other alternative approaches to hexavalent that could also ensure a timely and reliable supply of low-cost IPV based combination vaccines. PMID:23787559
van Rensburg, André J; van Rensburg, Dingie J
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
The Detroit Public Schools Michigan Department of Education CSRD Grant Funded Comprehensive School Reform Demonstration (CSRD) Models, 1998-1999 through 2000-2001. A Joint Collaborative Preliminary Evaluation.
Thomas, Regina; Woods, Paul; Hillman, Stephen; Ross, Steven M.
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…
King, Judson C., Ed.; Douglass, John Aubrey, Ed.; Feller, Irwin, Ed.
To frame the larger research agenda requires an intimate blending of knowledge of the situations of foreign research universities and those of public research universities in the United States. The first step was to bring together for a two-day symposium a group of scholars and practitioners, some with deep and varied knowledge of United States…
Schoen, Cathy; Davis, Karen; Collins, Sara R
This paper presents a framework for universal health insurance that builds on the current U.S. mixed private-public system by expanding group coverage through private markets and publicly sponsored insurance. This Building Blocks approach includes a new national insurance "connector" that offers small businesses and individuals a structured choice of a Medicare-like public option and private plans. Other features include an individual mandate, required employer contributions, Medicaid/State Children's Health Insurance Program (SCHIP) expansion, and tax credits to assure affordability. The paper estimates coverage and costs, and assesses the approach. Our findings indicate that the framework could reach near-universal coverage with little net increase in national health spending. PMID:18474952
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
Advises would-be reformers to envision what reformed schools should look like before advocating their pet changes. Most reformers fail to connect their proposals with their goals. As the 10 "equal opportunity" reform fantasies show, rhetoric alone is useless. Basic condition preventing significant school change is public resistance. Increasing the…
Aliff, John Vincent
Into the "quality of public schools" issue step politicians with quick fixes--"proven" business practices variously rejected by experts Peter Drucker (Management by Objectives) and W. E. Deming (Quality Management). These include the following. Determine product quality by inspection--hence, compare school quality by testing teachers and students.…
Modern personnel economics emphasizes the importance of strategic, integrated compensation policy in an organization. In this paper I review key features of the compensation system for public school teachers. The rigidities and inefficiencies that arise from single salary schedules and other features of the compensation regime, and their…
Watkins, William H., Ed.
In this timely interdisciplinary volume, William Watkins has brought together leading scholars and activists to address some of the most urgent issues facing public education. What is underneath and behind the language of choice, efficiency, and improvement in current neoliberal discourse? How will urban and poor populations be affected? Will…
Elliott, R. J.
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 public sector, 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.
Vahtera, Jussi; Stansfeld, Stephen; Yli-Tuomi, Tarja; Salo, Paula; Pentti, Jaana; Kivimäki, Mika; Lanki, Timo
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 public sector 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. PMID:22871637
Taveira, Alvaro D; James, Craig A; Karsh, Ben -Tzion; Sainfort, François
The integration of quality management initiatives, particularly total quality management (TQM), and ergonomics has received increasing attention from scholars and practitioners. Above all, the question of how TQM programs relate to ergonomic aspects of organizational design and culture is at the center of this discussion. This study examines how elements of a "typical", Deming-inspired, TQM program in the public sector interact with the work environment. Elements of the TQM program were defined and measured using the Malcom Baldridge Award criteria. The specific elements examined were "Management Support of Quality", "Information and Analysis", "Human Resources", "Processes and Quality Results", and "Customer Focus and Satisfaction". The relationship between these TQM elements and the work environment were defined through five separate hypotheses. The work environment was described by the constructs "Supervisor Support", "Task Clarity", "Task Orientation", and "Innovation". Data were obtained through survey questionnaires administered to employees of four departments in a municipal government organization. Results supported three of the hypotheses, but produced some unanticipated outcomes with regard to the other two. Namely, "Management Support of Quality" was significantly related to "Supervisor Support", "Task Orientation", "Task Clarity" and "Innovation"; "Human Resources" was significantly related to "Supervisor Support"; "Processes and Quality Results" was significantly related to "Task Orientation" and "Innovation". Contrary to predicted "Information and Analysis" was negatively related to "Innovation", and "Customer Focus" was unrelated to any of the outcome variables. The relationships between these TQM elements and work environment dimensions are discussed. Implications for TQM and ergonomic practice are analyzed, and directions for future research proposed. PMID:12880738
Ableidinger, Joe; Steiner, Lucy; Spong, Angie; Hassel, Bryan C.
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…
Zhou, Yingying; Miao, Qing
This study examined a possible mediating mechanism between servant leadership and the affective commitment in Chinese employees. Servant leadership, perceived organizational support, and affective commitment was assessed among 239 full-time employees in the Chinese public sector in three rounds of surveys. Servant leadership influenced affective commitment through perceived organizational support. The effect of servant leadership exists in Chinese culture as well as Western cultures. PMID:25310313
Jane A. Johnston Balkam; Karin Cadwell; Sara B. Fein
The purpose of this study was to evaluate the impact of the individual services offered via a workplace lactation program\\u000a of one large public-sector employer on the duration of any breastfeeding and exclusive breastfeeding. Exclusive breastfeeding\\u000a was defined as exclusive feeding of human milk for the milk feeding. A cross-sectional mailed survey approach was used. The\\u000a sample (n = 128) consisted of
Super, David A
The Patient Protection and Affordable Care Act (ACA) transformed U.S. public law in crucial ways extending far beyond health care. As important as were the doctrinal shifts wrought by National Federation of Independent Business v. Sebelius, the ACA's structural changes to public law likely will prove far more important should they become entrenched. The struggle over the ACA has triggered the kind of "constitutional moment" that has largely replaced Article V's formal amendment procedure since the Prohibition fiasco. The Court participates in this process, but the definitive and enduring character of these constitutional moments' outcomes springs from broad popular engagement. Despite the Court's ruling and the outcome of the 2012 elections, the battle over whether to implement or shelve the ACA will continue unabated, both federally and in the states, until We the People render a clear decision. Whether the ACA survives or fails will determine the basic principles that guide the development of federalism, social insurance, tax policy, and privatization for decades to come. In each of these areas, the New Deal bequeathed us a delicate accommodation between traditionalist social values and modernizing norms of economic efficiency and interest group liberalism. This balance has come under increasing stress, with individual laws rejecting tradition far more emphatically than the New Deal did. But absent broad popular engagement, no definitive new principles could be established. The ACA's entrenchment would elevate technocratic norms across public law, the first change of our fundamental law since the civil rights revolution. The ACA's failure would rejuvenate individualistic, moralistic, pre-New Deal norms and allow opponents to attempt a counterrevolution against technocracy. PMID:24834539
Butler, Paul M
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
The 'Gesundheitsstrukturgesetz 1993' (GSG 1993) and the following law has resp. will considerably change the hospital scene. Thus the intended cost reduction in the hospital sector ought to be reached by the following measures: abolition of covering cost prices a more sufficient connection of in- and outdoor-patient treatments fixed budgets for 1993/1994 and resp. 1995 adoption of a differentiated system of fees a growing quota of the head physicians' charges for the sick-insurances In this context the abolition of covering cost prices is a minor problem. A more significant subject in consideration of the increasing requirements of hospital management is the organizational realization of the following aspects: rising forms of operating on outdoor-patients, pre- and post-indoor treatments, the period of fixed budgets in 1993/1994, resp. to 1995, as well as the calculation of the various fees. In addition to that the reduced revenues from the charges of head physicians pose a problem for the hospitals. The adoption of the new forms of treatment causes serious changes in both the functional and the proceeding organization of hospitals. The period of fixed budgets is of disadvantage in particular for those hospitals which did not manage to agree upon 'Fallpauschalen' and 'Sonderentgelte' until 1992 under the law of 1986 (Bundespflegesatzverordnung 1986). These prices or fees are not subject of the fixed budgets. Thus only hospitals having agreed upon these prices have the chance to raise their budget in case of an increased number of patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7676748
Davis, Tomeka M.
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…
Mannocci, Virgilio; And Others
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…
Bennell, Paul; Bendera, Shane; Kanyenze, Godfrey; Kimambo, Emrode; Kiwia, Sixtus; Mbiriyakura, Tichafa; Mukyanuzi, Faustin; Munetsi, N.; Muzulu, Jo; Parsalaw, Willy; Temu, John
Developments in vocational education and training (VET) in Tanzania and Zimbabwe since the 1980s were examined in the context of economic reform. Formal VET provision in each country's public and private sectors was reviewed, and case studies of one firm in each country's manufacturing and tourism industries were conducted. The research identified…
Douglas, Kathy S
The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing. PMID:22970554
In 2002 Nepal's parliament passed a liberal abortion law, after nearly three decades of reform efforts. This paper reviews the history of the movement for reform and the combination of factors that contributed to its success. These include sustained advocacy for reform; the dissemination of knowledge, information and evidence; adoption of the reform agenda by the public sector and its leadership in involving other stakeholders; the existence of work for safe motherhood as the context in which the initiative could gain support; an active women's rights movement and support from international and multilateral organisations; sustained involvement of local NGOs, civil society and professional organisations; the involvement of journalists and the media; the absence of significant opposition; courageous government officials and an enabling democratic political system. The overriding rationale for reforming the abortion law in Nepal has been to ensure safe motherhood and women's rights. The first government abortion services officially began in March 2004 at the Maternity Hospital in Kathmandu; services will be expanded gradually to other public and private hospitals and private clinics in the coming years. PMID:15938161
Szesze, M.; Kahl, S.; Janney, D.
In the Montgomery County Public Schools (MCPS), the science curriculum is undergoing a comprehensive systemic review in an effort to revise the system's curriculum and the entire instructional program. As a part of this overall effort, MCPS has developed a framework for the astronomy curriculum that includes a rationale, essential indicators, and blueprints. The school system is partnering with the NASA Goddard Space Flight Center to involve professional astronomers/space scientists as content advisors to ensure science content accuracy and currency. Through this partnership, many NASA developed educational materials have been made available to the school system to assist with the instructional sequences. This new policy has resulted in the development of a clear and coherent astronomy curriculum for grades K-8. The blueprint is written in the form of a set of indicators which identify the exact skills and knowledge that need to be taught at each grade level so that students will meet and exceed state, national, and international standards. Each blueprint also includes the enduring understandings and essential questions that students should focus on for that specific unit of study, a proposed instructional sequence, and assessment and differentiation ideas. Using these blueprints, teachers will create curriculum guides that include model lessons, model assignments, concept maps, resources, assessment samples, and strategies for differentiating the curriculum to meet the needs of a wide range of learners. In addition, a 45 hour certification training course is being developed to train in service teachers in a wide range of space science disciplines from seasons to cosmology. The course is being developed and will be taught by a team composed of space scientists and master educational trainers. Pilot testing of the curriculum and the training course will begin in Fall 2002.
Thro, William E.
In May 1991 the Oregon Supreme Court, in "Coalition," went against the recent national trend and upheld Oregon's school finance scheme. Examines the Oregon decision and its implications for the future of school finance reform. (69 references) (MLF)
Pollitt, Michael G.
Chile was the first country in the world to implement a comprehensive reform of its electricity sector in the recent period. Among developing countries only Argentina has had a comparably comprehensive and successful reform. ...
Gething, Peter W.; Kirui, Viola C.; Alegana, Victor A.; Okiro, Emelda A.; Noor, Abdisalan M.; Snow, Robert W.
Background As international efforts to increase the coverage of artemisinin-based combination therapy in public health sectors gather pace, concerns have been raised regarding their continued indiscriminate presumptive use for treating all childhood fevers. The availability of rapid-diagnostic tests to support practical and reliable parasitological diagnosis provides an opportunity to improve the rational treatment of febrile children across Africa. However, the cost effectiveness of diagnosis-based treatment polices will depend on the presumed numbers of fevers harbouring infection. Here we compute the number of fevers likely to present to public health facilities in Africa and the estimated number of these fevers likely to be infected with Plasmodium falciparum malaria parasites. Methods and Findings We assembled first administrative-unit level data on paediatric fever prevalence, treatment-seeking rates, and child populations. These data were combined in a geographical information system model that also incorporated an adjustment procedure for urban versus rural areas to produce spatially distributed estimates of fever burden amongst African children and the subset likely to present to public sector clinics. A second data assembly was used to estimate plausible ranges for the proportion of paediatric fevers seen at clinics positive for P. falciparum in different endemicity settings. We estimated that, of the 656 million fevers in African 0–4 y olds in 2007, 182 million (28%) were likely to have sought treatment in a public sector clinic of which 78 million (43%) were likely to have been infected with P. falciparum (range 60–103 million). Conclusions Spatial estimates of childhood fevers and care-seeking rates can be combined with a relational risk model of infection prevalence in the community to estimate the degree of parasitemia in those fevers reaching public health facilities. This quantification provides an important baseline comparison of malarial and nonmalarial fevers in different endemicity settings that can contribute to ongoing scientific and policy debates about optimum clinical and financial strategies for the introduction of new diagnostics. These models are made publicly available with the publication of this paper. Please see later in the article for the Editors' Summary PMID:20625548
Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D.; Helms, David
Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476
Kelly, Kathleen S.
Finds that role as a technician, perception of public relations as a secondary function, organizational turbulence, and dependency on private gifts lead to the takeover of the public relations department by professionals from outside public relations. Theorizes about external and internal factors contributing to this. (SR)
Jan, Stephen; Bian, Ying; Jumpa, Manuel; Meng, Qingyue; Nyazema, Norman; Prakongsai, Phusit; Mills, Anne
This paper examines the policy options for the regulation of dual job holding by medical professionals in highly resource-constrained settings. Such activity is generally driven by a lack of resources in the public sector and low pay, and has been associated with the unauthorized use of public resources and corruption. It is also typically poorly regulated; regulations are either lacking, or when they exist, are vague or poorly implemented because of low regulatory capacity. This paper draws on the limited evidence available on this topic to assess a number of regulatory options in relation to the objectives of quality of care and access to services, as well as some of the policy constraints that can undermine implementation in resource-poor settings. The approach taken in highlighting these broader social objectives seeks to avoid the value judgements regarding dual working and some of its associated forms of behaviour that have tended to characterize previous analyses. Dual practice is viewed as a possible system solution to issues such as limited public sector resources (and incomes), low regulatory capacity and the interplay between market forces and human resources. This paper therefore offers some support for policies that allow for the official recognition of such activity and embrace a degree of professional self-regulation. In providing clearer policy guidance, future research in this area needs to adopt a more evaluative approach than that which has been used to date. PMID:16283054
This dissertation presents two models of resources allocation in the public sector. The first model, which assumes scarcity of resources available to the state and is suitable to the experiences of the developed Western States, is tested against the data for Denmark, the Netherlands, and Norway. The second model, which assumes an abundance of resources available to the state and is suitable to the experiences of oil-rich countries, is tested against the data for Saudi Arabia, Iran, and Iraq. Findings reveal that the allocation of resources in the public sector in Western countries followed a developmental pattern. Thus, before the 1970s, Western states allocated their budgets almost exclusively to defense and administration. They emphasized economic development until the administration. They emphasized economic development until the 1920s and social welfare programs since the 1930s. The emergence of social welfare and development as major categories of expenditures were separated by a substantial period of time. In contrast to the European experiences, the availability of non tax oil revenues promoted a relatively quick consolidation of state authority in the oil-rich countries. Consequently, oil-rich states were able to allocate large amounts of public resources to economic development and social welfare programs wither simultaneously or in quick succession without much concern for trade-offs.
Dinwoodie, Thomas L.
This work provides an assessment of the economic outlook for photovoltaic systems in the commercial, industrial and institutional sectors in the year 1986. We first summarize the expected cost and performance goals for ...
Rogers, R. H. (principal investigator)
The results achieved during the first eight months of a program to transfer LANDSAT technology to practicing professionals in the private and public sectors (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.
Tabvuma, Vurain; Bui, Hong T M; Homberg, Fabian
This article uses a quasi-natural experiment to investigate the adaptation of job satisfaction to externally driven political change in the public sector. This is important because democratic government bureaucracies often experience changes in leadership after elections. The analyses are based on data drawn from a large longitudinal data set, the British Household Panel Survey. Findings indicate that the impact of political elections is largely weak and temporary and is only present for men. For women, the internal processes of the organization tend to be more important. These findings suggest that changes in political leadership may not be associated with fundamental changes in policy. PMID:25598554
Together, the NOAA Space Environment Center (SEC) and private sector vendors need to develop mechanisms for communicating their future development needs and for defining their evolving partnership. While the SEC does hold an annual vendors meeting and continues to foster relationships within the space weather industry, there are additional steps it can take.
Health system reform in post-industrial countries has become a dominant problem facing national governments. This problem is aggravated by the pace of social and technological changes and continued economic pressures. In order to accomplish health system reform, governments must develop new policies to redirect or change the present course of the system. Health system reform involves broad based change in behaviors of consumers, providers and the government itself. The direction of the change requires nothing less than shifting the focus of the system and its actors from its predominant emphasis on sickness treatment (negative-health focus) towards an emphasis on maintaining and promoting the highest possible standards of personal health (positive-health focus). This paper introduces an implementation model for health system reform. The model was developed based on major supports and constraints presently operating in the United States health policy context. Major support is provided by the existence of both theoretical and structural frameworks upon which the policy shift can be built. The structural framework includes four laws and their associated activities which outline national health goals and objectives. A major constraint is the implementation conundrum. Policy is government's primary tool to achieve system reform. However, while government is strong in creating policies, it is extremely weak in implementing the very policies it creates. This implementation conundrum consists of three barriers. These barriers are: a universal fear of change; early stage in development of the technology of social change; and the failure of government to plan for implementation of the very policies it creates. The implementation model for health system reform is introduced to aid policy makers and analysts in overcoming this implementation conundrum. The model recognizes policy as a process of change and provides two stages for use in translating theory and aims of policy into a formula for action. Stage one is used to identify the factors of change necessary in achieving policy reform. Stage two identifies the appropriate process of change to achieve successful outcomes. The model can be used in planning for both national and local levels of health system reform by both public and private sector players in the health arena. PMID:3616677
Aratani, Yumiko; Lu, Hsien-Hen; Aber, J. Lawrence
Despite the claimed success of the 1996 Welfare Reform, little research using multivariate regression has examined changes in multiple public safety-net programs. Thus, we still do not know whether public safety-net programs for the poor have shrunk or increased nationwide, along with the sharp declines in cash assistance. Using state-level data…
Ezenwaji, Emma E.; Anyadike, Raymond N. C.; Igu, Nnaemeka I.
Recent studies in water supply in Enugu urban area have observed that there is a persistent water supply shortage relative to demand. One of the strategies for achieving a good water supply under the circumstance is through efficient water allocation to consumers. The existing allocation system by the Enugu State Water Corporation is not achieving the desired goal, because it is not based on any scientific criteria. In this study, we have employed the linear programming modelling technique to optimise the allocation of 35,000,000 L of water produced daily by the State Water Corporation and supplied to the four sectors of the town. The result shows that the model allocated 27,470,000 L to the residential sector, 3,360,000 L to commercial, 3,120,000 L to industrial and 882,000 L to public institutions sectors leaving a balance of 168,000 L to be utilised in emergency situations. This allocation pattern departs sharply from the present management technique adopted by the corporation. It is then suggested that for urban water supply to be sustainable in the town, the corporation should rely on this technique for water supply.
Grissom, Jason A.; Keiser, Lael R.
Studies of race representation in public organizations illustrate the importance of bureaucrat race in determining client-level outcomes. Building "upward" from this research, this study examines how supervisor race impacts outcomes for street-level bureaucrats using data from a nationally representative sample of public schools. Employing…
Fernandez, Sergio; Smith, Craig R.; Wenger, Jeffrey B.
We examine the effects of governments' use of alternative service provision on public employment using panel data from a nationally representative sample of local governments. We model the effects of alternative service provision on the size of the public workforce and hypothesize that alternative provision jointly impacts both full- and part-time…
Smit, Gary M.; And Others
Public employers, including school districts, are faced with unionized workers' demanding a larger share of public resources. The formation of regional bargaining associations for employers to counteract union demands is proposed. A case study of a successful association is provided. (MD)
America's reliance on technological systems that are vulnerable to space weather is growing at a rapid pace. Because such vital everyday technology as electric power grids, satellites, navigation, and communication systems are affected by space weather, it is essential to have the best possible space weather services. Although both the federal government and the private sector provide the bulk of currently available space weather products and services, a partnership between the two has been slow to develop and currently faces several challenges.
Rothstein, Steven J; Bi, Yong-Mei; Coneva, Viktoriya; Han, Mei; Good, Allen
It has been 30 years since the first transformation of a gene into a plant species, and since that time a number of biotechnology products have been developed, with the most important being insect- and herbicide-resistant crops. The development of second-generation products, including nutrient use efficiency and tolerance to important environmental stressors such as drought, has, up to this time, been less successful. This is in part due to the inherent complexities of these traits and in part due to limitations in research infrastructure necessary for public sector researchers to test their best ideas. Here we discuss lessons from previous work in the generation of the first-generation traits, as well as work from our labs and others on identifying genes for nitrogen use efficiency. We then describe some of the issues that have impeded rapid progress in this area. Finally, we propose the type of public sector organization that we feel is necessary to make advances in important second-generation traits such as nitrogen use efficiency. PMID:24948680
Sood, Neeraj; Burger, Nicholas; Yoong, Joanne; Kopf, Dan; Spreng, Connor
Background Health systems in Sub-Saharan Africa (SSA) are in urgent need of improvement. The private health sector is a major provider of care in the region and it will remain a significant actor in the future. Any efforts by SSA governments to improve health systems performance therefore has to account for the private health sector. Regional and international actors increasingly recognize importance of effectively engaging with the private health sector, and initiatives to improve engagement are underway in several countries. However, there is little systematic analysis of private health providers' view and experience with engagement. Methodology/Principal Findings In this study we surveyed private health facilities in Kenya and Ghana to understand the extent to which and how governments interact and engage with these facilities. The results suggest that government engagement with private health facilities is quite limited. The primary focus of this engagement is “command-and-control” type regulations to improve the quality of care. There is little attention paid to building the capacity of health care businesses through either technical or financial assistance. The vast majority of these facilities also receive no government assistance in meeting public health and social goals. Finally, government engagement with private pharmacies is often neglected and clinics receive a disproportionate share of government assistance. Conclusions/Significance Overall, our findings suggest that there may be considerable untapped potential for greater engagement with private health facilities—particularly pharmacies. Improving engagement will likely help governments with limited resources to better take advantage of the private sector capacity to meet access and equity objectives and to accelerate the achievement of the Millennium Development Goals. PMID:22132092
Ebler, Beth Anne; Giacalone Willis, Jacalyn
The Newark School System has implemented a systemwide reform, "Learn through the Lens of Science," which has several components that build and sustain the district's capacity for science education (e.g., establishing long-range planning processes, partnering with universities, and creating a science materials distribution center). The paper…
Arimoto, Akira, Ed.
This report contains papers from the Six Nation Higher Education Research Project, an initiative that has focused on making a comparative study of the reform of higher education at the stage of postmassification in six countries: China, Germany, Singapore, Switzerland, the United States, and Japan. The papers are: (1) The Six Nation Higher…
Educational reform movements--changes in state policies about teacher quality and recruitment and the professionalization of teaching--and their impact on the teacher labor market of the coming century are discussed. Four studies of teachers, teacher persistence, recruitment, and school district hiring practices are discussed. (JL)
Bruno Rossi; Barbara Russo; Giancarlo Succi
This paper reports about a study on the introduction of Open Source Software (OSS) in a Public Administration located in Europe.\\u000a The Public Administration examined has introduced OSS as a means to save on the license costs and to have a larger space for\\u000a customisation purposes. The adoption of new software may have an impact on the employees’ productivity that
McAdams, Donald R.
Much confusion exists today among board of education members and superintendents about governance roles, especially when a district is low performing and the public is demanding bold reform. Part of the confusion comes from the definition of reform. To many Americans, school reform means fine-tuning what education historian David B. Tyack calls…
Johnson, Richard W.; Butrica, Barbara A.; Haaga, Owen; Southgate, Benjamin G.
Hybrid retirement plans that combine defined benefit pensions with 401(k) type, defined contribution accounts can play important roles in the reform of public-sector pensions. Summarizing results from our longer report ["How Will Rhode Island's New Hybrid Pension Plan Affect Teachers? A Report of the Public Pension Project" (2014)], this…
Diane E. Hoffmann
On September 12, 2003, the University of Maryland School of Law's Intellectual Property and Law & Health Care Programs jointly sponsored and convened a roundtable discussion on the future public policy and ethical issues that will likely face the agricultural and microbial genomics sectors of the biotechnology industry. As this industry has developed over the last two decades, societal concerns have moved from what were often local issues, e.g., the safety of laboratories where scientists conducted recombinant DNA research on transgenic microbes, animals and crops, to more global issues. These newer issues include intellectual property, international trade, risks of genetically engineered foods and microbes, bioterrorism, and marketing and labeling of new products sold worldwide. The fast paced nature of the biotechnology industry and its new developments often mean that legislators, regulators and society, in general, must play ''catch up'' in their efforts to understand the issues, the risks, and even the benefits, that may result from the industry's new ways of conducting research, new products, and novel methods of product marketing and distribution. The goal of the roundtable was to develop a short list of the most significant public policy and ethical issues that will emerge as a result of advances in these sectors of the biotechnology industry over the next five to six years. More concretely, by ''most significant'' the conveners meant the types of issues that would come to the attention of members of Congress or state legislators during this time frame and for which they would be better prepared if they had well researched and timely background information. A concomitant goal was to provide a set of focused issues for academic debate and scholarship so that policy makers, industry leaders and regulators would have the intellectual resources they need to better understand the issues and concerns at stake. The goal was not to provide answers to any of the issues or problems, simply to identify those topics that deserve our attention as a society. Some of the issues may benefit from legislation at the federal or state levels, others may be more appropriately addressed by the private sector. Participants at the roundtable included over a dozen experts in the areas of microbiology, intellectual property, agricultural biotechnology, microbial genomics, bioterrorism, economic development, biotechnology research, and bioethics. These experts came from federal and state government, industry and academia. The participants were asked to come to the roundtable with a written statement of the top three to five public policy/ ethical issues they viewed as most likely to be significant to the industry and to policy makers over the next several years.
The paper analyzes conscientious objection by physicians, through the concrete situation of legal abortion in Brazil. It reviews the two main ethical frameworks about conscientious objection in public health, the incompatibility thesis and the integrity thesis, to analyze the reality of legal abortion services in the referral services of the Brazilian public health care system. From these two perspectives, a third perspective is proposed - the justification thesis, to manage the right to conscientious objection among physicians in referral services. This analysis may contribute to the organization of services for legal abortion and to the education of future physicians working in emergency obstetric care. PMID:21808831
There have been substantial changes in the labour market over the past few years and survey results indicate 60% of staff will leave public library service over the next decade. While this creates opportunities for library staff, limited training budgets and a focus on compliance and specific library skills training have led to a gap in the formal…
...40 CFR part 63, subpart HH); and the NESHAP From Natural Gas Transmission and Storage Facilities (40 CFR part 63, subpart HHH). As part of this process, EPA is holding public meetings in the Dallas, Texas, and Denver, Colorado, areas, both...
Leslie, Laurel K.; Canino, Glorisa; Landsverk, John; Wood, Patricia A.; Chavez, Ligia; Hough, Richard L.; Bauermeister, Jose J.; Ramirez, Rafael
This article investigates geographic variation in stimulant medication use by youth with attention-deficit/hyperactivity disorder (ADHD) served by public mental health and/or drug and alcohol programs in San Diego (n = 790) during 1997-1998 and in Puerto Rico (n = 726) during 1998. Youth were stratified into four groups: (a) ADHD, (b) ADHD--not…
Tor Wallin Andreassen
With public services operating as monopolies, dissatisfied users cannot exit from the relation without changing patronage. Apart from exit from the region, voicing their dissatisfaction in order to influence the service offer becomes the only alternative. Industries and companies may be classified as customer oriented if they market differentiated products and services reflecting heterogeneous customer preferences. Customer satisfaction is influenced
Hyde, Albert C.
Discusses the increasing concern for public service quality, morale, and compensation. Suggests that compensation is a major determinant of whether or not governmental units attract high-grade applicants and retain them. Compares salary increases of the last decade with the consumer price index. (CH)
Munoz, Marco A.
Healthy People 2010 is the initiative that defines the U.S. health agenda and guides policy. The initiative provides direction for individuals to change personal behaviors and for organizations and communities to support good health through health promotion policies. The objective of this research was to compare public and private schools on…
The capacity of public service staff in developing countries is crucial for achieving the Millennium Development Goals. Literature from developed countries shows that, working with higher education institutions (HEIs), industries have improved their human resource capacity through continuing professional development. This paper reports on research…
Deadlines are looming for school districts and other public employers to comply with a new financial-reporting rule on the long-term costs for health and other insurance benefits that have been promised to employees. For the first time, local, state, and federal agencies will have to disclose future benefit costs in current budgets, a requirement…
Deemer, Danielle R.; Lobao, Linda M.
The welfare of farm animals has become a continuing source of controversy as states seek greater regulation over the livestock industry. However, empirical studies addressing the determinants of public concern for farm-animal welfare are limited. Religion and politics, two institutional bases of attitudes, are rarely explored. Nor have…
Stein, Bradley D.; Sorbero, Mark J.; Goswami, Upasna; Schuster, James; Leslie, Douglas L.
Objective: Many states have implemented regulations (commonly referred to as waivers) to increase access to publicly insured services for autism spectrum disorders (ASD). In recent years, several states have passed legislation requiring improved coverage for ASD services by private insurers. This study examines the impact of such legislation on…
Reviews curriculum reform being implemented at the Library School of Stuttgart for students planning to work in public libraries. Components of the new curriculum include core courses in library science, electives in special areas of librarianship, seminars in chosen subject disciplines, and field work in libraries and government agencies. (LRW)
The necessity for reforming public education is evidenced in part by the failures of past programs and in part by the requirements of the future. The anti-school mood of the present is forcing a more realistic evaluation of the potentiality education possesses in counteracting the disintegrative forces of family breakdown, individual deprivation,…
Clark, Janet; Otte, Michelle; Fair, Lynn
Aurora (Colorado) Public Schools responded to the Colorado State Model Content Standards for Reading and Writing and the accountability measures attached to the state assessments by implementing the Aurora Achievement Initiative in 2001. Originating from literature on best practices and large-scale school reform, the goal of the districtwide…
Healy, Donagh A; Murphy, Shane P; Burke, John P; Coffey, John C
The past two decades have seen considerable advances in the application of artificial interfaces (AI) in surgery. Several have been developed including AESOP (Automated Endoscopic System for Optimal Positioning), Zeus and the Da Vinci Surgical System (DVSS). Whilst each has advantages DVSS is being used increasingly across multiple surgical specialities. These developments generate many challenges in an era where the emphasis is increasingly on safer and cost-effective surgery. Whilst the role of DVSS is firmly established in urologic and gynaecologic surgery, the role of DVSS in gastrointestinal surgery is evolving. Recent data indicate that it is at least as oncologically effective, whilst providing numerous benefits (e.g. reduced conversion and complication rates) over traditional laparoscopic approaches. The increasing adoption of AI/DVSS worldwide places institutes and health sectors under increasing pressure to adopt and develop such programs. This article provides (1) an update on the current status of AI in surgery in general and in colorectal surgery and (2) an appraisal of the cost implications of the establishment and implementation of AI/DVSS-based provisions in the public health sector. The numerous challenges faced generate many opportunities in the implementation of present and future surgical technologies. PMID:23375732
Atanasova, Elka; Pavlova, Milena; Velickovski, Robert; Nikov, Bogomil; Moutafova, Emanuela; Groot, Wim
This article discusses the financial reforms in the Bulgarian public health care sector. Since 1998, when the Bulgarian parliament passed the Health Insurance Act, compulsory contributions for social health insurance have become the main source of health care financing. They replaced the previous tax-based health care funding mechanism. This article reviews empirical evidence and macro indicators to analyse to what extent the expectations of this reform are achieved. Two groups of sources are reviewed: (1) publications prior to the implementation of the social health insurance in Bulgaria that discuss its potential impact; (2) publications after the insurance implementation, that investigate the actual impact of this reform. The results suggest that social health insurance in Bulgaria brought about certain efficiency improvements in the public health care sector. However, the overall social benefit of the reform is doubtful. The main reasons for this are related to the ineffective organisation of the Bulgarian public health care sector, as well as to the overall lack of financial resources for health care in the country. PMID:21216021
Parker, Demetrius M
The Georgia Cancer Awareness and Education Campaign was launched in September 2002 with the goals of supporting cancer prevention and early detection efforts, heightening awareness of and understanding about the five leading cancers among Georgia residents, and enhancing awareness and education about the importance of proper nutrition, exercise, and healthy lifestyles. The inaugural year of the campaign is outlined, beginning with adherence to the public health principles of surveillance, risk factor identification, intervention evaluation, and implementation. A strategic and integrated communications campaign, using tactics such as paid advertising, public service announcements, local community relations, media releases, a documentary film, special events, and other components, is described in detail with links to multimedia samples. With an estimated budget of 3.1 million dollars, the first year of the campaign focuses on breast and cervical cancer screening and early detection. PMID:15670430
Little, Peter C
In this case study, I use ethnographic data to explore how community engagement and science are deployed at the U.S. Agency for Toxic Substances and Disease Registry, with the goal of formulating an understanding of the personalized meanings of science-community relations for key environmental public health experts. In focus is the cultural discourse circulating in the agency that exposes the real concerns, beliefs, and attitudes of these scientists and experts vis-&-vis their community engagement experiences. Finally, I propose that critical attention to the place of power relations, knowledge politics, and environmental justice are fundamental to studies of toxic contamination where commitments to community engagement and quality science are joined to form a positive research goal and where attempts are made to improve the conditions of quality environmental public health service. PMID:19562950
University reforms around the world reflect many of the ideas and measures associated with the New Public Management (NPM) reform wave that emerged in Australia and New Zealand in the early 1980s. However, they also display features of the post-NPM reforms introduced in the last decade. In this article I focus on university reforms in Japan,…
C. J. Garrick; J. M. Garrick; D. R. Rue
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,
Howard, David H; Roy, Kakoli
Objective To determine whether patients who use private sector providers for curative services have lower vaccination rates and are less likely to receive prenatal care. Data Sources/Study Setting This study uses data from the 52d round of the National Sample Survey, a nationally representative socioeconomic and health survey of 120,942 rural and urban Indian households conducted in 1995–1996. Study Design Using logistic regression, we estimate the relationship between receipt of preventive care at any time (vaccinations for children, prenatal care for pregnant women) and use of public or private care for outpatient curative services, controlling for demographics, household socioeconomic status, and state of residence. Data Collection/Extraction Methods We analyzed samples of children ages 0 to 4 and pregnant women who used medical care within a 15-day window prior to the survey. Principal Findings With the exception of measles vaccination, predicted probabilities of the receipt of vaccinations and prenatal care do not differ based on the type of provider at which children and women sought curative care. Children and pregnant women in households who use private care are almost twice as likely to receive preventive care from private sources, but the majority still obtains preventive care from public providers. Conclusions We do not find support for the hypothesis that children and pregnant women who use private care are less likely to receive public health services. Results are consistent with the notion that Indian households are able to successfully navigate the coexisting public and private systems, and obtain services selectively from each. However, because the study employed an observational, cross-sectional study design, findings should be interpreted cautiously. PMID:15544642
Ware, Stephen J.
to happen. So I suggest we think about “un- derfunded” courts differently. Courts provide a service—binding adjudication—to disputing parties. This service is heavily subsidized by tax dollars, as only a portion of courts’ costs are covered by fees paid... by litigants. This public subsidy, basic economics suggests, causes demand for this service to exceed supply so disputing parties queue up to receive the subsidy. A court’s time and other resources are allocated among parties according to their willingness...
...FUTURES TRADING COMMISSION Acceptance of Public Submissions...ACTION: Notice; Acceptance of public submissions...Dodd-Frank Act by adopting rules to regulate the OTC...areas to facilitate the acceptance of submissions from...OTCDerivatives/otc_rules.html. The...
Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg
The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087
Kaspersma, J. M.; Alaerts, G. J.; Slinger, J. H.
A framework is introduced, describing three aggregate competences for technical issues, management and governance, and a meta-competence for continuous learning and innovation, for the water sector. The four competences are further organised in a T-shaped competence profile. The framework and an assessment methodology were tested in a case study on post-graduate water education for professional staff in the Directorate General Water Resources (DGWR) in Indonesia. Though DGWR professionals have a firmly "technical" orientation, both the surveys and interviews show strong interest in the other competences: in particular the learning meta-competence, as well as the aggregate competence for management. The aggregate competence for governance systematically scores lower. A discrepancy appears to exist between the competences that staff perceive as needed in daily work, and those that could be acquired during post-graduate water education. In both locally-based and international post-graduate water education, the aggregate competences for management as well as governance are reportedly addressed modestly, if at all. With only little competence in these disciplines, it will be difficult for professionals to communicate and collaborate effectively in an interdisciplinary way. As a result, the horizontal bar of the T-shaped profile remains weakly developed. In international post-graduate education, this seems partly compensated by the attention for continuous learning and innovation. The exposure to a different culture and learning format is reported as fundamentally formative. The policies of DGWR have gone through three distinct phases. In the first phase (1970-1987) technical competence and learning were valued highly and training was arranged effectively; in the current phase the need to develop new competences is raising new challenges.
Gottlob, Brian J.
This study documents the public costs of high school dropouts in Indiana, and examines how school choice would provide large public benefits by increasing the graduation rate in Indiana public schools. It calculates the annual cost of high school dropouts in Indiana due to lower state income tax payments, increased reliance on Medicaid, and…
Tian Lei; Liu Lieli; Liyan Han; Hai Huang
An optimal public investment model with two objective functions considering efficiency & equity and several constraints such\\u000a as taxes and capital transfer loss are established by dividing public & private sectors and relaxing several original hypotheses\\u000a respectively. And the objective functions and constraints are handled to adapt the model into the double-objective multi-constraint\\u000a programming model suitable for genetic algorithm-based solution.
Poulsen, Henrik Enghusen; Grønlykke, Thor Buch
Exclusively private companies do drug development. The State contributes with education of academics and basic research constituting the basis of half of the drugs developed by the private companies. The Danish private drug research amounts to six billion DKK per year, corresponding to the estimated price of the development of one new drug. The development shows a negative tendency. There are doubts about the scientific credibility, the number of new drugs is declining, drug development costs are rising, and the competitiveness in Europe is declining compared with the one of The United States. Continued improvement of Danish drug development can be achieved by stimulation of the public research related to drug development. PMID:12756828
Hadi, Muhammad Abdul; Alldred, David Phillip; Briggs, Michelle; Closs, S José
Chronic pain has become one of the most prevalent problems in primary care. The management of chronic pain is complex and often requires a multidisciplinary approach. The limited capacity of general practitioners to manage chronic pain and long waiting time for secondary care referrals further add to the complexity of chronic pain management. Restricted financial and skilled human capital make it hard for healthcare systems across the world to establish and maintain multidisciplinary pain clinics, in spite of their documented effectiveness. Affordability and accessibility to such multidisciplinary pain clinics is often problematic for patients. The purpose of this paper is to share our experience and relevant research evidence of a community based combined nurse-pharmacist managed pain clinic. The pain clinic serves as an example of public-private partnership in healthcare. PMID:22120700
Boardman, Craig; Ponomariov, Branco
In today's economic climate, government is now considered by many to be the "employer of choice." However, employers at all levels of government may eventually lose their recent gains in the war for talent, as the economy improves. Accordingly, it is important to explain how public sector managers viewed the relative advantages and…
This paper presents a part of the findings from a larger study undertaken to explore the experience of graduate students in education in Pakistan. Analysis of a smaller slice of data collected from students who were enrolled in the PhD and MPhil programmes of the Department of Education in a large public sector university in Northern Pakistan was…
Gorton, Matthew; Zaric, Vlade; Lowe, Philip; Quarrie, Steve
Using primary survey data and interview evidence this paper analyses the implementation and enforcement of public and private environmental regulation in the Serbian Fresh Fruit and Vegetable (FFV) sector. This provides a basis for engaging in a wider debate on the nature of agri-food regulation in post-socialist economies. Depictions of the…
Alnasrawi, Abbas; And Others
This report deals with the absorptive capacity of Vermont's private and public sectors to accommodate welfare clients into gainful employment. Detailed attention is given to estimating the immediate and projected job vacancies in the state. When seeking these jobs, the client must not only compete against other unemployed persons, but also has to…
Booysen, F. Le R.; Van Rensburg, H. C. J.; Bachmann, M.; Louwagie, G.; Fairall, L.
This paper reports on the quality of life of patients enrolled in the public sector antiretroviral treatment programme in the Free State province of South Africa. Statistical analysis of cross-sectional data reveals that it is not access to treatment "per se" that enhances the quality of life of those who have come forward for ART. Rather, it is…
Jacobsen, Nancy M.
This dissertation explores the private-public sector partnership between CVS/pharmacy and the federal/state workforce development system in Minnesota. The study describes how CVS creates partnerships with the federal/state system of one-stop career centers and other partners in the workforce development arena such as community or faith-based…
GEOLOGY A variety of opportunities exist for geology graduates in the private and public sectors, and research. Federal government resource agencies use geologists for geologic mapping, oil and rehabilitation programs, and research. State and local governments hire geologists for geologic and soils mapping
Gharawi, Mohammed A.
This dissertation contributes to the growing base of theory relating to Transnational Public Sector Knowledge Networks (TPSKNs) presented by Dawes, Gharawi, and Burke (2012). A case study explores the TPSKN formed between the United States Center for Disease Control and the Saudi Arabian Ministry of Health ahead of the 2009 Hajj, one of the…
Birch, Derek W.; Cuthbert, R. E.
A discussion is presented of the process of resource allocation and the use of performance indicators in public sector higher education in Britain. First, background is presented on the method of providing resources to institutions of advanced further education (AFE) and non-advanced further education (NAFE) on the basis of pooled recurrent…
Groves, Cecil L.
Discusses recent technological advances, especially in computers and telecommunications, and their impact on the workplace. Highlights the need for educational reform in vocational/technical programs reflecting a systems-oriented approach rooted in the sciences. Discusses the future role of the private sector in education. (HB)
Heyssel, R M
The author discusses the need to make corrections in the U.S. health care system, describes the simplistic and money-oriented definition that many persons have of "health care reform," and discusses the issues he thinks will and will not be dealt with in the coming reforms of the health care system. He maintains that true reform would deal with matters such as restraining expansion of the health care industry, setting reasonable fees, and confronting the harmful social and environmental conditions that result in high "medical" care costs and poor health statistics. The medical profession--including academic medical centers--has a large role to play in true health care reform, which will involve facing the major barriers (which he outlines) that are now impeding important reforms (e.g., increasing the number of generalist physicians; finding better ways to pay for medical students' and residents' education). The profession cannot make progress in true reform without developing a vision of what the U.S. health care system should be and becoming active in moving toward that vision, acting in the interests of both the individual patient and the community as a whole. The author outlines some of the barriers to finding that vision (such as the influence of third-party payers on the doctor-patient relationship and the fragmentation of medicine and medical education by specialties and subspecialties) and proposes the characteristics and values of the kind of medical education and community involvement of academic medical centers that can help create the needed vision, regain the trust of the public, and thereby reform health care in the interests of both the community and the profession. PMID:8447905
Logan, John R.; Fang, Yiping; Zhang, Zhanxin
Housing reform in China has proceeded on two tracks: privatization of public housing and development of a new private housing sector. During this period of transition, rents have remained relatively low in the remaining public housing, and purchase prices offered to occupants of public housing have been well below market prices. Although these rents and prices are partly based on known formulas, there is considerable variability in how much people pay for similar apartments. This study uses 2000 Census data to estimate the housing subsidy received by the remaining renters in the public sector and purchasers of public housing, based on private sector prices for housing of comparable quality and size. The paper also analyzes variation in the estimated discount from market prices that these people receive. The findings show that the biggest winners in China’s transition from socialist housing allocation are those who were favored in the previous system, based on such factors as residence status, education and occupation. PMID:24163494
Barradale, Merrill Jones
This dissertation examines the influence of attitudes, beliefs, and preferences of energy industry practitioners on investment decision-making with regard to fuel choice for new electric power plants. The conclusions are based on in-depth interviews and an extensive online survey I conducted of 600-800 energy professionals in the U.S. power sector. Chapter 1 analyzes the impact of policy uncertainty on investment decision-making in renewable energy, using the federal production tax credit (PTC) and wind energy investment as an example. It is generally understood that the pattern of repeated expiration and short-term renewal of the PTC causes a boom-bust cycle in wind power plant investment in the U.S. This on-off pattern is detrimental to the wind industry, since ramp-up and ramp-down costs are high, and players are deterred from making long-term investments. The widely held belief that the severe downturn in investment during "off" years implies that wind power is unviable without the PTC turns out to be unsubstantiated: this chapter demonstrates that it is not the absence of the PTC that causes the investment downturn during "off" years, but rather the uncertainty over its return. Specifically, it is the dynamic of power purchase agreement negotiations in the face of PTC renewal uncertainty that drives investment volatility. This suggests that reducing regulatory uncertainty is a crucial component of effective renewable energy policy. The PTC as currently structured is not the only means, existing or potential, for encouraging wind power investment. Using data from my survey, various alternative policy incentives are considered and compared in terms of their perceived reliability for supporting long-term investment. Chapter 2 introduces the concept of expected payment of carbon as a factor in investment decision-making. The notion of carbon risk (the financial risk associated with CO2 emissions under potential climate change policy) is usually incorporated into investment decision-making by including a cost of carbon in the budget analysis. Most existing literature uses the expected price of carbon as a proxy for this cost, where expected price is a weighted average of various scenarios, often comparing policy proposals and representing either the price of traded permits or level of carbon tax, depending on the type of policy. The literature focuses on the minimum price of carbon required to influence power plant investment decisions. In contrast, this chapter introduces expected payment as a more accurate measure of carbon cost as it is perceived by industry practitioners. The expected payment of carbon is the expected price of carbon times the probability that this cost would actually be faced in the case of a particular investment. This concept helps explain both the 2005-2006 surge of activity in coal-fired power plant development and the subsequent decline in that interest. The energy industry has been slow to move away from fossil fuels and towards renewable resources. In chapter 3 I find evidence for a cognitive bias that plays a role in this momentum. Energy executives' expectations of future energy prices are strongly correlated with their own preferences, which I document for the case of natural gas prices. This is an example of wishful expectations, a form of overconfidence in which people are excessively optimistic over uncontrollable future outcomes. This implies energy executives with strong exposure to fossil fuels are excessively optimistic on future prices and so continue to invest despite the presence of superior alternatives.
Barbieri, Dechristian França; Nogueira, Helen Cristina; Bergamin, Letícia Januário; Oliveira, Ana Beatriz
Work-related musculoskeletal disorders (WRMD) are the result of the combination of different risk factors. They are very common among computer workers, mainly when neck and upper limbs are considered. Forty-two office workers from a public university participated in this study. They were divided into two groups: Symptomatic Subjects (SS, n=20) and Asymptomatic Subjects (AS, n=22), according to the Nordic Musculoskeletal Questionnaire (NMQ). Psychosocial indicators were assessed using the Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES). Workplaces were evaluated according to the Ergonomic Workplace Analysis (EWA), proposed by the Finnish Institute of Occupational Health. The NMQ showed higher weekly prevalence of complaints on neck, shoulders and wrist/hands (p=0.00) among SS. The annual prevalence of symptoms on wrist/hands was also higher among SS (p=0.02). The JCQ did not show any difference between groups (p>0.05). Higher proportion of servers with 'high level' of engagement, dedication and absorption, according to UWES, was identified among SS (p<0.01). EWA showed worse scores for 'Work Site', 'Job Content' and 'Repetitiveness of the Work' among SS (p<0.05). Servers are exposed to physical and psychosocial risk factors that can contribute to the development of WRMD. Work conditions need to be change in order to improve musculoskeletal health. PMID:22317087
Al-Hassan, Suha M.; Obeidat, Osama M.; Lansford, Jennifer E.
The present study evaluates a major education reform in Jordan--the implementation of public kindergartens--and provides an example of how evaluation can be incorporated into education reform. In the context of education reform in Jordan, 532 public kindergartens have been created over the last five years. A stratified random sample of…
The National Health Survey undertaken in 1935 and 1936 was the largest morbidity survey until that time. It was also the first national survey to focus on chronic disease and disability. The decision to conduct a survey of this magnitude was part of the larger strategy to reform health care in the United States. The focus on morbidity allowed reformers to argue that the health status of Americans was poor, despite falling mortality rates that suggested the opposite. The focus on chronic disease morbidity proved to be an especially effective way of demonstrating the poor health of the population and the strong links between poverty and illness. The survey, undertaken by a small group of reform-minded epidemiologists led by Edgar Sydenstricker, was made possible by the close interaction during the Depression of agencies and actors in the public health and social welfare sectors, a collaboration which produced new ways of thinking about disease burdens. PMID:21233434
This report reviews the six most recent major acquisition reform reports, starting in 1949 with the Hoover Commissions and including McNamara's Total Package Procurement, Fitzhugh Commission, the Commission on Government ...
Parochial and private schools in the United States have maintained opportunities for students to attend same-gender settings without interference from policies governing public education. The gender composition and curriculum of public schools, however, have been influenced by societal regulations and expectations that have often utilized…
Gottlob, Brian J.
As a large body of high-quality research has emerged in the past few years showing that school choice benefits the students who use it, much of the debate has shifted to the "public" or "social" effects of school choice. This study examines how school choice in Missouri would raise high school graduation rates, and measures the public benefits…
Gottlob, Brian J.
Research has documented a crisis in Texas high school graduation rates. Only 67 percent of Texas students graduate from high school, and some large urban districts have graduation rates of 50 percent or lower. This study documents the public costs of high school dropouts in Texas and examines how school choice could provide large public benefits…
Anselmi, Laura; Lagarde, Mylene; Hanson, Kara
This review aims to identify, assess and analyse the evidence on equity in the distribution of public health sector expenditure in low- and middle-income countries. Four bibliographic databases and five websites were searched to identify quantitative studies examining equity in the distribution of public health funding in individual countries or groups of countries. Two different types of studies were identified: benefit incidence analysis (BIA) and resource allocation comparison (RAC) studies. Quality appraisal and data synthesis were tailored to each study type to reflect differences in the methods used and in the information provided. We identified 39 studies focusing on African, Asian and Latin American countries. Of these, 31 were BIA studies that described the distribution, typically across socio-economic status, of individual monetary benefit derived from service utilization. The remaining eight were RAC studies that compared the actual expenditure across geographic areas to an ideal need-based distribution. Overall, the quality of the evidence from both types of study was relatively weak. Looking across studies, the evidence confirms that resource allocation formulae can enhance equity in resource allocation across geographic areas and that the poor benefits proportionally more from primary health care than from hospital expenditure. The lack of information on the distribution of benefit from utilization in RAC studies and on the countries' approaches to resource allocation in BIA studies prevents further policy analysis. Additional research that relates the type of resource allocation mechanism to service provision and to the benefit distribution is required for a better understanding of equity-enhancing resource allocation policies. PMID:24837639
Objectives The aim of this study was to evaluate musculoskeletal and psychosocial perception and compare these conditions regarding the type of job (white or blue-collar) and the type of management model (private or public). Methods Forty-seven public white-collar (PuWC), 84 private white-collar (PrWC) and 83 blue-collar workers (PrBC) were evaluated. Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial factors. Nordic Musculoskeletal Questionnaire (NMQ) was used to assess musculoskeletal symptoms. Pressure Pain Threshold (PPT) was measured to evaluate sensory responses. Results According to JCQ, all groups were classified as active profile. There was a significant association between work engagement and workers’ categories (p?0.05). PrWC workers had the highest scores for all the UWES domains, while PrBC had the lowest ones. PPT showed that PrBC workers had an increased sensitivity for left deltoid (p?0.01), and for both epicondyles (p?0.01), when compared to the other groups. PrWC workers had an increased sensitivity for both epicondyles than PuWC (right p?0.01; left, p?=?0.05). There was no significant association in the report of symptoms across the groups (p?>?0.05). Conclusion This study showed differences in psychosocial risk factors and musculoskeletal symptoms in workers engaged in different types of jobs and work organization. Personal and work-related characteristics, psychosocial factors and PPT responses were different across workers’ group. Despite all, there was no significant difference in reported symptoms across the groups, possibly indicating that the physical load is similar among the sectors. PMID:25854836
Phoenix, D. D.; Lybrook, S. M.; Trottier, R. W.; Hodgin, F. C.; Crandall, L. A.
The Human Genome Project holds much promise for providing dramatic improvements in our understanding of and means to diagnose and treat many diseases. As this enormously important endeavor proceeds, research on ethical, legal, and social implications of this new science is being conducted to forecast problems and recommend policy option solutions to avoid what might otherwise become adverse consequences. Sickle cell screening is an example of a technology that was introduced in a manner that raised poignant issues. On the basis of sickle cell issues, we examined policy issues likely to occur as new genetic technologies are incorporated into medical practice. Discussion and development of a national consensus on the appropriate content and just delivery of public sector genetic services is vital; otherwise, the impact of Human Genome Project-derived technology may result in misadventures that amplify problems currently evident in newborn screening programs. New DNA-based diagnostic technologies and therapies will soon enter the stream of commerce. The recommendations offered here, while based on examination of sickle cell disease policies, are intended to address both current inequities as well as potential future issues related to stigmatization and distributive justice. PMID:8907815
Janes, C R; Chuluundorj, O; Hilliard, C E; Rak, K; Janchiv, K
Driven in part by a resurgent interest in social inequality and health, and in part by increasing scrutiny of the social and health consequences of neoliberal economic reform, principles of health equity and social justice, the centerpieces of the Health for All strategy drafted at Alma Ata in 1978, are once again at center stage in global public health debates. Whether and how equity in access to health care can be maintained in a context of market-based health sector reform has not been systematically addressed, particularly from the perspective of local communities. This paper will explore how health reform affects health care in post-socialist Mongolia. Through a mixed-methods household-based study of low-to-middle income communities in urban and rural Mongolia we find that despite explicit and concerted efforts to reduce inequities, the reform system is unable to provide equitable health care either vertically or horizontally. Emphasis on privatization of the secondary and tertiary sectors of the system, coupled with deployment of universally-accessible, but from a clinical standpoint, limited, version of essential primary care, produces a fragmented system. Particularly for the vulnerable poor, access to services beyond the primary care system is compromised by financial, opportunity, and informational cost barriers. This research suggests that new models of health reform are needed that will effectively bridge the growing gaps between public and private resources, primary and secondary and/or tertiary care, and clinical and public health services. PMID:19153892
Bowers, C. A.
This book posits that public schools and universities currently reinforce a culture of denial regarding global environmental trends, and that education, from the primary grades to universities, must be totally revamped to support new, ecologically sustainable paths for society. In Chapter 1, it is argued that few public school teachers and…
The power sector is actively exploring and pursuing the myriad opportunities that exist under the concessions and independent power plant laws recently enacted by the Brazilian legislature. While Brazil has not yet finalized the necessary implementing regulations, it has taken positive steps to reform its infrastructure, develop proactive fiscal policies and address the problem of inflation. The author goes on to discuss issues unique to the situation of Brazil as they relate to the ability of foreign companies to break into the business sector, in particular the power generation field. Many rules are in the process of change, but there still remains uncertainties which cloud the question as to the economic viability of investments in the power generation field.
Harrison, M I; Calltorp, J
Sweden was an important pioneer of market-oriented reform in publicly funded health-care systems. Yet by the mid-1990s the county councils, which fund and manage most health-care, had substantially scaled back reforms based on provider competition while continuing to constrain health budgets. As policy makers faced new issues, they turned increasingly to longer-term and more cooperative contracts to define relations between hospitals and the county councils. Growing regionalization of government and hospital mergers further reconfigured acute care and limited opportunities for competition between hospitals. We seek to explain this reorientation of market-oriented reforms between 1989 and 1996 in terms of shifts in the positions taken by powerful policy actors, and in particular by county council politicians. During this period, elections moved liberal and conservative politicians, who were the most enthusiastic supporters of market-oriented reform, in and out of control of most county governments. Meanwhile many Social Democratic politicians gradually turned from initial support of competitive reform toward opposition. Politicians and county administrators from all parties were particularly concerned about controlling health expenditures during a period of recession. In addition, the public, politicians in the counties and municipalities, and health professionals resisted steps that threatened health sector employment and would have allowed market mechanisms, rather than governments, to determine the prices and distribution of health services. During the years under study Sweden's market-oriented reforms followed a course of development similar to that taken by other management and policy fashions (Abrahamson E. Management fashion, Academy of Management Review 1996;21: 254-85). At first the reforms enjoyed uncritical support by a broad spectrum of stakeholders. Gradually participants in the reform process recognized inherent tensions among the goals of the reform, conflicts between reform programs and fundamental social and political values, unrealistic assumptions about the effects of competition, technical and organizational obstacles to implementation, and threats to interest groups. Since 1998, there have been indications that Sweden may be entering yet another stage of experimentation with market-oriented reform. PMID:10827309
Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. PMID:10916919
Maruthappu, Mahiben; Da Zhou, Charlie; Williams, Callum; Zeltner, Thomas; Atun, Rifat
Background The global economic downturn has been associated with increased unemployment and reduced public–sector expenditure on health care (PSEH). We determined the association between unemployment, PSEH and HIV mortality. Methods Data were obtained from the World Bank and the World Health Organisation (1981–2009). Multivariate regression analysis was implemented, controlling for country–specific demographics and infrastructure. Time–lag analyses and robustness–checks were performed. Findings Data were available for 74 countries (unemployment analysis) and 75 countries (PSEH analysis), equating to 2.19 billion and 2.22 billion people, respectively, as of 2009. A 1% increase in unemployment was associated with a significant increase in HIV mortality (men: 0.1861, 95% CI: 0.0977 to 0.2744, P?=?0.0000, women: 0.0383, 95% CI: 0.0108 to 0.0657, P?=?0.0064). A 1% increase in PSEH was associated with a significant decrease in HIV mortality (men: –0.5015, 95% CI: –0.7432 to –0.2598, P?=?0.0001; women: –0.1562, 95% CI: –0.2404 to –0.0720, P?=?0.0003). Time–lag analysis showed that significant changes in HIV mortality continued for up to 5 years following variations in both unemployment and PSEH. Interpretation Unemployment increases were associated with significant HIV mortality increases. PSEH increases were associated with reduced HIV mortality. The facilitation of access–to–care for the unemployed and policy interventions which aim to protect PSEH could contribute to improved HIV outcomes. PMID:25734005
Higgins, Angela; O'Halloran, Peter; Porter, Sam
Purpose The success of measures to reduce long-term sickness absence (LTSA) in public sector organisations is contingent on organisational context. This realist evaluation investigates how interventions interact with context to influence successful management of LTSA. Methods Multi-method case study in three Health and Social Care Trusts in Northern Ireland comprising realist literature review, semi-structured interviews (61 participants), Process-Mapping and feedback meetings (59 participants), observation of training, analysis of documents. Results Important activities included early intervention; workplace-based occupational rehabilitation; robust sickness absence policies with clear trigger points for action. Used appropriately, in a context of good interpersonal and interdepartmental communication and shared goals, these are able to increase the motivation of staff to return to work. Line managers are encouraged to take a proactive approach when senior managers provide support and accountability. Hindering factors: delayed intervention; inconsistent implementation of policy and procedure; lack of resources; organisational complexity; stakeholders misunderstanding each other's goals and motives. Conclusions Different mechanisms have the potential to encourage common motivations for earlier return from LTSA, such as employees feeling that they have the support of their line manager to return to work and having the confidence to do so. Line managers' proactively engage when they have confidence in the support of seniors and in their own ability to address LTSA. Fostering these motivations calls for a thoughtful, diagnostic process, taking into account the contextual factors (and whether they can be modified) and considering how a given intervention can be used to trigger the appropriate mechanisms. PMID:25385199
Spurrier, Francis R. (Whitehall, PA); DeZubay, Egon A. (Mt. Lebanon, PA); Murray, Alexander P. (Murrysville, PA); Vidt, Edward J. (Churchill, PA)
Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot comubstion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.
Spurrier, Francis R. (Inventor); DeZubay, Egon A. (Inventor); Murray, Alexander P. (Inventor); Vidt, Edward J. (Inventor)
Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot comubstion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.
Nelson, A. [Nuclear Energy Inst., Washington, DC (United States)
This presentation reviews current regulatory process and proposes a modified approach for use in continuing to verify reasonable assurance of the protection of public health and safety in case of a radiological emergency. Topics include the following: emergency preparedness - regulatory roles; federal agency coordination; NRC/FEMA process comparison; new approaches to regulation; NRC`s current focus; technical basis supporting regulatory reform; justification for regulatory reform; recommendation for FEMA regulatory reform.
Bulkley, Katrina E.; Burch, Patricia
Recent years have seen a shifting landscape around private engagement in K-12 public education, one that involves a reorientation of education policy and practice around the principles of the marketplace. In this article, we examine the roles of both not-for-profit and for-profit agencies, as distinct from government agencies, in this movement.…
...34-63423; File No. 4-620] Acceptance of Public Submissions on a...analysis of individual derivative contracts and to calculate net exposures...legal definition of derivative contracts.'' In connection with this...analysis of individual derivative contracts and to calculate net...
Sheikhzadeh, Yaghoub; Roudsari, Abdul V.; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed
Background: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. Methods: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Results: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). Conclusion: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level. PMID:24688915
Jennings, Edward T., Jr., Ed.; Zank, Neal S., Ed.
The 16 chapters in this book are intended to stimulate thinking about approaches to dealing with the substance of public assistance policy as it bears on coordination issues, organizational arrangements for policy development and delivery, and processes for building linkages between disparate but related programs. Part I, an introduction, contains…
Marsh, Julie A.; Strunk, Katharine O.; Bush, Susan
Purpose: Despite the popularity of school "turnaround" and "portfolio district" management as solutions to low performance, there has been limited research on these strategies. The purpose of this paper is to address this gap by exploring the strategic case of Los Angeles Unified School District's Public School Choice…
Anwar, Iqbal; Kalim, Nahid; Koblinsky, Marge
This study explored the quality of obstetric care in public-sector facilities and the constraints to programming comprehensive essential obstetric care (EOC) services in rural areas of Khulna and Sylhet divisions, relatively high- and low-performing areas of Bangladesh respectively. Quality was explored by physically inspecting all public-sector EOC facilities and the constraints through in-depth interviews with public-sector programme managers and service providers. Distribution of the functional EOC facilities satisfied the United Nation's minimum criteria of at least one comprehensive EOC and four basic EOC facilities for every 500,000 people in Khulna but not in Sylhet region. Human-resource constraints were the major barrier for maternal health. Sanctioned posts for nurses were inadequate in rural areas of both the divisions; however, deployment and retention of trained human resources were more problematic in rural areas of Sylhet. Other problems also plagued care, including unavailability of blood in rural settings and lack of use of evidence-based techniques. The overall quality of care was better in the EOC facilities of Khulna division than in Sylhet. 'Context' of care was also different in these two areas: the population in Sylhet is less literate, more conservative, and faces more geographical and sociocultural barriers in accessing services. As a consequence of both care delivered and the context, more normal vaginal and caesarian-section deliveries were carried out in the public-sector EOC facilities in the Khulna region, with the exception of the medical college hospitals. To improve maternal healthcare, there is a need for a human-resource plan that increases the number of posts in rural areas and ensures availability. All categories of maternal healthcare providers also need training on evidence-based techniques. While the centralized push system of management has its strengths, special strategies for improving the response in the low-performing areas is urgently warranted. PMID:19489412
van de Vijver, Steven; Oti, Samuel; Tervaert, Thijs Cohen; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela B.; Brewster, Lizzy; Agyemang, Charles; Lange, Joep
Introduction Cardiovascular disease (CVD) is a leading cause of death in sub-Saharan Africa (SSA), with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD) and African Population and Health Research Center (APHRC), collaborated with private-sector Boston Consulting Group (BCG) to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year). The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO), and leading non-governmental organizations (NGOs). Conclusion Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by relevant policymakers and NGOs. PMID:24149078
Since 2001 the government of Cambodia has striven to advance policy-led education reform based on a sector-wide approach. This paper critically reviews the status and progress of Cambodia's education reform from the perspective of the aid's effectiveness. The paper looks at the performance of the sector reform in the three priority areas…
Agrawal, Shantanu; Chen, Christopher; Tanio, Craig P
We propose the establishment of a public-private approach which creates and maintains a "delivery systems innovations knowledge management system" to define, describe, and assess novel delivery approaches. The public sector could provide the foundational technology, resources and convening power for this innovations database. The private sector would contribute practical innovations that could guide annual strategic planning and implementation. A crowd-sourced effort would jump start delivery system reform. We believe that providing a comprehensive knowledge resource will not stifle competition or private sector opportunities but rather augment and speed the application of effective innovation. PMID:26179583
Quantum computers potentially offer a faster way to calculate chemical properties, but the exact implications of this speed-up have only become clear over the last year. The first quantum computers are likely to enable calculations that cannot be performed classically, which might reform quantum chemistry -- but we should not expect a revolution.
Tyler, Ralph W.
Because past educational reform movements were stimulated by events not directly related to schools, the movements' leaders have lacked dependable information about schools' actual effectiveness. This article faults past commissions for their omissions and impractical solutions. Real school improvement happens when school staff and parents…
To many education reformers, the passage of the federal government's massive stimulus plan, the American Recovery and Reinvestment Act (ARRA), appeared to be a final bright star falling into alignment. The ARRA seemed to complete the constellation: an astounding $100 billion of new federal funds--nearly twice the annual budget of the U.S.…
Abbott, Ann L
The Patient Protection and Affordable Care Act (PPACA) put new requirements on not-for-profit (NFP) hospitals to document provision of community benefits, to justify their tax-exempt status. Specific PPACA provisions include requirements that NFP hospitals conduct or participate in a community health needs assessment and work to address the needs identified. Consideration is given to these particular PPACA mandates and to Internal Revenue Service (IRS) actions to implement them. The background of concerns that have been expressed about whether the NFP hospitals' tax exemption should be continued and a brief history of that exemption is noted. Not-for-profit hospitals have resources that the federal government is requiring them to bring to public health improvement, during a time when the public health agencies at the federal and state level continue to experience reductions in funding. Linking of the NFP hospitals' compliance activities with the public health agency community health planning activities will help fulfill its PPACA requirements and the regulatory reporting requirements for the IRS. PMID:21964364
Background The primary care sector represents the linchpin of many health systems. However, the translation of evidence-based practices into patient care can be difficult, particularly during healthcare reform. This can have significant implications for patients, their communities, and the public purse. This is aptly demonstrated in the area of sexual health. The aim of this paper is to determine what works to facilitate evidence-based sexual healthcare within the primary care sector. Methods 431 clinicians (214 general practitioners and 217 practice nurses) in New South Wales, Australia, were surveyed about their awareness, their use, the perceived impact, and the factors that hindered the use of six resources to promote sexual healthcare. Descriptive statistics were calculated from the responses to the closed survey items, while responses to open-ended item were thematically analyzed. Results All six resources were reported to improve the delivery of evidence-based sexual healthcare. Two resources – both double-sided A4-placards – had the greatest reach and use. Barriers that hindered resource-use included limited time, limited perceived need, and limited access to, or familiarity with the resources. Furthermore, the reorganization of the primary care sector and the removal of particular medical benefits scheme items may have hampered clinician capacity to translate evidence-based practices into patient care. Conclusions Findings reveal: (1) the translation of evidence-based practices into patient care is viable despite reform; (2) the potential value of a multi-modal approach; (3) the dissemination of relatively inexpensive resources might influence clinical practices; and (4) reforms to governance and/or funding arrangements may widen the void between evidence-based practices and patient care. PMID:24274773
Coggshall, Jane G.; Ott, Amber
As a new decade dawns, teachers stand at the center of a policy vortex. They serve as the primary focus of one of the Obama administration's four pillars of educational reform--effective teachers and leaders. Educational reformers of all stripes have focused tremendous energy on thinking of ways to identify effective teachers and in turn recruit,…
Bulgarian Communist Party, Sofia.
This document is an English language abstract (approximately 1,500 words) of the reform provisions of the Bulgarian education system as formulated by the Bulgarian Communist Party in 1969. These reforms include the following items: access to compulsory secondary education for all; enrollment of all six-year olds; teachers to be specialized from…
In answer to sweeping reform of public schools in Oregon, the state's colleges and universities are adopting proficiency-based admissions, designed to measure how much applicants know instead of how many courses they took in high school. Observers praise the higher education community's cooperative response to school reform efforts. (MSE)
The latest movement to reform German spelling is discussed, focusing on the need for greater consistency in spelling of words from other languages and the major changes proposed. Issues addressed include capitalization, specific idiosyncracies in German spelling, concerns related to computerization, public opinion, and the scope of the reform.…
Brickman, William W.
This study is one of a series of Office of Education publications on educational developments in other countries. It describes and analyzes in social, economic, and historical context the educational changes mandated in Spain by the Education Reform Law of 1970, one of contemporary Europe's most far-reaching plans for educational reform and…
Wendel, Frederick C., Ed.
This publication contains four chapters that examine the reform of administrator preparation programs. In "The Reform Paradigm: Exploring the Fuzzy Logic of Educational Administration," William Ammentorp and Thomas Morgan develop a model based on linguistic algorithms to understand qualitative policy formation and decision making. In "Student…
Background In Uganda, long-lasting insecticidal nets (LLIN) have been predominantly delivered through two public sector channels: targeted campaigns or routine antenatal care (ANC) services. Their combination in a mixed-model strategy is being advocated to quickly increase LLIN coverage and maintain it over time, but there is little evidence on the efficiency of each system. This study evaluated the two delivery channels regarding LLIN retention and use, and estimated the associated costs, to contribute towards the evidence-base on LLIN delivery channels in Uganda. Methods Household surveys were conducted 5-7 months after LLIN distribution, combining questionnaires with visual verification of LLIN presence. Focus groups and interviews were conducted to further investigate determinants of LLIN retention and use. Campaign distribution was evaluated in Jinja and Adjumani while ANC distribution was evaluated only in the latter district. Costs were calculated from the provider perspective through retrospective analysis of expenditure data, and effects were estimated as cost per LLIN delivered and cost per treated-net-year (TNY). These effects were calculated for the total number of LLINs delivered and for those retained and used. Results After 5-7 months, over 90% of LLINs were still owned by recipients, and between 74% (Jinja) and 99% (ANC Adjumani) were being used. Costing results showed that delivery was cheapest for the campaign in Jinja and highest for the ANC channel, with economic delivery cost per net retained and used of USD 1.10 and USD 2.31, respectively. Financial delivery costs for the two channels were similar in the same location, USD 1.04 for campaign or USD 1.07 for ANC delivery in Adjumani, but differed between locations (USD 0.67 for campaign delivery in Jinja). Economic cost for ANC distribution were considerably higher (USD 2.27) compared to campaign costs (USD 1.23) in Adjumani. Conclusions Targeted campaigns and routine ANC services can both achieve high LLIN retention and use among the target population. The comparatively higher economic cost of delivery through ANC facilities was at least partially due to the relatively short time this system had been in existence. Further studies comparing the cost of well-established ANC delivery with LLIN campaigns and other delivery channels are thus encouraged. PMID:20406448
This book is based on a study of a 4-year reform effort in the Newark (New Jersey) public schools. The discussion focuses on an elementary school as it attempted reform in an effort that was ultimately unsuccessful. Part I opens the discussion of the effects of social class and race on educational reform. To see why inner city schools have not…
Library of Congress, Washington, DC. Congressional Research Service.
This document compiles materials and bibliographic references to assist national high school debaters in researching the 1989-1990 topic, "How Can the Federal Government Reform Prisons and Jails in the United States?" Materials are organized into a section of general materials and around each of three official debate propositions within the topic:…
The global dimension of the Internet requires new approaches to formulating policy infrastructures. Commerce must invest in the development of policy infrastructures and governments must support these new approaches; an effective balance between commercial needs and social requirements is necessary in order to achieve universal access. The…
Wisell, Kristin; Winblad, Ulrika; Sporrong, Sofia Kälvemark
In 2009, a reregulation of the Swedish pharmacy sector took place, and a fundamental change in ownership and structure followed. The reregulation provides an opportunity to reveal the politicians' views on pharmacies. The aim of this study was to explore and analyze the political arguments for the reregulation of the Swedish pharmacy sector in 2009. The method used was a qualitative content analysis of written political documents regarding the reregulation. The primary rationales for the reregulation were better availability, efficiency, price pressure, and safe usage of medicines. During the preparatory work, the rationales of diversity on the market and entrepreneurship were added, while the original rationales of efficiency, price pressure, and better usage of medicines were abandoned. The reform can be seen as a typical New Public Management reform influenced by the notion that private actors are better equipped to perform public activities. The results point to that the reform was done almost solely in order to introduce private ownership in the pharmacy sector, and was not initiated in order to solve any general problems, or to enhance patient outcomes of medicine use. PMID:25841749
...Government Reform for Competitiveness and Innovation...economic growth and competitiveness such as education, innovation...public health, and education, I have proposed...support American competitiveness and...
Donmoyer, Robert, Ed.; Merryfield, Merry M., Ed.
This theme issue highlights the diversity of reform initiatives in order to provide a deep understanding of the complexities associated with educational reform in general and the reform of science education in particular. Systemic reform initiatives at the national and state levels along with locally-inspired efforts at reform are outlined.…
In 2001, the New Zealand government commenced a program to reform the organization of publicly funded primary care services. While there have been several positive results of this reform, including the reduction of patient co-payments and the extension of the range of primary care services, the government's program was a hastily implemented attempt to place primary care, the delivery of which is dominated by private doctors, under firm state control. It was also an attempt to override preexisting arrangements. As such, the government succeeded in its goal of establishing new primary health organizations (PHOs), but there were also significant unintended consequences. As detailed in this article, these consequences include (1) the creation of a labyrinthine funding and organizational system with a variable capacity to deliver on the government's reform objectives, (2) an increase in the power and scope of preexisting doctor organizations combined with a government unable to wrest control over the setting of patient co-payment levels, and (3) an emerging lack of clarity about future directions for the primary health care sector. PMID:18252858
Zhong, Li-Jin; Mol, Arthur P J
In the late 1990s China started to expand its market economic reform to the public sector, such as water services. This reform led to major changes in urban water management, including water tariff management. The reforms in water tariff management relate not only to tariffs, but also to the decision-making on tariffs. Water tariff decision-making seems to move away from China's conventional mode of highly centralized and bureaucratic policy- and decision-making. The legalization, institutionalization and performance of public hearings in water tariff management forms a crucial innovation in this respect. This article analyzes the emergence, development and current functioning of public hearings in water tariff setting, and assesses to what extent public hearings are part of a turning point in China's tradition of centralized bureaucratic decision-making, towards more transparent, decentralized and participative governance. PMID:17573184
Brown, Paul; Panattoni, Laura; Cameron, Linda; Knox, Stephanie; Ashton, Toni; Tenbensel, Tim; Windsor, John
This study uses a discrete choice experiment (DCE) to measure patients' preferences for public and private hospital care in New Zealand. A labeled DCE was administered to 583 members of the general public, with the choice between a public and private hospital for a non-urgent surgery. The results suggest that cost of surgery, waiting times for surgery, option to select a surgeon, convenience, and conditions of the hospital ward are important considerations for patients. The most important determinant of hospital choice was whether it was a public or private hospital, with respondents far more likely to choose a public hospital than a private hospital. The results have implications for government policy toward using private hospitals to clear waiting lists in public hospitals, with these results suggesting the public might not be indifferent to policies that treat private hospitals as substitutes for public hospitals. PMID:26232651
Background In June of 2003 the Commonwealth of Pennsylvania passed S. 259 which repealed the state's 35-year old motorcycle helmet safety law. Motorcycle helmets are now only required for riders who are under the age of 21 and for those who are 21 years or older who have had a motorcycle operator's license for less than two years, or who have not completed an approved motorcycle safety course. Discussion Prior to the repeal, and in the years that have followed, there has been intense debate and controversy regarding Pennsylvania's decision to repeal the law that required universal and mandatory use of motorcycle helmets for all riders. Proponents of the helmet repeal have argued in favor of individual rights and freedom, whereas advocates for mandatory helmet laws have voiced concerns over public health and safety based on available data. Summary This commentary will discuss the policy-making process that led to Pennsylvania's repeal of the motorcycle helmet safety law from an ethical, political, and economic perspective. PMID:20409343
Littleton, Fiona Kisby
Despite an 'epidemic' of delayed childbirth in England and Wales beyond a woman's optimally fertile years, research shows that young adults are unaware of or misunderstand the risks regarding starting or extending families that such behaviour entails. Currently, sex education syllabi in British schools neglect these issues, rendering school leavers ignorant of them.These curricula cannot be improved until more is known about adolescents' knowledge of relevant topics. In the light of this, this article describes exploratory research on how teenage girls in one English school think about the reproductive lifespan. Going beyond recent 'scientific' investigations which have mostly only tested the extent of ignorance of young adults, this qualitative enquiry used theories of the life course and emerging adulthood to analyse data gathered in interviews. It sought to understand not only what girls know, but how they apply their knowledge in relation to their assumptions about aging, motherhood, pregnancy, parenting and employment. One finding is highlighted here: that whilst "correct" knowledge about the reproductive lifespan does appear to be held by teenage girls, the ability to apply that knowledge and connect the socio-cultural with the biological domain, may not always be in place. This is relevant for curriculum developers aiming to prepare future citizens to take full control of their reproductive health, and policy makers responsible for ensuring an appropriate public health message about these concerns is available after formal schooling ends. PMID:25105323
Marchildon, Gregory P
This paper analyses recent health reform agenda in Canada. From 1988 until 1997, the first phase of reforms focused on service integration through regionalisation and a rebalancing of services from illness care to prevention and wellness. The second phase, which has been layered onto the ongoing first phase, is concerned with fiscal sustainability from a provincial perspective, and the fundamental nature of the system from a national perspective. Despite numerous commissions and studies, some questions remain concerning the future direction of the public system. The Canadian reform experience is compared with recent Australian health reform initiatives in terms of service integration through regionalisation, primary care reform, Aboriginal health, the public-private debate, intergovernmental relations and the role of the federal government. PMID:15683362
Coffey, Elizabeth; Lashway, Larry
This article discusses some of the various school-reform strategies that have been implemented since the publication of A Nation at Risk. It opens with an examination of standards-based accountability and some of the concerns and objections surrounding this movement. It asks whether standards are achieving their purpose, looks at the role of state…
Reforming Engineering Education Milind Sohoni CSE and CTARA, IIT Bombay February 2015 () February 8, 2015 1 / 12 #12;Broad Comment Development Ouctomes and Engineering: Strong Connection. A more suitable of Engineering Poor outcomes and disturbing trends in HDI such as drinking water, cooking energy, public
Pajak, Edward F.
Background/Context: Scholars have described American culture in recent decades as narcissistic, manifested by displays of self-absorption tantamount to a pathological syndrome that has reached epidemic proportions. An education reform movement that is highly critical of public schools, teachers, and students has simultaneously emerged, espousing a…
Thro, William E.
In 1989, the supreme courts of Montana, Kentucky, and Texas declared their respective school finance systems unconstitutional. Explores why these cases represent a major change in litigation and will prompt a third wave of school finance reform litigation. (MLF)
Young, I; Gropp, K; Pintar, K; Waddell, L; Marshall, B; Thomas, K; McEwen, S A; Raji?, A
Policy-makers working at the interface of agri-food and public health often deal with complex and cross-cutting issues that have broad health impacts and socio-economic implications. They have a responsibility to ensure that policy-making based on these issues is accountable and informed by the best available scientific evidence. We conducted a qualitative descriptive study of agri-food public health policy-makers and research and policy analysts in Ontario, Canada, to understand their perspectives on how the policy-making process is currently informed by scientific evidence and how to facilitate this process. Five focus groups of 3-7 participants and five-one-to-one interviews were held in 2012 with participants from federal and provincial government departments and industry organizations in the agri-food public health sector. We conducted a thematic analysis of the focus group and interview transcripts to identify overarching themes. Participants indicated that the following six key principles are necessary to enable and demonstrate evidence-informed policy-making (EIPM) in this sector: (i) establish and clarify the policy objectives and context; (ii) support policy-making with credible scientific evidence from different sources; (iii) integrate scientific evidence with other diverse policy inputs (e.g. economics, local applicability and stakeholder interests); (iv) ensure that scientific evidence is communicated by research and policy stakeholders in relevant and user-friendly formats; (V) create and foster interdisciplinary relationships and networks across research and policy communities; and (VI) enhance organizational capacity and individual skills for EIPM. Ongoing and planned efforts in these areas, a supportive culture, and additional education and training in both research and policy realms are important to facilitate evidence-informed policy-making in this sector. Future research should explore these findings further in other countries and contexts. PMID:24528517
Background Artemisinin-based combination therapy (ACT) is the first-line malaria treatment throughout most of the malaria-endemic world. Data on ACT availability, price and market share are needed to provide a firm evidence base from which to assess the current situation concerning quality-assured ACT supply. This paper presents supply side data from ACTwatch outlet surveys in Benin, the Democratic Republic of Congo (DRC), Madagascar, Nigeria, Uganda and Zambia. Methods Between March 2009 and June 2010, nationally representative surveys of outlets providing anti-malarials to consumers were conducted. A census of all outlets with the potential to provide anti-malarials was conducted in clusters sampled randomly. Results 28,263 outlets were censused, 51,158 anti-malarials were audited, and 9,118 providers interviewed. The proportion of public health facilities with at least one first-line quality-assured ACT in stock ranged between 43% and 85%. Among private sector outlets stocking at least one anti-malarial, non-artemisinin therapies, such as chloroquine and sulphadoxine-pyrimethamine, were widely available (> 95% of outlets) as compared to first-line quality-assured ACT (< 25%). In the public/not-for-profit sector, first-line quality-assured ACT was available for free in all countries except Benin and the DRC (US$1.29 [Inter Quartile Range (IQR): $1.29-$1.29] and $0.52[IQR: $0.00-$1.29] per adult equivalent dose respectively). In the private sector, first-line quality-assured ACT was 5-24 times more expensive than non-artemisinin therapies. The exception was Madagascar where, due to national social marketing of subsidized ACT, the price of first-line quality-assured ACT ($0.14 [IQR: $0.10, $0.57]) was significantly lower than the most popular treatment (chloroquine, $0.36 [IQR: $0.36, $0.36]). Quality-assured ACT accounted for less than 25% of total anti-malarial volumes; private-sector quality-assured ACT volumes represented less than 6% of the total market share. Most anti-malarials were distributed through the private sector, but often comprised non-artemisinin therapies, and in the DRC and Nigeria, oral artemisinin monotherapies. Provider knowledge of the first-line treatment was significantly lower in the private sector than in the public/not-for-profit sector. Conclusions These standardized, nationally representative results demonstrate the typically low availability, low market share and high prices of ACT, in the private sector where most anti-malarials are accessed, with some exceptions. The results confirm that there is substantial room to improve availability and affordability of ACT treatment in the surveyed countries. The data will also be useful for monitoring the impact of interventions such as the Affordable Medicines Facility for malaria. PMID:22039838
Butterfield, P. H.
According to a 1980 estimate, 5,678,000 black South African adults are illiterate. A large number of organizations has been created to address the problem--among them such private sector operations as the South African Committee for Higher Education, Operation TEACH (Teach Every African Child), the Bureau of Literacy and Literature, the Urban…
Bryan J. Christensen; DeeVon Bailey; Lynn Hunnicutt; Ruby A. Ward
Focus groups and street surveys are used in the US and the UK to determine consumer perceptions of the ability of different agencies, associations, and groups to certify beef products for quality, food safety, animal welfare, social responsibility, and environmental responsibility. US consumers see the role of the federal government primarily as assuring food safety but desire the private sector
Bryan J. Christensena; Ruby Wardd
Focus groups and street surveys are used in the US and the UK to determine consumer perceptions of the ability of different agencies, associations, and groups to certify beef products for quality, food safety, animal welfare, social responsibility, and environmental responsibility. US consumers see the role of the federal government primarily as assuring food safety but desire the private sector
Kabir, Ariful Haq
Since the 1990s, enormous changes have been made in the higher education sector in Bangladesh. The government promulgated the Private University Act in 1992, and formulated a 20-year Strategic Plan for Higher Education: 2006-2026 (SPHE). A critical review shows that the objective of the plan is to connect education with market-driven economic…
Anderson, Malcolm; Holcombe, Liz
This article stresses the importance of within-government capacity build as the optimal approach to minimizing landslide risk to the most vulnerable communities in the developing world. Landslide risk is an integrated issue that demands strong managerial leadership and multidisciplinary inclusion to develop structures that deliver sustainable improvements in the reduction of risk. The tension between projects demanding international technical and financial intervention and those capable of “within-country” solutions are examined. More particularly, the challenges of developing a management methodology capable of energizing inter-ministry collaboration to achieve community-level action is examined in the context of a recently established program of slope stability management in St. Lucia. The program, Management of Slope Stability in Communities (MoSSaiC), is shown to have successfully fostered not only extensive technical collaboration within government but also to have energized local communities in the shared mission of capacity build through their direct involvement in the management process.
Baum, Donald Rey
Public-private partnerships are being increasingly supported and advocated for, ideologically and financially, as an approach to educational reform in many countries across the world. Proponents suggest that non-state involvement in the education sector has the potential to bolster international Education for All efforts, improve school…
The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as "free choice models" in which "the money follows the patient." The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented. PMID:19069288
Education International, Brussels (Belgium).
On the eve of the year 2000, global public spending on education tops one trillion dollars. Against the backdrop of globalization, public education is currently being subjected to attacks by proponents of privatization and deregulation. The process is already underway, as is apparent from an important agreement reached by the World Trade…
Gounko, Tatiana; Smale, William
In this paper, the authors analyze the existing higher education policies in the Russian Federation and discuss the implications of current reforms for the future of the higher education sector and those involved in it. The authors' analytical framework was based on the work of Olssen, Codd, and O'Neill (2004), outlining the major tenets of the…
Marx, Ronald W.
Background: Educational reform responds to local and national pressures to improve educational outcomes, and reform efforts cycle as similar pressures recur. Currently, reform efforts focus on teachers, even though confidence in a host of American social institutions is dropping. One of the most widespread reforms regarding teachers is the…
Dunn, Abe; Shapiro, Adam Hale
This study examines the impact of major health insurance reform on payments made in the health care sector. We study the prices of services paid to physicians in the privately insured market during the Massachusetts health care reform. The reform increased the number of insured individuals as well as introduced an online marketplace where insurers compete. We estimate that, over the reform period, physician payments increased at least 11 percentage points relative to control areas. Payment increases began around the time legislation passed the House and Senate-the period in which their was a high probability of the bill eventually becoming law. This result is consistent with fixed-duration payment contracts being negotiated in anticipation of future demand and competition. PMID:25497755
Brito Quintana, P E
According to those in charge of health sector reform, human resources are the key component of health sector reform processes and offer health services their greatest competitive advantage. With the help of the Observatory for Human Resources within Health Sector Reform promoted by the Pan American Health Organization and other groups, countries of the Region of the Americas have now begun to gather, in a methodical fashion, tangible evidence of the decisive importance of human resources within health sector reform initiatives and particularly of the impact of these initiatives on health personnel. This mutual influence is the main theme of this article, which explores the most disturbing aspects of health sector reform from a human resources perspective, including job instability and conflicting interests of employers and employees. PMID:11026774
This book results from two seminars regarding the subject title that were held at Rutgers the State University, New Brunswick, NJ on October 30, 1981 and March 26, 1982. The seminars received financial support from leading New Jersey utilities. The introductory chapter (by the editor) and the other nine chapters are all written within the context of the pressures facing regulated utilities and their regulators. A separate abstract was prepared for each chapter.