Third Sector Involvement in Public Education: The Israeli Case

ERIC Educational Resources Information Center

Berkovich, Izhak; Foldes, Vincent Jonathan

2012-01-01

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…

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

DTIC Science & Technology

2002-01-01

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

The third sector, user involvement and public service reform: a case study in the co-governance of health service provision.

PubMed

Martin, Graham P

2011-01-01

The ‘modernization’ of British public services seeks to broaden public sector governance networks, bringing the views of third sector organizations, the public and service users (among others) to the design, management and delivery of welfare. Building on previous analyses of the contradictions generated by these roles, this paper draws on longitudinal qualitative research to enunciate the challenges faced by one third-sector organization in facilitating service user influence in a UK National Health Service (NHS) pilot programme, alongside other roles in tension with this advocacy function. The analysis highlights limits in the extent to which lateral governance networks pluralize stakeholder involvement. The ‘framing’ of governance may mean that traditional concerns outweigh the views of new stakeholders such as the third sector and service users. Rather than prioritizing wider stakeholders' views in the design and delivery of public services, placing third sector organizations at the centre of governance networks may do more to co-opt these organizations in reproducing predominant priorities.

Managing the Public Sector Research and Development Portfolio Selection Process: A Case Study of Quantitative Selection and Optimization

DTIC Science & Technology

2016-09-01

PUBLIC SECTOR RESEARCH & DEVELOPMENT PORTFOLIO SELECTION PROCESS: A CASE STUDY OF QUANTITATIVE SELECTION AND OPTIMIZATION by Jason A. Schwartz...PUBLIC SECTOR RESEARCH & DEVELOPMENT PORTFOLIO SELECTION PROCESS: A CASE STUDY OF QUANTITATIVE SELECTION AND OPTIMIZATION 5. FUNDING NUMBERS 6...describing how public sector organizations can implement a research and development (R&D) portfolio optimization strategy to maximize the cost

The politics of public sector change.

PubMed

Harvey, Peter

2003-05-01

As the changes underpinning the Coordinated Care Trials in South Australia have become more apparent, similarities have emerged between the rationalisation of public schooling in the mid 1980s and the transformation of public health in the 1990s. This article aims to discuss the evolution of health services in South Australia and help us answer the question of how best to manage our public and private health infrastructure in a changing economic and social context. Both strategies in education and health share common elements of cost cutting, attempts at improving efficiencies, a flirting with the private sector and the attendant risk of reduced quality of services to the public. This situation in both sectors is indicative of a shift in public policy and a growth in the belief that private management of public sector infrastructure can help resolve the funding crises around our education and health systems.

Recent Changes in Public-Sector Governance.

ERIC Educational Resources Information Center

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…

Behavioral economics perspectives on public sector pension plans.

PubMed

Beshears, John; Choi, James J; Laibson, David; Madrian, Brigitte C

2011-04-01

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.

Behavioral economics perspectives on public sector pension plans

PubMed Central

BESHEARS, JOHN; CHOI, JAMES J.; LAIBSON, DAVID; MADRIAN, BRIGITTE C.

2011-01-01

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

Defining the Impact of Public Administration Programmes for Public Sector Organizations

ERIC Educational Resources Information Center

Broucker, Bruno

2015-01-01

In times of financial and economic crises, public organizations seem to cut their budgets for training and education, especially when the impact of a programme is questioned. Therefore, PA programmes need to clarify what impact can be expected and what individual and organizational processes are influencing the impact of a PA programme on the…

Motivating the Private vs. Public Sector Managers.

ERIC Educational Resources Information Center

Khojasteh, Mak

1993-01-01

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

[Organization and technology in the catering sector].

PubMed

Tinarelli, Arnaldo

2014-01-01

The catering industry is a service characterized by a contract between customer and supplier. In institutional catering industry, the customer is represented by public administration; in private catering industry, the customer is represented by privates. The annual catering trades size is about 6.74 billions of euros, equally distributed between health sector (hospitals, nursing homes), school sector and business sector (ivorkplace food service), with the participation of nearly 1.200 firms and 70.000 workers. Major services include off-premises catering (food prepared away from the location where it's served) and on-premises catering (meals prepared and served at the same place). Several tools and machineries are used during both warehousing and food refrigerating operations, and during preparation, cooking, packaging and transport of meals. In this sector, injuries, rarely resulting serious or deadly, show a downward trend in the last years. On the contrary, the number of occupational diseases shows an upward trend. About the near future, the firms should become global outsourcer, able to provide other services as cleaning, transport and maintenance. In addition, they should invest in innovation: from tools and machineries technology to work organization; from factory lay-out to safely and health in the workplaces.

The US Public Sector and Its Adoption of Service Oriented Technology

ERIC Educational Resources Information Center

Coleman, David W.

2012-01-01

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…

Labor in the Public and Nonprofit Sectors.

ERIC Educational Resources Information Center

Hamermesh, Daniel S., Ed.

Originally presented at a Conference on Labor in Nonprofit Industry and Government held at Princeton University, the studies are the first to provide an economic discussion of the public sector labor market. Melvin Reder examines the effect of the absence of the profit motive on employment and wage determination in the public sector. Orley…

Dues and Deep Pockets: Public-Sector Unions' Money Machine. Civic Report. No. 67

ERIC Educational Resources Information Center

DiSalvo, Daniel

2012-01-01

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…

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

PubMed

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

2013-04-01

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

Public Sector Employee Assistance Programs.

ERIC Educational Resources Information Center

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…

Awaking the Public Sector with Strategic Corporate Philanthropy: Revitalizing the Public Servant's Organizational Knowledge, Innovative Capability, and Commitment

ERIC Educational Resources Information Center

Jackson, Janese Marie

2011-01-01

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…

24 CFR 1006.335 - Use of nonprofit organizations and public-private partnerships.

Code of Federal Regulations, 2010 CFR

2010-04-01

... efforts to maximize participation by the private sector, including nonprofit organizations and for-profit... public-private partnerships. 1006.335 Section 1006.335 Housing and Urban Development Regulations Relating... Requirements § 1006.335 Use of nonprofit organizations and public-private partnerships. (a) Nonprofit...

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

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-01-01

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

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

DOT National Transportation Integrated Search

2010-10-01

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

Public Sector Employment Inequality in the United States and the Great Recession.

PubMed

Laird, Jennifer

2017-02-01

Historically in the United States, the public sector has served as an equalizing institution through the expansion of job opportunities for minority workers. This study examines whether the public sector continues to serve as an equalizing institution in the aftermath of the Great Recession. Using data from the Current Population Survey, I investigate changes in public sector employment between 2003 and 2013. My results point to a post-recession double disadvantage for black public sector workers: they are concentrated in a shrinking sector of the economy, and they are more likely than white and Hispanic public sector workers to experience job loss. These two trends are a historical break for the public sector labor market. I find that race and ethnicity gaps in public sector employment cannot be explained by differences in education, occupation, or any of the other measurable factors that are typically associated with employment. Among unemployed workers who most recently worked for the public sector, black women are the least likely to transition into private sector employment.

The for-profit sector in humanitarian response: integrating ethical considerations in public policy decision making.

PubMed

Huckel Schneider, Carmen; Negin, Joel

2016-01-01

The engagement of the for-profit private sector in health, social and humanitarian services has become a topic of keen interest. It is particularly contentious in those instances where for-profit organizations have become recipients of public funds, and where they become key decision-makers in terms of how, and to whom, services are provided. We put forward a framework for identifying and organizing the ethical questions to be considered when contracting government services to the for-profit sector, specifically in those areas that have traditionally remained in the public or not-for-profit spheres. The framework is designed to inform both academic debate and practical decision-making regarding the acceptability, feasibility and legitimacy of for-profit organizations carrying out humanitarian work. First, we outline the importance of posing ethical questions in government contracting for-profit vs. not-for-profit organizations. We then outline five key areas to be considered before then examining the extent to which ethics concerns are warranted and how they may be safeguarded.

A Guide to Discipline in the Public Sector.

ERIC Educational Resources Information Center

Seidman, Joel

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…

Environmental performance policy indicators for the public sector: the case of the defence sector.

PubMed

Ramos, Tomás B; Alves, Inês; Subtil, Rui; Joanaz de Melo, João

2007-03-01

The development of environmental performance policy indicators for public services, and in particular for the defence sector, is an emerging issue. Despite a number of recent initiatives there has been little work done in this area, since the other sectors usually focused on are agriculture, transport, industry, tourism and energy. This type of tool can be an important component for environmental performance evaluation at policy level, when integrated in the general performance assessment system of public missions and activities. The main objective of this research was to develop environmental performance policy indicators for the public sector, specifically applied to the defence sector. Previous research included an assessment of the environmental profile, through the evaluation of how environmental management practices have been adopted in this sector and an assessment of environmental aspects and impacts. This paper builds upon that previous research, developing an indicator framework--SEPI--supported by the selection and construction of environmental performance indicators. Another aim is to discuss how the current environmental indicator framework can be integrated into overall performance management. The Portuguese defence sector is presented and the usefulness of this methodology demonstrated. Feasibility and relevancy criteria are applied to evaluate the set of indicators proposed, allowing indicators to be scored and indicators for the policy level to be obtained.

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

PubMed

Pillay, Rubin

2008-02-08

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

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

PubMed Central

Pillay, Rubin

2008-01-01

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

A fair day's wage? Perceptions of public sector pay.

PubMed

Furnham, Adrian; Stieger, Stefan; Haubner, Tanja; Voracek, Martin; Swami, Viren

2009-12-01

There is a scarcity of evidence pertaining to the general public's perception of public sector pay. Hence, in the present study, 161 women and 149 men were asked to estimate the wages 35 public sector professions should receive annually in the fictitious nation of Maldoria, based on a comparison value of an annual income of T10,000 for general practitioners. Analysis showed that only pilots were given a higher annual income than general practitioners; miners and local government workers were also provided with relatively high annual incomes. By contrast, newscasters were provided with the lowest annual income. Participants' sex did not affect these evaluations, and other demographic variables and public sector-related information of the participants were poor predictors of their evaluations. The implications of this research on public attitudes toward wage determination are discussed, and avenues for further research highlighted.

Privatizing responsibility: public sector reform under neoliberal government.

PubMed

Ilcan, Suzan

2009-08-01

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

Public sector energy management: A strategy for catalyzing energy efficiency in Malaysia

NASA Astrophysics Data System (ADS)

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

Public sector reform and demand for human resources for health (HRH).

PubMed

Lethbridge, Jane

2004-11-23

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.

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

PubMed

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

2013-02-01

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

Factors associated with the recruitment and retention of dentists in the public sector.

PubMed

Hopcraft, Matthew Scott; Milford, Elizabeth; Yapp, Kehn; Lim, Yujin; Tan, Vanessa; Goh, Leo; Low, Cheng Cheng; Phan, Tung

2010-01-01

There is an increasing demand for public dental services in Australia, with many community dental clinics unable to meet this demand because of an inadequate number of dentists in the workforce. The aim of this study was to identify factors contributing to the recruitment and retention of dentists in the public sector. A postal questionnaire survey of 180 dentists (response rate 75.6 percent) working in the Victorian public sector was undertaken to investigate the characteristics of public sector dentists, job satisfaction, remuneration, perceptions of public dentistry, future career intentions, and issues that relate to recruitment and retention of staff. Victorian public dentists' main reason for entering the public sector was to work in a community-based setting in a supportive and mentored environment. The main factors related to dentists leaving the public sector were poor remuneration, lack of clinical experience, and frustration with administrative policies. Victoria's oral health workforce shortages in the public sector are mainly attributed to retention issues. The potential for mentoring and a desire for helping those in need were factors attracting dentists to work in the public sector. There was a disproportionate number of female dentists in the public sector compared with the general population, and female dentists had a lower mean salary than male dentists regardless of experience. A range of factors were associated with retention, and gradual frustration because of poor remuneration and lack of professional autonomy were significant reasons for the decision to leave the public sector.

Public-Sector Information Security: A Call to Action for Public-Sector CIOs

DTIC Science & Technology

2002-10-01

scenarios. However, in a larger sense, it is a story for all public-sector CIOs, a story both prophetic and sobering. Deep in this story, however, there...information technology (IT), our way of life, and the values that lay deep in the core of our American culture. These values include rights to...defines roles and accountabilities. The Scope of the Problem Today there are 109.5 million Internet hosts on the World Wide Web . Five years ago there

Public sector hospitals and organizational change: an agenda for policy analysis.

PubMed

Collins, C; Green, A

1999-01-01

An important feature of health care systems in recent years is the change in the organizational position and relations of public sector hospitals. Health sector reforms have led to increasing heterogeneity in the organizational location and status of public sector hospitals and new organizational forms of public-private relations are being developed by and for hospitals. These changes can have important implications for health and health care. They raise issues around equity, control, accountability and performance of health care. Yet the policy process in practice may be failing to develop and implement appropriate forms of policy formulation on health sector reform. This paper focuses on the organizational position and relations of hospitals within public sector health services. It firstly outlines key elements of health sector reform and relates these to two dimensions of organizational change for hospitals: increasing heterogeneity and forms of public-private relations. The paper provides a descriptive format for classifying forms of hospital organizational change and proposes a framework of six questions for analysing these organizational forms. This may be used to assess the appropriateness of specific policies to particular country situations and to develop more open debate around hospital organizational forms.

Challenges and responsibilities for public sector scientists.

PubMed

Van Montagu, Marc

2010-11-30

Current agriculture faces the challenge of doubling food production to meet the food needs of a population expected to reach 9 billion by mid-century whilst maintaining soil and water quality and conserving biodiversity. These challenges are more overwhelming for the rural poor, who are the custodians of environmental resources and at the same time particularly vulnerable to environmental degradation. Solutions have to come from concerted actions by different segments of society in which public sector science plays a fundamental role. Public sector scientists are at the root of all the present generation of GM crop traits under cultivation and more will come with the new knowledge that is being generated by systems biology. To speed up innovation, molecular biologists must interact with scientists from the different fields as well as with stakeholders outside the academic world in order to create an environment capable of capturing value from public sector knowledge. I highlight here the measures that have to be taken urgently to guarantee that science and technology can tackle the problems of subsistence farmers. Copyright © 2010 Elsevier B.V. All rights reserved.

Public Service Motivation as a Predictor of Attraction to the Public Sector

ERIC Educational Resources Information Center

Carpenter, Jacqueline; Doverspike, Dennis; Miguel, Rosanna F.

2012-01-01

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…

28 CFR 302.1 - Public and private sector comment procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

28 CFR 302.1 - Public and private sector comment procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

28 CFR 302.1 - Public and private sector comment procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

28 CFR 302.1 - Public and private sector comment procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

28 CFR 302.1 - Public and private sector comment procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Competence Development in the Public Sector: Development, or Dismantling of Professionalism?

ERIC Educational Resources Information Center

Hjort, Katrin

2008-01-01

For more than a decade, competence development has been a key concept of modern management in both the private and the public sector, but to some extent its meaning and practice have been different in the two sectors. In the public sector in particular, competence development has been closely related to a number of other buzzwords characterizing…

How Does Retiree Health Insurance Influence Public Sector Employee Saving?

PubMed Central

Clark, Robert L.

2017-01-01

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

Intellectual assets management and transfer in food science sector in Indian research and development organizations.

PubMed

Singh, Vikram; Chakraborty, Kajal

2016-05-01

In recent years, the food science sector has gained importance since the society is focusing on high-quality and safety foods. With a specific end goal to meet this societal need, the research and development organizations in India have adopted innovative technical and research processes, which gave more accentuation on intellectual assessment in food processing industry. The global Intellectual Property regime in food science sector had witnessed an increment in the number of patents filed and granted during 2006-2010. Ever since there has been a gradual increase in the number of patents applied mainly in food processing industries by research organizations related to food sciences, for example, those working under the aegis of ICAR and CSIR in India. In this study, a review has been done on the intellectual assets generated by ICAR and other national research organizations in India, in the food science sector. Emphasis has been given on the global relevance of these assets, modes of IP protection and technology transfer mechanisms followed by different public and private organizations.

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

PubMed Central

Jinabhai, Champaklal C.; Taylor, Myra

2010-01-01

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

Activities of the NASA sponsored SRI technology applications team in transferring aerospace technology to the public sector

NASA Technical Reports Server (NTRS)

Berke, J. G.

1971-01-01

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.

Wage Gaps Between the Public and Private Sectors in Spain.

ERIC Educational Resources Information Center

Lassibille, Gerard

1998-01-01

Estimates separate earnings equations by employment sector and gender in Spain and identifies returns to human capital, based on 1990-91 household survey data. Public wages are higher, and civil servants more highly educated. However, the public sector pays lower returns to education and experience. Earnings advantage is largest for least skilled…

Technology Transfer: A Think Tank Approach to Managing Innovation in the Public Sector

DTIC Science & Technology

1985-01-01

TECHNOLOGY TRANSFER: A THINK TANK APPROACH TO MANAGING INNOVATION IN THE PUBLIC SECTOR CISIRIBUTIOtl STATEMENT A Approved for Public Release...NAVAL FACILITIES ENGINEERING COMMAND TECHNOLOGY TRANSFER: A THINK TANK APPROACH TO MANAGING INNOVATION IN THE PUBLIC SECTOR Edited by J. W. Creighton...Publication of this book, Technology Transfer: A Think Tank Approach to Managing Innovation in the Public Sector, was in part supported by funds from the U.S

How does retiree health insurance influence public sector employee saving?

PubMed

Clark, Robert L; Mitchell, Olivia S

2014-12-01

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. Copyright © 2014 Elsevier B.V. All rights reserved.

Social Media for e-Government in the Public Health Sector: Protocol for a Systematic Review.

PubMed

Franco, Massimo; Tursunbayeva, Aizhan; Pagliari, Claudia

2016-03-11

Public sector organizations worldwide are engaging with social media as part of a growing e-government agenda. These include government departments of health, public health agencies, and state-funded health care and research organizations. Although examples of social media in health have been described in the literature, little is known about their overall scope or how they are achieving the objectives of e-government. A systematic literature review is underway to capture and synthesize existing evidence on the adoption, use, and impacts of social media in the public health sector. A series of parallel scoping exercises has taken place to examine (1) relevant existing systematic reviews, to assess their focus, breadth, and fit with our review topic, (2) existing concepts related to e-government, public health, and the public health sector, to assess how semantic complexity might influence the review process, and (3) the results of pilot searches, to examine the fit of social media within the e-government and health literatures. The methods and observations of the scoping exercises are reported in this protocol, alongside the methods and interim results for the systematic review itself. The systematic review has three main objectives: To capture the corpus of published studies on the uses of social media by public health organizations; to classify the objectives for which social media have been deployed in these contexts and the methods used; and to analyze and synthesize evidence of the uptake, use, and impacts of social media on various outcomes. A set of scoping exercises were undertaken, to inform the search strategy and analytic framework. Searches have been carried out in MEDLINE, the Cochrane Library, Web of Science, and the Scopus international electronic databases, and appropriate gray literature sources. Articles published between January 1, 2004, and July 12, 2015, were included. There was no restriction by language. One reviewer (AT) has independently

Social Media for e-Government in the Public Health Sector: Protocol for a Systematic Review

PubMed Central

Franco, Massimo; Tursunbayeva, Aizhan

2016-01-01

Background Public sector organizations worldwide are engaging with social media as part of a growing e-government agenda. These include government departments of health, public health agencies, and state-funded health care and research organizations. Although examples of social media in health have been described in the literature, little is known about their overall scope or how they are achieving the objectives of e-government. A systematic literature review is underway to capture and synthesize existing evidence on the adoption, use, and impacts of social media in the public health sector. A series of parallel scoping exercises has taken place to examine (1) relevant existing systematic reviews, to assess their focus, breadth, and fit with our review topic, (2) existing concepts related to e-government, public health, and the public health sector, to assess how semantic complexity might influence the review process, and (3) the results of pilot searches, to examine the fit of social media within the e-government and health literatures. The methods and observations of the scoping exercises are reported in this protocol, alongside the methods and interim results for the systematic review itself. Objective The systematic review has three main objectives: To capture the corpus of published studies on the uses of social media by public health organizations; to classify the objectives for which social media have been deployed in these contexts and the methods used; and to analyze and synthesize evidence of the uptake, use, and impacts of social media on various outcomes. Methods A set of scoping exercises were undertaken, to inform the search strategy and analytic framework. Searches have been carried out in MEDLINE, the Cochrane Library, Web of Science, and the Scopus international electronic databases, and appropriate gray literature sources. Articles published between January 1, 2004, and July 12, 2015, were included. There was no restriction by language. One

Job satisfaction among public health professionals working in public sector: a cross sectional study from Pakistan

PubMed Central

2013-01-01

Background Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector. Methods This was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011. Results Overall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards. Conclusion Our study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change. PMID:23298253

Sector Distinctions and the Privatization of Public Education Policymaking

ERIC Educational Resources Information Center

Lubienski, Christopher

2016-01-01

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

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths.

PubMed

Lister, Cameron; Payne, Hannah; Hanson, Carl L; Barnes, Michael D; Davis, Siena F; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes.

The Public Health Innovation Model: Merging Private Sector Processes with Public Health Strengths

PubMed Central

Lister, Cameron; Payne, Hannah; Hanson, Carl L.; Barnes, Michael D.; Davis, Siena F.; Manwaring, Todd

2017-01-01

Public health enjoyed a number of successes over the twentieth century. However, public health agencies have arguably been ill equipped to sustain these successes and address the complex threats we face today, including morbidity and mortality associated with persistent chronic diseases and emerging infectious diseases, in the context of flat funding and new and changing health care legislation. Transformational leaders, who are not afraid of taking risks to develop innovative approaches to combat present-day threats, are needed within public health agencies. We propose the Public Health Innovation Model (PHIM) as a tool for public health leaders who wish to integrate innovation into public health practice. This model merges traditional public health program planning models with innovation principles adapted from the private sector, including design thinking, seeking funding from private sector entities, and more strongly emphasizing program outcomes. We also discuss principles that leaders should consider adopting when transitioning to the PHIM, including cross-collaboration, community buy-in, human-centered assessment, autonomy and creativity, rapid experimentation and prototyping, and accountability to outcomes. PMID:28824899

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

PubMed

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

2015-11-01

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

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

PubMed

Bhatia, Jagdish; Cleland, John

2004-11-01

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

National Electric Sector Cybersecurity Organization Resource (NESCOR)

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

None, None

The goal of the National Electric Sector Cybersecurity Organization Resource (NESCOR) project was to address cyber security issues for the electric sector, particularly in the near and mid-term. The following table identifies the strategies from the DOE Roadmap to Achieve Energy Delivery Systems Cybersecurity published in September 2011 that are applicable to the NESCOR project.

Changing Times: A Changing Public Sector May Require Changes to Public Management Education Programmes

ERIC Educational Resources Information Center

Oldfield, Chrissie

2017-01-01

It is becoming apparent that the environment in which Executive Masters in Public Administration programmes operate has changed dramatically in the wake of economic crisis and subsequent cuts in public spending. Changes in the funding of public sector organisations has been compounded by a broader "crisis" in the wider public sector…

International patients within the NHS: a case of public sector entrepreneurialism.

PubMed

Lunt, Neil; Exworthy, Mark; Hanefeld, Johanna; Smith, Richard D

2015-01-01

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

Public sector health financing in Pakistan: a retrospective study.

PubMed

Mohammad, Khalif Bile; Hafeez, Assad; Nishter, Sania

2007-06-01

To assess the existing situation relating to investments made by development partners in the health sector in Pakistan. This was a retrospective study completed over a period of 6 months in which financial data for the year July 2004 to June 2005 was collected. A uniform matrix was circulated to all the stakeholders in public sector and international donors who had a stake in health. Details of expenses in health over the last 5 years and plans for the next 10 years were requested. Initial draft was shared with all concerned for concurrence before finalization. Simple analysis was carried out on the collected data. About 80% of the financial resources in the public sector are provided by the Government of Pakistan with non-development and recurring expenses predominating in these allocations. The study shows that Pakistan's per capita spending on health by the public sector is Rs 375.00 (US$ 6.4) out of which Rs 80 (US$ 1.3) is being contributed by the partners. Majority of the partners contributions are used for development projects. The study concludes that an additional amount of about 250 billion rupees per year (keeping in mind the recommendations of Commission for Macroeconomics and Health) are required by the health sector. This can only be achieved by allocating at least 50% more for health every year for next 10 years in order to catch up on the lagging targets set by Millennium Development Goals for Pakistan.

Job satisfaction of primary health-care providers (public sector) in urban setting.

PubMed

Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini

2013-07-01

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. 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. 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. 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.

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

PubMed

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

2007-01-01

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

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

PubMed

Do, Mai

2009-05-01

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

The public sector nursing workforce in Kenya: a county-level analysis

PubMed Central

2014-01-01

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

The public sector nursing workforce in Kenya: a county-level analysis.

PubMed

Wakaba, Mabel; Mbindyo, Patrick; Ochieng, Jacob; Kiriinya, Rose; Todd, Jim; Waudo, Agnes; Noor, Abdisalan; Rakuom, Chris; Rogers, Martha; English, Mike

2014-01-27

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. 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. 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). 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.

An Investigation of Conflict Management in Public and Private Sector Universities

ERIC Educational Resources Information Center

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

2011-01-01

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

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

PubMed

Yang, Estin; Cook, Colin; Kahn, Delawir

2015-07-01

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

Social Mobility and Public Sector Employment.

ERIC Educational Resources Information Center

Rumberger, Russell W.

Although the government's role as provider of social services and guardian of individual rights has had little effect on the economic position of women and minorities, as an employer it has greatly improved their welfare in terms of job opportunities and earnings. U.S. census data from 1960 to 1980 show that the public sector currently employs…

Differences in the availability of medicines for chronic and acute conditions in the public and private sectors of developing countries.

PubMed

Cameron, Alexandra; Roubos, Ilse; Ewen, Margaret; Mantel-Teeuwisse, Aukje K; Leufkens, Hubertus G M; Laing, Richard O

2011-06-01

To investigate potential differences in the availability of medicines for chronic and acute conditions in low- and middle-income countries. 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. 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. 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.

Differences in the availability of medicines for chronic and acute conditions in the public and private sectors of developing countries

PubMed Central

Roubos, Ilse; Ewen, Margaret; Mantel-Teeuwisse, Aukje K; Leufkens, Hubertus GM; Laing, Richard O

2011-01-01

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

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

ERIC Educational Resources Information Center

Karl, Katherine A.; Sutton, Cynthia L.

1998-01-01

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

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

PubMed

Reichert, Janice M; Milne, Christopher-Paul

2002-01-01

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

Understanding human resource management practices in Botswana's public health sector.

PubMed

Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

2016-11-21

Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

Challenges in Preparing Veterinarians for Global Animal Health: Understanding the Public Sector.

PubMed

Hollier, Paul J; Quinn, Kaylee A; Brown, Corrie C

Understanding of global systems is essential for veterinarians seeking to work in realms outside of their national domain. In the global system, emphasis remains on the public sector, and the current curricular emphasis in developed countries is on private clinical practice for the domestic employment market. There is a resulting lack of competency at graduation for effective engagement internationally. The World Organisation for Animal Health (OIE) has created standards for public sector operations in animal health, which must be functional to allow for sustainable development. This public sector, known as the Veterinary Services, or VS, serves to control public good diseases, and once effectively built and fully operational, allows for the evolution of a functional private sector, focused on private good diseases. Until the VS is fully functional, support of private good services is non-sustainable and any efforts delivered are not long lasting. As new graduates opt for careers working in the international development sector, it is essential that they understand the OIE guidelines to help support continuing improvement. Developing global veterinarians by inserting content into the veterinary curriculum on how public systems can operate effectively could markedly increase the potential of our professional contributions globally, and particularly in the areas most in need.

How to Enhance the Impact of Training on Service Quality? Evidence from Malaysian Public Sector Context

ERIC Educational Resources Information Center

Zumrah, Abdul Rahim

2015-01-01

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…

A proposed framework of big data readiness in public sectors

NASA Astrophysics Data System (ADS)

Ali, Raja Haslinda Raja Mohd; Mohamad, Rosli; Sudin, Suhizaz

2016-08-01

Growing interest over big data mainly linked to its great potential to unveil unforeseen pattern or profiles that support organisation's key business decisions. Following private sector moves to embrace big data, the government sector has now getting into the bandwagon. Big data has been considered as one of the potential tools to enhance service delivery of the public sector within its financial resources constraints. Malaysian government, particularly, has considered big data as one of the main national agenda. Regardless of government commitment to promote big data amongst government agencies, degrees of readiness of the government agencies as well as their employees are crucial in ensuring successful deployment of big data. This paper, therefore, proposes a conceptual framework to investigate perceived readiness of big data potentials amongst Malaysian government agencies. Perceived readiness of 28 ministries and their respective employees will be assessed using both qualitative (interview) and quantitative (survey) approaches. The outcome of the study is expected to offer meaningful insight on factors affecting change readiness among public agencies on big data potentials and the expected outcome from greater/lower change readiness among the public sectors.

People Management Practices in the Public Health Sector: Developments from Victoria, Australia

ERIC Educational Resources Information Center

Stanton, Pauline; Bartram, Timothy; Harbridge, Raymond

2004-01-01

This study investigates the impact on human resource management (HRM) practices in the public health sector in Victoria, Australia of two different government policy environments. First, it explores the Liberal Coalition Government's decentralisation of public health sector management, from 1992-1999 and second, the Labor Government's…

Mack Center on Nonprofit and Public Sector Management in Human Service Organizations

ERIC Educational Resources Information Center

Austin, Michael J.

2018-01-01

This invited set of reflections upon the research carried out under the auspices of a school of social work is part of a series featuring research centers. It reflects 25 years of scholarly work related to both public and nonprofit human service organizations at the only university-based research center in the United States devoted to research on…

Job Satisfaction of Primary Health-Care Providers (Public Sector) in Urban Setting

PubMed Central

Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini

2013-01-01

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

Why do health workers in rural Tanzania prefer public sector employment?

PubMed Central

2012-01-01

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

Why do health workers in rural Tanzania prefer public sector employment?

PubMed

Songstad, Nils Gunnar; Moland, Karen Marie; Massay, Deodatus Amadeus; Blystad, Astrid

2012-04-05

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. 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. 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. 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

Community-based organizations in the health sector: A scoping review

PubMed Central

2012-01-01

Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks). Given the range of terms used to describe community

Community-based organizations in the health sector: a scoping review.

PubMed

Wilson, Michael G; Lavis, John N; Guta, Adrian

2012-11-21

Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues), we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry.We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff), the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks).Given the range of terms used to describe community

How to improve collaboration between the public health sector and other policy sectors to reduce health inequalities? - A study in sixteen municipalities in the Netherlands.

PubMed

Storm, Ilse; den Hertog, Frank; van Oers, Hans; Schuit, Albertine J

2016-06-22

The causes of health inequalities are complex. For the reduction of health inequalities, intersectoral collaboration between the public health sector and both social policy sectors (e.g. youth affairs, education) and physical policy sectors (e.g. housing, spatial planning) is essential, but in local practice difficult to realize. The aim of this study was to examine the collaboration between the sectors in question more closely and to identify opportunities for improvement. A qualitative descriptive analysis of five aspects of collaboration within sixteen Dutch municipalities was performed to examine the collaboration between the public health sector and other policy sectors: 1) involvement of the sectors in the public health policy network, 2) harmonisation of objectives, 3) use of policies by the relevant sectors, 4) formalised collaboration, and 5) previous experience. Empirical data on these collaboration aspects were collected based on document analysis, questionnaires and interviews. The study found that the policy workers of social sectors were more involved in the public health network and more frequently supported the objectives in the field of health inequality reduction. Both social policy sectors and physical policy sectors used policies and activities to reduce health inequalities. More is done to influence the determinants of health inequality through policies aimed at lifestyle and social setting than through policies aimed at socioeconomic factors and the physical environment. Where the physical policy sectors are involved in the public health network, the collaboration follows a very similar pattern as with the social policy sectors. All sectors recognise the importance of good relationships, positive experiences, a common interest in working together and coordinated mechanisms. This study shows that there is scope for improving collaboration in the field of health inequality reduction between the public health sector and both social policy sectors

The Empowering of Public Sector Officers in the Mauritian Public Sector in the Context of Reforms: How Far Has Management Education Helped?

ERIC Educational Resources Information Center

Bhiwajee, Soolakshna Lukea; Garavan, Thomas N.

2016-01-01

Purpose: The purpose of this study is to provide insights about the usefulness of management education for the public sector in the Republic of Mauritius, which embarked on reforms initiatives around two decades ago. In this context, public officers were encouraged to follow specialised management courses. However, as at date, there is…

[Availability of generic drugs in the public sector and prices in the private sector in different regions of Brazil].

PubMed

Miranda, Elaine Silva; Pinto, Cláudia Du Bocage Santos; dos Reis, André Luis de Almeida; Emmerick, Isabel Cristina Martins; Campos, Mônica Rodrigues; Luiza, Vera Lucia; Osorio-de-Castro, Claudia Garcia Serpa

2009-10-01

A study to identify availability and prices of medicines, according to type of provider, was conducted in the five regions of Brazil. A list of medicines to treat prevalent diseases was investigated, using the medicines price methodology developed by the World Health Organization and Health Action International, adapted for Brazil. In the public sector, bioequivalent (vis-à-vis reference brand) generics are less available than multisource products. For most medicines (71.4%), the availability of bioequivalent generics was less than 10%. In the private sector, the average number of different bioequivalent generic versions in the outlets was far smaller than the number of versions on the market. There was a positive correlation between the number of generics on the market, or those found at outlets, and the price variation in bioequivalent generic products, in relation to the maximum consumer price. It is estimated that price competition is occurring among bioequivalent generic drugs and between them and multisource products for the same substance, but not with reference brands.

[On the issues of private-public partnership in health care: the case of organization of optometric service)].

PubMed

2011-01-01

The article deals with the issue of private-public partnership in health care. It is demonstrated that in many countries health care system condition is characterized by increase of problems in organization, financing and provision of medical sanitary care. The exponent up growth of aggregate costs of health care, medical services financing occurs. The system of public and municipal health care has no adequate resources to efficiently function without interaction with private organizations. The reason is that most of the suppliers of medical services are not public or municipal belonging. It is necessary to provide inter-financing of curative preventive care at the expense of funds of public and private economic sectors within a framework of full-scale implementation health care the mechanisms of private-public partnership. The studies in this field are to be organized on the example of organizational specificity of optometric service which is positioned concurrently in public and private sectors. This approach makes it possible to reveal feasible ways of implementation of the private-public partnership institution to enhance quality and accessibility of medical care to population in the conditions of concurrent model of health care and globalization challenges.

Quality management and the work environment: an empirical investigation in a public sector organization.

PubMed

Taveira, Alvaro D; James, Craig A; Karsh, Ben -Tzion; Sainfort, François

2003-07-01

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.

How can psychiatrists offer psychotherapeutic leadership in the public sector?

PubMed

Cammell, Paul; Amos, Jackie; Baigent, Michael

2016-06-01

This article reviews the forms that psychotherapeutic leadership can take for psychiatrists attempting to optimise outcomes for individuals receiving treatment in the public mental health sector. It explores a range of roles and functions that psychiatrists can take on as psychotherapy leaders, and how these can be applied in clinical, administrative and research contexts. Psychiatrists need to play an increasing role in clinical, administrative and academic settings to advance service provision, resource allocation, training and research directed at psychotherapies in the public health sector. © The Royal Australian and New Zealand College of Psychiatrists 2016.

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

PubMed

Pillay, Rubin

2009-02-20

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

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

PubMed Central

Pillay, Rubin

2009-01-01

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

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

PubMed

Johnston, Lee M; Finegood, Diane T

2015-03-18

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

The role of public-sector research in the discovery of drugs and vaccines.

PubMed

Stevens, Ashley J; Jensen, Jonathan J; Wyller, Katrine; Kilgore, Patrick C; Chatterjee, Sabarni; Rohrbaugh, Mark L

2011-02-10

Historically, public-sector researchers have performed the upstream, basic research that elucidated the underlying mechanisms of disease and identified promising points of intervention, whereas corporate researchers have performed the downstream, applied research resulting in the discovery of drugs for the treatment of diseases and have carried out development activities to bring them to market. However, the boundaries between the roles of the public and private sectors have shifted substantially since the dawn of the biotechnology era, and the public sector now has a much more direct role in the applied-research phase of drug discovery. We identified new drugs and vaccines approved by the Food and Drug Administration (FDA) that were discovered by public-sector research institutions (PSRIs) and classified them according to their therapeutic category and potential therapeutic effect. We found that during the past 40 years, 153 new FDA-approved drugs, vaccines, or new indications for existing drugs were discovered through research carried out in PSRIs. These drugs included 93 small-molecule drugs, 36 biologic agents, 15 vaccines, 8 in vivo diagnostic materials, and 1 over-the-counter drug. More than half of these drugs have been used in the treatment or prevention of cancer or infectious diseases. PSRI-discovered drugs are expected to have a disproportionately large therapeutic effect. Public-sector research has had a more immediate effect on improving public health than was previously realized.

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

DTIC Science & Technology

1994-01-01

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

Deceased donor liver transplant: Experience from a public sector hospital in India.

PubMed

Pamecha, Viniyendra; Borle, Deeplaxmi Purushottam; Kumar, Senthil; Bharathy, Kishore Gurumoorthy Subramanya; Sinha, Piyush Kumar; Sasturkar, Shridhar Vasantrao; Sharma, Vibuti; Pandey, Chandra Kant; Sarin, Shiv Kumar

2018-01-01

Deceased donor liver transplant (DDLT) is an uncommon procedure in India. We present our experience of DDLT from a public sector teaching hospital. A retrospective analysis of all DDLT was performed from April 2012 till September 2016. Demographics, intraoperative, donor factors, morbidity, and outcome were analyzed. During the study period, 305 liver transplants were performed, of which 36 were DDLT (adult 32, pediatric 4; 35 grafts; 1 split). The median age was 42.5 (1-62) years; 78% were men. The median donor age was 28 (1-77) years; 72.2% were men. About 45% of organs were procured from outside of Delhi and 67% of all grafts used were marginal. Three of 38 liver grafts (7.8%) were rejected due to gross steatosis. Commonest indication was cryptogenic cirrhosis (19.4%). The median model for end-stage liver disease sodium and pediatric end-stage liver disease scores were 23.5 (9-40) and 14.5 (9-22), respectively. Median warm and cold ischemia times were 40 (23-56) and 396 (111-750) min, respectively. Major morbidity of grade III and above occurred in 63.8%. In hospital (90 days), mortality was 16.7% and there were two late deaths because of chronic rejection and biliary sepsis. The overall survival was 77.8% at median follow up of 8.6 (1-54) months. DDLT can be performed with increasing frequency and safety in a public sector hospital. The perioperative and long-term outcomes are acceptable despite the fact that most organs were extended criteria grafts.

[Managment in nursing and the administration of third sector organizations].

PubMed

Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm

2006-01-01

In this article of bibliographical revision it was aimed at verifying the evolution of the third sector and the relations between nursing management in that organizations. It is observed a growing of this sector in health area, bringing a market anplification in the work of the nurse. Thus, it is considered the need for warning the nurses to be prepared for the management in these organizations, seeking for development in hospital management. Third sector is being valued as a form of social promotion in the health, education, social assistance and others segments, congregating individuals and institutions in a participative form.

Examining the Relationship between Perceived Organizational Support, Transfer of Training and Service Quality in the Malaysian Public Sector

ERIC Educational Resources Information Center

Zumrah, Abdul Rahim

2015-01-01

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…

Health care inequities in north India: role of public sector in universalizing health care.

PubMed

Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

2012-09-01

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. Data from National Sample Survey 60 th 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. 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. 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.

Health care inequities in north India: Role of public sector in universalizing health care

PubMed Central

Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

2012-01-01

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

Weapons to widgets: Organic systems and public policy for tech transfer

NASA Technical Reports Server (NTRS)

Cargo, Russell A.

1994-01-01

Large cuts in defense spending cause serious repercussions throughout the American economy. One means to counter the negative effects of defense reductions is to redirect federal dollars to temporarily prop up defense industries and, over the longer-term, stimulate growth of new nondefense industries. The creation of non-defense products and industries by channeling ideas from public laboratories into the private sector manufacturing facilities, known as technology transfer, is being undertaken in a massive program that has high visibility, large amounts of money, and broad federal agency involvement. How effectively federal money can be directed toward stimulating the creation of non-defense products will define the strength of the economy, (i.e., tax base, employment level, trade balance, capital investments, etc.), over the next decade. Key functions of the tech transfer process are technology and market assessment, capital formation, manufacturing feasibility, sales and distribution, and business organization creation. Those, however, are not functions typically associated with the federal government. Is the government prepared to provide leadership in those areas? This paper suggests organic systems theory as a means to structure the public sector's actions to provide leadership in functional areas normally outside their scope of expertise. By applying new ideas in organization theory, can we design government action to efficiently and effectively transfer technologies?

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

PubMed

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

2018-06-01

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

Managed Behavioral Health Care: An Instrument to Characterize Critical Elements of Public Sector Programs

PubMed Central

Ridgely, M Susan; Giard, Julienne; Shern, David; Mulkern, Virginia; Burnam, M Audrey

2002-01-01

Objective To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and “unmanaged” care and among managed care arrangements. Study Design The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. Data Collection Methods Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. Principal Findings This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. Conclusions If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary. PMID:12236386

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

PubMed

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

2013-09-27

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

Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study.

PubMed

van de Vijver, Steven; Oti, Samuel; Tervaert, Thijs Cohen; Hankins, Catherine; Kyobutungi, Catherine; Gomez, Gabriela B; Brewster, Lizzy; Agyemang, Charles; Lange, Joep

2013-10-21

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. To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. 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. 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). 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.

Performance Contracting as a Performance Management Tool in the Public Sector in Kenya: Lessons of learning

ERIC Educational Resources Information Center

Hope, Kempe Ronald, Sr.

2013-01-01

The purpose of this article is to provide an assessment and analysis of public sector performance contracting as a performance management tool in Kenya. It aims to demonstrate that performance contracting remains a viable and important tool for improving public sector performance as a key element of the on-going public sector transformation…

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda

PubMed Central

2013-01-01

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

An assessment of opportunities and challenges for public sector involvement in the maternal health voucher program in Uganda.

PubMed

Okal, Jerry; Kanya, Lucy; Obare, Francis; Njuki, Rebecca; Abuya, Timothy; Bange, Teresah; Warren, Charlotte; Askew, Ian; Bellows, Ben

2013-10-18

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. 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. 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

Applying total quality management concepts to public health organizations.

PubMed Central

Kaluzny, A D; McLaughlin, C P; Simpson, K

1992-01-01

Total quality management (TQM) is a participative, systematic approach to planning and implementing a continuous organizational improvement process. Its approach is focused on satisfying customers' expectations, identifying problems, building commitment, and promoting open decision-making among workers. TQM applies analytical tools, such as flow and statistical charts and check sheets, to gather data about activities within an organization. TQM uses process techniques, such as nominal groups, brainstorming, and consensus forming to facilitate communication and decision making. TQM applications in the public sector and particularly in public health agencies have been limited. The process of integrating TQM into public health agencies complements and enhances the Model Standards Program and assessment methodologies, such as the Assessment Protocol for Excellence in Public Health (APEX-PH), which are mechanisms for establishing strategic directions for public health. The authors examine the potential for using TQM as a method to achieve and exceed standards quickly and efficiently. They discuss the relationship of performance standards and assessment methodologies with TQM and provide guidelines for achieving the full potential of TQM in public health organizations. The guidelines include redefining the role of management, defining a common corporate culture, refining the role of citizen oversight functions, and setting realistic estimates of the time needed to complete a task or project. PMID:1594734

Veteran status, disability rating, and public sector employment.

PubMed

Winters, John V

2018-06-01

This paper used microdata from the 2013-2015 American Community Survey to examine differences in federal government, state and local government, private sector, and self-employment among employed veterans and nonveterans. The U.S. federal and state governments have hiring preferences to benefit veterans, especially disabled veterans. Other factors may also push veterans toward public sector employment. I found that veteran status substantially increased the likelihood of federal employment, with the largest magnitudes for severely disabled veterans. Differences in state and local government employment were modest and exhibited heterogeneity by disability severity. Copyright © 2018 John Wiley & Sons, Ltd.

Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment.

PubMed

Honda, Ayako; Ryan, Mandy; van Niekerk, Robert; McIntyre, Diane

2015-06-01

The introduction of national health insurance (NHI), aimed at achieving universal coverage, is the most important issue currently on the South African health policy agenda. Improvement in public sector health-care provision is crucial for the successful implementation of NHI as, regardless of whether health-care services become more affordable and available, if the quality of the services provided is not acceptable, people will not use the services. Although there has been criticism of the quality of public sector health services, limited research is available to identify what communities regard as the greatest problems with the services. A discrete choice experiment (DCE) was undertaken to elicit public preferences on key dimensions of quality of care when selecting public health facilities in South Africa. Qualitative methods were applied to establish attributes and levels for the DCE. To elicit preferences, interviews with community members were held in two South African provinces: 491 in Western Cape and 499 in Eastern Cape. The availability of necessary medicine at health facilities has the greatest impact on the probability of attending public health facilities. Other clinical quality attributes (i.e. provision of expert advice and provision of a thorough examination) are more valued than non-clinical quality of care attributes (i.e. staff attitude, treatment by doctors or nurses, and waiting time). Treatment by a doctor was less valued than all other attributes. Communities are prepared to tolerate public sector health service characteristics such as a long waiting time, poor staff attitudes and lack of direct access to doctors if they receive the medicine they need, a thorough examination and a clear explanation of the diagnosis and prescribed treatment from health professionals. These findings prioritize issues that the South African government must address in order to meet their commitment to improve public sector health-care service provision. Published

The Applicability of Market-Based Solutions to Public Sector Problems.

ERIC Educational Resources Information Center

Kelley, Carolyn

This paper examines the ways in which private- and public-sector location affects organizational structure and functions, and the implications for school reform. It identifies the differences that are often overlooked when policymakers utilize market-based organizational reform models to address public school problems. Two fundamental questions…

Private sector accountable care organization development: a qualitative study.

PubMed

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

2017-03-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

Investigating the effectiveness of response strategies for vulnerabilities to corruption in the chinese public construction sector.

PubMed

Shan, Ming; Chan, Albert P C; Le, Yun; Hu, Yi

2015-06-01

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.

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

PubMed

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

2011-10-01

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

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

PubMed Central

Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-01-01

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

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

PubMed Central

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

2015-01-01

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

Institutional delivery in India, 2004-14: unravelling the equity-enhancing contributions of the public sector.

PubMed

Joe, William; Perkins, Jessica M; Kumar, Saroj; Rajpal, Sunil; Subramanian, S V

2018-06-01

To achieve faster and equitable improvements in maternal and child health outcomes, the government of India launched the National Rural Health Mission in 2005. This paper describes the equity-enhancing role of the public sector in increasing use of institutional delivery care services in India between 2004 and 2014. Information on 24 661 births from nationally representative survey data for 2004 and 2014 is analysed. Concentration index is computed to describe socioeconomic-rank-related relative inequalities in institutional delivery and decomposition is used to assess the contributions of public and private sectors in overall socioeconomic inequality. Multilevel logistic regression is applied to examine the changes in socioeconomic gradient between 2004 and 2014. The analysis finds that utilization of institutional delivery care in India increased from 43% in 2004 to 83% in 2014. The bulk of the increase was in public sector use (21% in 2004 to 53% in 2014) with a modest increase in private sector use (22% in 2004 to 30% in 2014). The shift from a pro-rich to pro-poor distribution of public sector use is confirmed. Decomposition analysis indicates that 51% of these reductions in socioeconomic inequality are associated with improved pro-poor distribution of public sector births. Multilevel logistic regressions confirm the disappearance of a wealth-based gradient in public sector births between 2004 and 2014. We conclude that public health investments in India have significantly contributed towards an equitable increase in the coverage of institutional delivery care. Sustained policy efforts are necessary, however, with an emphasis on education, sociocultural and geographical factors to ensure universal coverage of institutional delivery care services in India.

Strengthening the evidence and action on multi-sectoral partnerships in public health: an action research initiative

PubMed Central

Willis, C. D.; Greene, J. K.; Abramowicz, A.; Riley, B. L.

2016-01-01

Abstract Introduction: The Public Health Agency of Canada’s Multi-sectoral Partnerships Initiative, administered by the Centre for Chronic Disease Prevention (CCDP), brings together diverse partners to design, implement and advance innovative approaches for improving population health. This article describes the development and initial priorities of an action research project (a learning and improvement strategy) that aims to facilitate continuous improvement of the CCDP’s partnership initiative and contribute to the evidence on multi-sectoral partnerships. Methods: The learning and improvement strategy for the CCDP’s multi-sectoral partnership initiative was informed by (1) consultations with CCDP staff and senior management, and (2) a review of conceptual frameworks to do with multi-sectoral partnerships. Consultations explored the development of the multi-sectoral initiative, barriers and facilitators to success, and markers of effectiveness. Published and grey literature was reviewed using a systematic search strategy with findings synthesized using a narrative approach. Results: Consultations and the review highlighted the importance of understanding partnership impacts, developing a shared vision, implementing a shared measurement system and creating opportunities for knowledge exchange. With that in mind, we propose a six-component learning and improvement strategy that involves (1) prioritizing learning needs, (2) mapping needs to evidence, (3) using relevant data-collection methods, (4) analyzing and synthesizing data, (5) feeding data back to CCDP staff and teams and (6) taking action. Initial learning needs include investigating partnership reach and the unanticipated effects of multi-sectoral partnerships for individuals, groups, organizations or communities. Conclusion: While the CCDP is the primary audience for the learning and improvement strategy, it may prove useful for a range of audiences, including other government departments and external

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

PubMed

Ashmore, John

2013-01-03

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

Public sector scale-up of zinc and ORS improves coverage in selected districts in Bihar, India.

PubMed

Walker, Christa L Fischer; Taneja, Sunita; Lamberti, Laura M; Black, Robert E; Mazumder, Sarmila

2015-12-01

In Bihar, India, a new initiative to enhance diarrhea treatment with zinc and ORS in the public sector was rolled out in selected districts. We conducted an external evaluation to measure changes in diarrhea careseeking and treatment in intervention districts. We conducted baseline and endline household surveys among caregivers of children 2-59 months of age. We calculated summary statistics for household characteristics, knowledge, careseeking and treatments given to children with a diarrhea episode in the last 14 days and built logistic regression models to compare baseline and endline values. Caregivers named a public health center as an appropriate source of care for childhood diarrhea more often at endline (71.3%) compared to baseline (38.4%) but did not report increased careseeking to public sector providers for the current diarrhea episode. In logistic regression analyses, the odds of receiving zinc, with or without oral rehydration salts (ORS), increased at endline by more than 2.7 as compared to baseline. Children who were taken to the public sector for care were more likely to receive zinc (odds ratio, OR = 3.93) and zinc in addition to ORS (OR = 6.10) compared to children who were not taken to the public sector. Coverage of zinc and ORS can improve with public sector programs targeted at training and increasing product availability, but demand creation may be needed to increase public sector careseeking in areas where the private sector has historically provided much of the care.

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

PubMed

Dell, A; Kahn, D; Klopper, J

2017-09-01

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

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

PubMed

Agha, Sohail; Do, Mai

2009-04-01

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

Prevention and rehabilitation in Swedish public sector workplaces: Effects on co-workers' and leaders' health and psychosocial working conditions.

PubMed

Vinberg, Stig; Romild, Ulla; Landstad, Bodil J

2015-01-01

Leaders and co-workers in Swedish public sector organizations are exposed to demanding psychosocial working conditions; more knowledge about workplace-based interventions in this sector of working life is needed. To compare co-workers' and leaders' self-ratings of health and psychosocial working conditions, and investigate how prevention and rehabilitation in Swedish public sector workplaces affects these ratings. The longitudinal panel data consisted of 311 individuals (20 leaders, 291 co-workers) at 19 workplaces. Based on questionnaire data, statistical analyses were performed using Mann-Whitney U-Test, pair-wise Spearman correlations, a mixed between-within subjects ANOVA and Friedman's test. Results indicate differences in how the leaders and the co-workers judge their health and psychosocial working conditions. Leaders report work content that is more varied and interesting as well as more possibilities for personal development through work, yet they also report more tiredness, concern over managing their work situation and time pressure at work. Comparisons of mean values for used indicators show some improvements after one year, but also several non-significant or negative time trends two years after the interventions were initiated. The study provides some support for experienced differences between co-workers' and leaders' health and psychosocial working conditions in public sector workplaces, indicating the importance of different workplace-oriented prevention and rehabilitation interventions for these two categories of employees.

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

PubMed

Tuominen, Risto; Eriksson, Anna-Leena

2011-10-01

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

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

ERIC Educational Resources Information Center

Otieno, Wycliffe; Levy, Daniel

2007-01-01

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

Teaching Chinese Students: Understanding Their Public Sector Paradigm

ERIC Educational Resources Information Center

Conrad, Cynthia; Coleman, Charles

2011-01-01

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…

End of an era? Managerial losses of African American and Latinos in the public sector.

PubMed

Wilson, George; Roscigno, Vincent

2015-11-01

In this article, we examine whether "new governance" reforms in public sector work over the last two decades have generated managerial wage losses for African Americans and Latinos. Findings from Integrated Public Use Micro-Series data across three time points indicate that the new "business logic" encompassing, most notably, increased employer discretion has progressively disadvantaged African American and Latino men and women relative to their White and gender counterparts. Indeed, for both African Americans and Latinos in the managerial ranks, relative parity in wages that were witnessed in the public sector progressively eroded between 2000 and 2010. Qualifications to these findings indicate that levels of inequality become pronounced for African Americans, and more so among men than women. We discuss the historical niche status of public sector work for racial and ethnic minorities in the U.S. and the importance of conducting further analyses of the public sector because of its fluid nature as a locus of racial stratification. Copyright © 2015 Elsevier Inc. All rights reserved.

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

PubMed

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

2008-06-01

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

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

PubMed

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

2017-06-01

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

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

PubMed

Liu, Hsi-Chen; Cheng, Yawen

2018-04-01

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

Local File Disclosure Vulnerability: A Case Study of Public-Sector Web Applications

NASA Astrophysics Data System (ADS)

Ahmed, M. Imran; Maruf Hassan, Md; Bhuyian, Touhid

2018-01-01

Almost all public-sector organisations in Bangladesh now offer online services through web applications, along with the existing channels, in their endeavour to realise the dream of a ‘Digital Bangladesh’. Nations across the world have joined the online environment thanks to training and awareness initiatives by their government. File sharing and downloading activities using web applications have now become very common, not only ensuring the easy distribution of different types of files and documents but also enormously reducing the time and effort of users. Although the online services that are being used frequently have made users’ life easier, it has increased the risk of exploitation of local file disclosure (LFD) vulnerability in the web applications of different public-sector organisations due to unsecure design and careless coding. This paper analyses the root cause of LFD vulnerability, its exploitation techniques, and its impact on 129 public-sector websites in Bangladesh by examining the use of manual black box testing approach.

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

PubMed

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

2015-02-23

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

76 FR 57723 - Electricity Sector Cybersecurity Risk Management Process Guideline

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... DEPARTMENT OF ENERGY Electricity Sector Cybersecurity Risk Management Process Guideline AGENCY... public comment on DOE's intent to publish the Electricity Sector Cybersecurity Risk Management Process... electricity sector organizations and adds to the body of resources that help refine the definition and...

Health sector reform and public sector health worker motivation: a conceptual framework.

PubMed

Franco, Lynne Miller; Bennett, Sara; Kanfer, Ruth

2002-04-01

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

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

ERIC Educational Resources Information Center

Tsigilis, Nikolaos; Zachopoulou, Evridiki; Grammatikopoulos, Vasilios

2006-01-01

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

Corporate governance of public health services: lessons from New Zealand for the state sector.

PubMed

Perkins, R; Barnett, P; Powell, M

2000-01-01

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.

Occupational Structures and Profiles in Italy in the Field of Environmental Protection in the Public Service Sector with Reference to Air Pollution Control. CEDEFOP Panorama. National Report.

ERIC Educational Resources Information Center

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…

Public health workforce employment in US public and private sectors.

PubMed

Kennedy, Virginia C

2009-01-01

The purpose of this study was to describe the number and distribution of 26 administrative, professional, and technical public health occupations across the array of US governmental and nongovernmental industries. This study used data from the Occupational Employment Statistics program of the US Bureau of Labor Statistics. For each occupation of interest, the investigator determined the number of persons employed in 2006 in five industries and industry groups: government, nonprofit agencies, education, healthcare, and all other industries. Industry-specific employment profiles varied from one occupation to another. However, about three-fourths of all those engaged in these occupations worked in the private healthcare industry. Relatively few worked in nonprofit or educational settings, and less than 10 percent were employed in government agencies. The industry-specific distribution of public health personnel, particularly the proportion employed in the public sector, merits close monitoring. This study also highlights the need for a better understanding of the work performed by public health occupations in nongovernmental work settings. Finally, the Occupational Employment Statistics program has the potential to serve as an ongoing, national data collection system for public health workforce information. If this potential was realized, future workforce enumerations would not require primary data collection but rather could be accomplished using secondary data.

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

PubMed Central

2013-01-01

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

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

PubMed

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

2017-11-01

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

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

PubMed

Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

2016-09-01

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. © The Author 2016. Published by Oxford

Adaptation to climate change in the Ontario public health sector

PubMed Central

2012-01-01

Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

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

PubMed

Bíró, Anikó; Hellowell, Mark

2016-07-01

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

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

ERIC Educational Resources Information Center

Network Planning Paper, 1983

1983-01-01

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

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

PubMed

Almeida, Celia

2017-10-02

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

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

PubMed

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

2018-01-01

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

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

PubMed Central

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

2018-01-01

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

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

DTIC Science & Technology

2003-03-01

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

Buprenorphine Maintenance for Opioid Dependence in Public Sector Healthcare: Benefits and Barriers

PubMed Central

Duncan, Laura G.; Mendoza, Sonia; Hansen, Helena

2015-01-01

Background Since its U.S. FDA approval in 2002, buprenorphine has been available for maintenance treatment of opiate dependence in primary care physicians’ offices. Though buprenorphine was intended to facilitate access to treatment, disparities in utilization have emerged; while buprenorphine treatment is widely used in private care setting, public healthcare integration of buprenorphine lags behind. Results Through a review of the literature, we found that U.S. disparities are partly due to a shortage of certified prescribers, concern of patient diversion, as well as economic and institutional barriers. Disparity of buprenorphine treatment dissemination is concerning since buprenorphine treatment has specific characteristics that are especially suited for low-income patient population in public sector healthcare such as flexible dosing schedules, ease of concurrently treating co-morbidities such as HIV and hepatitis C, positive patient attitudes towards treatment, and the potential of reducing addiction treatment stigma. Conclusion As the gap between buprenorphine treatment in public sector settings and private sector settings persists in the U.S., current research suggests ways to facilitate its dissemination. PMID:27088135

Buprenorphine Maintenance for Opioid Dependence in Public Sector Healthcare: Benefits and Barriers.

PubMed

Duncan, Laura G; Mendoza, Sonia; Hansen, Helena

Since its U.S. FDA approval in 2002, buprenorphine has been available for maintenance treatment of opiate dependence in primary care physicians' offices. Though buprenorphine was intended to facilitate access to treatment, disparities in utilization have emerged; while buprenorphine treatment is widely used in private care setting, public healthcare integration of buprenorphine lags behind. Through a review of the literature, we found that U.S. disparities are partly due to a shortage of certified prescribers, concern of patient diversion, as well as economic and institutional barriers. Disparity of buprenorphine treatment dissemination is concerning since buprenorphine treatment has specific characteristics that are especially suited for low-income patient population in public sector healthcare such as flexible dosing schedules, ease of concurrently treating co-morbidities such as HIV and hepatitis C, positive patient attitudes towards treatment, and the potential of reducing addiction treatment stigma. As the gap between buprenorphine treatment in public sector settings and private sector settings persists in the U.S., current research suggests ways to facilitate its dissemination.

Public sector employment, relative deprivation and happiness in adult urban Chinese employees.

PubMed

Hu, Anning

2013-09-01

The decline in perceived happiness within economic prosperity in Chinese society calls for further examination. In this research, we investigate the effect of employment in public sector work units on perceived happiness through the mediation of economic and social status relative deprivations. In the reform era of China, work unit is still an important mechanism maintaining social inequality, and those working in government/Communist Party agencies and public institutions have advantages of getting access to high wage, comprehensive welfare and the manipulation of administrative public power. Such economic and social status advantages are expected to reduce their relative deprivation and further promote their perceived happiness. Using a nationwide survey data conducted in 2006, we find working in public sector can significantly reduce the odds of experiencing economic relative deprivation, which is further contributive to the improvement of subjective wellbeing.

Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

PubMed

Fajans, Peter; Simmons, Ruth; Ghiron, Laura

2006-03-01

Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability.

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

PubMed

Long, S H; Marquis, M S

1999-01-01

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

Relationships between Organizations and Publics: Development of a Multi-Dimensional Organization-Public Relationship Scale.

ERIC Educational Resources Information Center

Bruning, Stephen D.; Ledingham, John A.

1999-01-01

Attempts to design a multiple-item, multiple-dimension organization/public relationship scale. Finds that organizations and key publics have three types of relationships: professional, personal, and community. Provides an instrument that can be used to measure the influence that perceptions of the organization/public relationship have on consumer…

A Value Measure for Public-Sector Enterprise Risk Management: A TSA Case Study.

PubMed

Fletcher, Kenneth C; Abbas, Ali E

2018-05-01

This article presents a public value measure that can be used to aid executives in the public sector to better assess policy decisions and maximize value to the American people. Using Transportation Security Administration (TSA) programs as an example, we first identify the basic components of public value. We then propose a public value account to quantify the outcomes of various risk scenarios, and we determine the certain equivalent of several important TSA programs. We illustrate how this proposed measure can quantify the effects of two main challenges that government organizations face when conducting enterprise risk management: (1) short-term versus long-term incentives and (2) avoiding potential negative consequences even if they occur with low probability. Finally, we illustrate how this measure enables the use of various tools from decision analysis to be applied in government settings, such as stochastic dominance arguments and certain equivalent calculations. Regarding the TSA case study, our analysis demonstrates the value of continued expansion of the TSA trusted traveler initiative and increasing the background vetting for passengers who are afforded expedited security screening. © 2017 Society for Risk Analysis.

Medicaid Waivers and Public Sector Mental Health Service Penetration Rates for Youth.

PubMed

Graaf, Genevieve; Snowden, Lonnie

2018-01-22

To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the present study investigated whether any of several Medicaid waiver options-and those that completely omit the means test in particular-are associated with higher state-wide public sector treatment penetration rates. The investigators obtained data from the U.S. Census, SAMHSA's Uniform Reporting System, and the Centers for Medicare and Medicaid Services. Analysis employed random intercept and random slope linear regression models, controlling for a variety of state demographic and fiscal variables, to determine whether a relationship between Medicaid waiver policies and state-level public sector penetration rates could be observed. Findings indicate that, whether relaxing or completely waiving Medicaid's qualifying income limits, waivers increase public sector penetration rates, particularly for youth under age 17. However, completely waiving Medicaid income limits did not uniquely contribute to penetration rate increases. States offering Medicaid waivers that either relax or completely waive Medicaid's means test to qualify for health coverage present higher public sector treatment rates for youth with behavioral health care needs. There is no evidence that restricting the program to waiving the means test for accessing Medicaid would increase treatment access. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Stigma of Failure in Organizations

DTIC Science & Technology

2008-01-15

divisions, suggests why the stigma of failure may not always apply in public-sector organizations, and suggests why the development of entrepreneurship ...within organizations may be path- dependent. 14. SUBJECT TERMS Corporate entrepreneurship , stigma of failure 15. NUMBER OF PAGES 59 16. PRICE...of failure may not always apply in public-sector organizations, and suggests why the development of entrepreneurship within organizations may be

Public Sector Transformation, Racial Inequality and Downward Occupational Mobility

ERIC Educational Resources Information Center

Wilson, George; Roscigno, Vincent J.; Huffman, Matt L.

2013-01-01

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…

Primer in Public Sector Labor Relations. A Practitioner's Guide.

ERIC Educational Resources Information Center

Indiana Univ., Bloomington. Midwest Center for Public Sector Labor Relations.

This guide is intended as a brief primer for the employer or employee new to public sector labor relations. A simple step-by-step approach to labor relations includes techniques for analysis of state enabling legislation, union self-perpetuation, scope of bargaining, preparing for and winning bargaining, settling disputes, solving contract…

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

PubMed

Slipicevic, Osman; Malicbegovic, Adisa

2012-01-01

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

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

PubMed Central

Slipicevic, Osman; Malicbegovic, Adisa

2012-01-01

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

Public Sector Reform and Governance for Adaptation: Implications of New Public Management for Adaptive Capacity in Mexico and Norway

NASA Astrophysics Data System (ADS)

Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie

2011-03-01

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.

Public sector reform and governance for adaptation: implications of new public management for adaptive capacity in Mexico and Norway.

PubMed

Eakin, Hallie; Eriksen, Siri; Eikeland, Per-Ove; Øyen, Cecilie

2011-03-01

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.

Organizing for Social Partnership: Higher Education in Cross-Sector Collaboration

ERIC Educational Resources Information Center

Siegel, David J.

2010-01-01

The most complex social challenges--such as post-secondary access and success for under-represented students, diversification of the workforce, poverty, environmental degradation, and global health--exceed the problem-solving capacity of single organizations or societal sectors. "Organizing for Social Partnership" provides colleges and…

Public Sector Training: A "Blind" Spot in the 1999 South African National Levy-Grant Policy

ERIC Educational Resources Information Center

Paterson, Andrew

2005-01-01

In 2000, South Africa implemented a levy-grant policy (Skills Development Levies Act, 1999) to give an incentive for workplace training across private and public sector workplaces alike, but the impact of the levy-grant scheme in the public sector was restricted by financial and management processes unique to that environment. This article shows…

Insights Into Collaborative Networks Of Nonprofit, Private, And Public Organizations That Address Complex Health Issues.

PubMed

Hogg, Rachel A; Varda, Danielle

2016-11-01

Community networks that include nonprofit, public, and private organizations have formed around many health issues, such as chronic disease management and healthy living and eating. Despite the increases in the numbers of and funding for cross-sector networks, and the growing literature about them, there are limited data and methods that can be used to assess their effectiveness and analyze their designs. We addressed this gap in knowledge by analyzing the characteristics of 260 cross-sector community health networks that collectively consisted of 7,816 organizations during the period 2008-15. We found that nonprofit organizations were more prevalent than private firms or government agencies in these networks. Traditional types of partners in community health networks such as hospitals, community health centers, and public health agencies were the most trusted and valued by other members of their networks. However, nontraditional partners, such as employer or business groups and colleges or universities, reported contributing relatively high numbers of resources to their networks. Further evidence is needed to inform collaborative management processes and policies as a mechanism for building what the Robert Wood Johnson Foundation describes as a culture of health. Project HOPE—The People-to-People Health Foundation, Inc.

Downsizing in the public sector: Metro-Toronto's hospitals.

PubMed

Flint, Douglas H

2003-01-01

This study has two objectives. First, to predict the outcomes of a public sector downsizing; second to measure effects of downsizing at organizational and inter-organizational levels. Primary data to assess the organizational level effects was collected through interviews with senior executives at two of Metro-Toronto's hospitals. Secondary data, to assess the inter-organizational effects, was collected from government documents and media reports. Due to the exploratory nature of the study's objectives a case study method was employed. Most institutional downsizing practices aligned with successful outcomes. Procedures involved at the inter-organizational level aligned with unsuccessful outcomes and negated organizational initiatives. This resulted in an overall alignment with unsuccessful procedures. The implication, based on private sector downsizings, is that the post-downsized hospital system was more costly and less effective.

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

PubMed

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

2008-01-01

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

Autonomous public organization policy: a case study for the health sector in Thailand.

PubMed

Rajataramya, B; Fried, B; van der Pütten, M; Pongpanich, S

2009-09-01

This paper describes factors affecting autonomous public organization (APO) policy agenda setting and policy formation through comparison of policy processes applied to one educational institute under the Ministry of Education and the other educational institute under the Ministry of Public Health in Thailand. This study employs mixed method including a qualitative approach through documentary research, in-depth interviews, and participant observation. Factors that facilitated the formulation of the APO policy were: (1) awareness of need; (2) clarity of strategies; (3) leadership, advocacy, and strategic partnerships, (4) clear organizational identity; (5) participatory approach to policy formulation, and (6) identification of a policy window. Factors that impeded the formulation of the APO policy were: (1) diverting political priorities; (2) ill-defined organizational identity; (3) fluctuating leadership direction, (4) inadequate participation of stakeholders; and (5) political instability. Although findings cannot be generalized, this case study does offer benchmarking for those in search of ways to enhance processes of policy formulation.

Civil society, third sector, and healthcare: the case of social cooperatives in Italy.

PubMed

Borzaga, Carlo; Fazzi, Luca

2014-12-01

In many European countries, the third sector is considered an actor able to improve both the efficiency and the efficacy of public healthcare systems afflicted by the crisis of the welfare state. Attributed to third-sector organizations is the role of a hybrid actor tasked with the professional supply of services, not for profit but rather for mutualistic purposes, and to serve the public interest. However, empirical evidence on the capacity of the third sector to pursue objectives of social inclusion in a phase of withdrawal by the public sector is almost entirely lacking in the European countries. The article describes the results of research on the transformation of the Italian healthcare system and on the emergence of a new third sector in Italy. The results of the inquiry highlight the strategies, characteristics, and governance processes which enable third-sector organizations operating in the healthcare sector to pursue objectives of inclusion, and to serve the needs of disadvantaged groups by assuming the form of social enterprises. Copyright © 2014 Elsevier Ltd. All rights reserved.

[THE ORGANIZATION OF REHABILITATION CARE OF POPULATION USING INNOVATIVE MEDICAL ORGANIZATIONAL TECHNOLOGIES AND PRINCIPLES OF PUBLIC PRIVATE PARTNERSHIP].

PubMed

Totskaia, E G; Sheliakina, O W; Sadovoii, M A; Netchaev, V S

2015-01-01

The article considers actual problems of actual stage of development of health care related to using innovative approaches to organization and management of rehabilitation care ofpopulation. The rehabilitation is most important direction of medical sector supporting complex of services in closed cycle of rendering medical care to population and significant social economic effects. The capacity and extreme unprofitability of rehabilitation services determine necessity of searching alternative forms of organization of this type of care and financing including mechanisms of public-private partnership. The experience is presented related to involvement of resources of non-public medical organizations for implementing public commitments on rendering qualitative rehabilitation services to population using innovative medical organizational technologies.

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

PubMed

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

2012-08-01

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

Applying a private sector capitation model to the management of type 2 diabetes in the South African public sector: a cost-effectiveness analysis.

PubMed

Volmink, Heinrich C; Bertram, Melanie Y; Jina, Ruxana; Wade, Alisha N; Hofman, Karen J

2014-09-30

Diabetes mellitus contributes substantially to the non-communicable disease burden in South Africa. The proposed National Health Insurance system provides an opportunity to consider the development of a cost-effective capitation model of care for patients with type 2 diabetes. The objective of the study was to determine the potential cost-effectiveness of adapting a private sector diabetes management programme (DMP) to the South African public sector. Cost-effectiveness analysis was undertaken with a public sector model of the DMP as the intervention and a usual practice model as the comparator. Probabilistic modelling was utilized for incremental cost-effectiveness ratio analysis with life years gained selected as the outcome. Secondary data were used to design the model while cost information was obtained from various sources, taking into account public sector billing. Modelling found an incremental cost-effectiveness ratio (ICER) of ZAR 8 356 (USD 1018) per life year gained (LYG) for the DMP against the usual practice model. This fell substantially below the Willingness-to-Pay threshold with bootstrapping analysis. Furthermore, a national implementation of the intervention could potentially result in an estimated cumulative gain of 96 997 years of life (95% CI 71 073 years - 113 994 years). Probabilistic modelling found the capitation intervention to be cost-effective, with an ICER of ZAR 8 356 (USD 1018) per LYG. Piloting the service within the public sector is recommended as an initial step, as this would provide data for more accurate economic evaluation, and would also allow for qualitative analysis of the programme.

WARF's stem cell patents and tensions between public and private sector approaches to research.

PubMed

Golden, John M

2010-01-01

While society debates whether and how to use public funds to support work on human embryonic stem cells (hESCs), many scientific groups and businesses debate a different question - the extent to which patents that cover such stem cells should be permitted to limit or to tax their research. The Wisconsin Alumni Research Foundation (WARF), a non-profit foundation that manages intellectual property generated by researchers at the University of Wisconsin at Madison, owns three patents that have been at the heart of the latter controversy The story of WARF's patents and the controversy they have fostered highlights not only continuing tensions between proprietary and nonproprietary approaches to developing science and technology, but also an at least partly reassuring capacity of public and private sectors to deal with those tensions in a way that can render them substantially manageable, and frequently more manageable as a technology matures. More particularly, the cumulative story of WARF's patents features three leitmotifs that suggest how an attentive and engaged public sector might commonly succeed in working with public and private sector actors to achieve workable balances between proprietary rights and more general social interests: (1) right holders' decisions to pursue less than full rights assertion or enforcement; (2) the ability of government and other public sector actors to help bring about such decisions through co-option or pressure; and (3) the frequent availability or development of technological alternatives that limit research bottlenecks.

The incidence of public sector hospitalisations due to dog bites in Australia 2001-2013.

PubMed

Rajshekar, Mithun; Blizzard, Leigh; Julian, Roberta; Williams, Anne-Marie; Tennant, Marc; Forrest, Alex; Walsh, Laurence J; Wilson, Gary

2017-08-01

To estimate the incidence of dog bite-related injuries requiring public sector hospitalisation in Australia during the period 2001-13. Summary data on public sector hospitalisations due to dog bite-related injuries with an ICD 10-AM W54.0 coding were sourced from the Australian Institute of Health and Welfare for the study period 2001-2013. In Australia, on average, 2,061 persons were hospitalised each year for treatment for dog bite injuries at an annual rate of 12.39 (95%CI 12.25-12.53) per 100,000 during 2001-13. The highest annual rates of 25.95 (95%CI 25.16-26.72) and 18.42 (95%CI 17.75-19.07) per 100,000 were for age groups 0-4 and 5-9 years respectively. Rates of recorded events increased over the study period and reached 16.15 (95%CI 15.78-16.52) per 100,000 during 2011-13. Dog bites are a largely unrecognised and growing public health problem in Australia. Implications for public health: There is an increasing public sector burden of hospitalisations for injuries from dog bites in Australia. © 2017 Menzies Institute for Medical Research.

Digital Broadband Content: Public Sector Information. OECD Digital Economy Papers, No. 112

ERIC Educational Resources Information Center

OECD Publishing (NJ1), 2006

2006-01-01

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.…

Applications of aerospace technology in the public sector

NASA Technical Reports Server (NTRS)

Anuskiewicz, T.; Johnston, J.; Zimmerman, R. R.

1971-01-01

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.

Factors Affecting Teachers' Motivation: An HRM Challenge for Public Sector Higher Educational Institutions of Pakistan (HEIs)

ERIC Educational Resources Information Center

Rasheed, Muhammad Imran; Humayon, Asad Afzal; Awan, Usama; Ahmed, Affan ud Din

2016-01-01

Purpose: The purpose of this paper is to explore/investigate various issues of teachers ' motivation in public sector Higher Educational Institutions of Pakistan. Design/methodology/approach: This is an exploratory research where surveys have been conducted in the well known public sector Universities of Pakistan; primary data have been collected…

Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

PubMed

Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura

During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD). In this study, we evaluated experiences in preparedness among stakeholders of both curative and public health sectors to formulate recommendations for optimizing preparedness protocols. Timeliness of referred patients with suspected EVD was used as indicator for preparedness. In focus group sessions and semistructured interviews, experiences of curative and public health stakeholders about the regional and national process of preparedness and response were listed. Timeliness recordings of all referred patients with suspected EVD (13) were collected from first date of illness until arrival in the referral academic hospital. Ebola preparedness was considered extensive compared with the risk of an actual patient, however necessary. Regional coordination varied between regions. More standardization of regional preparation and operational guidelines was requested, as well as nationally standardized contingency criteria, and the National Centre for Infectious Disease Control was expected to coordinate the development of these guidelines. For the timeliness of referred patients with suspected EVD, the median delay between first date of illness until triage was 2.0 days (range: 0-10 days), and between triage and arrival in the referral hospital, it was 5.0 hours (range: 2-7.5 hours). In none of these patients Ebola infection was confirmed. Coordination between the public health sector and the curative sector needs improvement to reduce delay in patient management in emerging infectious diseases. Standardization of preparedness and response practices, through guidelines for institutional preparedness and blueprints for regional and national coordination, is necessary, as preparedness for emerging infectious

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

PubMed

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

2017-11-27

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

The role of retiree health insurance in the early retirement of public sector employees.

PubMed

Shoven, John B; Slavov, Sita Nataraj

2014-12-01

Most government employees have access to retiree health coverage, which provides them with group health coverage even if they retire before Medicare eligibility. We study the impact of retiree health coverage on the labor supply of public sector workers between the ages of 55 and 64. We find that retiree health coverage raises the probability of stopping full time work by 4.3 percentage points (around 38 percent) over two years among public sector workers aged 55-59, and by 6.7 percentage points (around 26 percent) over two years among public sector workers aged 60-64. In the younger age group, retiree health insurance mostly seems to facilitate transitions to part-time work rather than full retirement. However, in the older age group, it increases the probability of stopping work entirely by 4.3 percentage points (around 22 percent). Copyright © 2014 Elsevier B.V. All rights reserved.

Design and implementation of an affordable, public sector electronic medical record in rural Nepal.

PubMed

Raut, Anant; Yarbrough, Chase; Singh, Vivek; Gauchan, Bikash; Citrin, David; Verma, Varun; Hawley, Jessica; Schwarz, Dan; Harsha Bangura, Alex; Shrestha, Biplav; Schwarz, Ryan; Adhikari, Mukesh; Maru, Duncan

2017-06-23

Globally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility.DevelopmentThe electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives. For these purposes, we adapted Bahmni, a product built with open-source components for patient tracking, clinical protocols, pharmacy, laboratory, imaging, financial management, and supply logistics. In close partnership with government officials, we deployed the system in February of 2015, added on additional functionality, and iteratively improved the system over the following year. This experience enabled us then to deploy the system at an additional district-level hospital in a different part of the country in under four weeks. We discuss the implementation challenges and the strategies we pursued to build an electronic medical record for the public sector in rural Nepal.DiscussionOver the course of 18 months, we were able to develop, deploy and iterate upon the electronic medical record, and then deploy the refined product at an additional facility within only four weeks. Our experience suggests the feasibility of an integrated electronic medical record for public sector care delivery even in settings of rural poverty.

Design and implementation of an affordable, public sector electronic medical record in rural Nepal

PubMed Central

Raut, Anant; Yarbrough, Chase; Singh, Vivek; Gauchan, Bikash; Citrin, David; Verma, Varun; Hawley, Jessica; Schwarz, Dan; Harsha, Alex; Shrestha, Biplav; Schwarz, Ryan; Adhikari, Mukesh; Maru, Duncan

2018-01-01

Introduction Globally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility. Development The electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives. Application For these purposes, we adapted Bahmni, a product built with open-source components for patient tracking, clinical protocols, pharmacy, laboratory, imaging, financial management, and supply logistics. In close partnership with government officials, we deployed the system in February of 2015, added on additional functionality, and iteratively improved the system over the following year. This experience enabled us then to deploy the system at an additional district-level hospital in a different part of the country in under four weeks. We discuss the implementation challenges and the strategies we pursued to build an electronic medical record for the public sector in rural Nepal. Discussion Over the course of 18 months, we were able to develop, deploy and iterate upon the electronic medical record, and then deploy the refined product at an additional facility within only four weeks. Our experience suggests the feasibility of an integrated electronic medical record for public sector care delivery even in settings of rural poverty. PMID:28749321

To serve or to leave: a question faced by public sector healthcare providers in Pakistan.

PubMed

Mir, Ali Mohammad; Shaikh, Muhammad Saleem; Rashida, Gul; Mankani, Neha

2015-11-25

The availability of properly trained and motivated providers is a prerequisite for provision of easily accessible healthcare. Pakistan has been listed by the World Health Organization in its World Health Report 2006 as one of 57 countries with a critical health workforce deficiency. This study examines the factors associated with the willingness of public sector healthcare providers to leave government service and recommends measures that can be adopted to attract and retain staff in the country's public healthcare system. A stratified, random sampling methodology was adopted to recruit a nationally representative sample of 1,296 public sector healthcare providers, including paramedics, medical doctors, and specialists. A semi-structured questionnaire was used to interview these providers. Logistic regressions measured the association with determinants of their willingness to leave the public health sector for better prospects elsewhere. A third of all healthcare providers who were interviewed were of the view that, provided the opportunity, they would leave government service. The odds of willingness to leave service were highest among providers from the region of Azad Jammu and Kashmir (adjusted odds ratio [AOR] = 4.33; 95% CI, 2.49-7.54) followed by the province of Balochistan (AOR = 4.21; 95% CI, 2.41-7.33), and the region of Gilgit Baltistan (AOR = 3.34; 95% CI, 1.67-6.67). Providers who expressed dissatisfaction in the manner their performance was evaluated and those who were dissatisfied with the current salary, each had higher odds of considering leaving government service (AOR = 1.67; 95% CI, 1.18-2.40 and AOR = 2.03; 95% CI, 1.47-2.81, respectively). Providers who reported experiencing interference in their work by influential politicians of the area were more inclined to leave (AOR = 1.44; 95% CI, 1.05-1.98). This study clearly highlights the need to implement more focused strategies in the public healthcare system in Pakistan in

Democratizing Process Innovation? On Citizen Involvement in Public Sector BPM

NASA Astrophysics Data System (ADS)

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.

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

PubMed

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

2010-11-25

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

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

PubMed Central

2010-01-01

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

Insurance Sector Dynamics: Towards Transformation into Learning Organization

ERIC Educational Resources Information Center

Barkur, Gopalakrishna; Varambally, K. V. M.; Rodrigues, Lewlyn L. R.

2007-01-01

Purpose: The purpose of this research is to study the influence of five critical factors on service quality in the insurance sector. Having studied the influence of these critical factors, an attempt has been made to obtain a generic solution to enhance the quality of service by proposing a holistic framework of learning organization. As…

Autonomy and performance in the public sector: the experience of English NHS hospitals.

PubMed

Verzulli, Rossella; Jacobs, Rowena; Goddard, Maria

2018-05-01

Since 2004, English NHS hospitals have been given the opportunity to acquire a more autonomous status known as a Foundation Trust (FT), whereby regulations and restrictions over financial, management, and organizational matters were reduced in order to create incentives to deliver higher-quality services in the most efficient way. Using difference-in-difference models, we test whether achieving greater autonomy (FT status) improved hospital performance, as proxied by measures of financial management, quality of care, and staff satisfaction. Results provide little evidence that the FT policy per se has made any difference to the performance of hospitals in most of these domains. Our findings have implications for health policy and inform the trend towards granting greater autonomy to public-sector organizations.

Implications for Higher Education of the Public Sector Reform Agenda.

ERIC Educational Resources Information Center

Coaldrake, Peter

1995-01-01

It is argued that issues of accountability, competition, the technology, and internationalization of education suggest it is in the best interest of Australian higher education to adopt strategic management techniques being promoted for the public sector. This includes new emphases on staffing policies and practices, resource allocation and…

Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa.

PubMed

Ashmore, John; Gilson, Lucy

2015-01-19

'Dual practice', or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries' public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Findings suggest dual practice can impact both positively and negatively on specialists' intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a 'stepping stone' to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.

A Community Checklist for Health Sector Resilience Informed by Hurricane Sandy.

PubMed

Toner, Eric S; McGinty, Meghan; Schoch-Spana, Monica; Rose, Dale A; Watson, Matthew; Echols, Erin; Carbone, Eric G

This is a checklist of actions for healthcare, public health, nongovernmental organizations, and private entities to use to strengthen the resilience of their community's health sector to disasters. It is informed by the experience of Hurricane Sandy in New York and New Jersey and analyzed in the context of findings from other recent natural disasters in the United States. The health sector is defined very broadly, including-in addition to hospitals, emergency medical services (EMS), and public health agencies-healthcare providers, outpatient clinics, long-term care facilities, home health providers, behavioral health providers, and correctional health services. It also includes community-based organizations that support these entities and represent patients. We define health sector resilience very broadly, including all factors that preserve public health and healthcare delivery under extreme stress and contribute to the rapid restoration of normal or improved health sector functioning after a disaster. We present the key findings organized into 8 themes. We then describe a conceptual map of health sector resilience that ties these themes together. Lastly, we provide a series of recommended actions for improving health sector resilience at the local level. The recommended actions emphasize those items that individuals who experienced Hurricane Sandy deemed to be most important. The recommendations are presented as a checklist that can be used by a variety of interested parties who have some role to play in disaster preparedness, response, and recovery in their own communities. Following a general checklist are supplemental checklists that apply to specific parts of the larger health sector.

A Community Checklist for Health Sector Resilience Informed by Hurricane Sandy

PubMed Central

Toner, Eric S.; McGinty, Meghan; Schoch-Spana, Monica; Rose, Dale A.; Watson, Matthew; Echols, Erin; Carbone, Eric G.

2017-01-01

This is a checklist of actions for healthcare, public health, nongovernmental organizations, and private entities to use to strengthen the resilience of their community’s health sector to disasters. It is informed by the experience of Hurricane Sandy in New York and New Jersey and analyzed in the context of findings from other recent natural disasters in the United States. The health sector is defined very broadly, including—in addition to hospitals, emergency medical services (EMS), and public health agencies—healthcare providers, outpatient clinics, long-term care facilities, home health providers, behavioral health providers, and correctional health services. It also includes community-based organizations that support these entities and represent patients. We define health sector resilience very broadly, including all factors that preserve public health and healthcare delivery under extreme stress and contribute to the rapid restoration of normal or improved health sector functioning after a disaster. We present the key findings organized into 8 themes. We then describe a conceptual map of health sector resilience that ties these themes together. Lastly, we provide a series of recommended actions for improving health sector resilience at the local level. The recommended actions emphasize those items that individuals who experienced Hurricane Sandy deemed to be most important. The recommendations are presented as a checklist that can be used by a variety of interested parties who have some role to play in disaster preparedness, response, and recovery in their own communities. Following a general checklist are supplemental checklists that apply to specific parts of the larger health sector. PMID:28192055

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

PubMed

Ezebilo, Eugene E; Animasaun, Emmanuel D

2012-08-01

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

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

DTIC Science & Technology

1988-09-01

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

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

PubMed

Kolodziejczyk, Christophe; Heinesen, Eskil

2016-05-01

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

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

NASA Astrophysics Data System (ADS)

Nikitenko, SM; Goosen, EV

2017-02-01

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

Public and private sector interactions: an economic perspective.

PubMed

Maynard, A

1986-01-01

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

The Practice of Evaluation in Public Sector Contexts: A Response

ERIC Educational Resources Information Center

Chouinard, Jill Anne

2013-01-01

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…

Incentives and Their Dynamics in Public Sector Performance Management Systems

ERIC Educational Resources Information Center

Heinrich, Carolyn J.; Marschke, Gerald

2010-01-01

We use the principal-agent model as a focal theoretical frame for synthesizing what we know, both theoretically and empirically, about the design and dynamics of the implementation of performance management systems in the public sector. In this context, we review the growing body of evidence about how performance measurement and incentive systems…

Investigating the Underlying Factors of Corruption in the Public Construction Sector: Evidence from China.

PubMed

Shan, Ming; Le, Yun; Yiu, Kenneth T W; Chan, Albert P C; Hu, Yi

2017-12-01

Over recent years, the issue of corruption in the public construction sector has attracted increasing attention from both practitioners and researchers worldwide. However, limited efforts are available for investigating the underlying factors of corruption in this sector. Thus, this study attempted to bridge this knowledge gap by exploring the underlying factors of corruption in the public construction sector of China. To achieve this goal, a total of 14 structured interviews were first carried out, and a questionnaire survey was then administered to 188 professionals in China. Two iterations of multivariate analysis approaches, namely, stepwise multiple regression analysis and partial least squares structural equation modeling were successively utilized to analyze the collected data. In addition, a case study was also conducted to triangulate the findings obtained from the statistical analysis. The results generated from these three research methods achieve the same conclusion: the most influential underlying factor leading to corruption was immorality, followed by opacity, unfairness, procedural violation, and contractual violation. This study has contributed to the body of knowledge by exploring the properties of corruption in the public construction sector. The findings from this study are also valuable to the construction authorities as they can assist in developing more effective anti-corruption strategies.

Publication Trends in Model Organism Research

PubMed Central

Dietrich, Michael R.; Ankeny, Rachel A.; Chen, Patrick M.

2014-01-01

In 1990, the National Institutes of Health (NIH) gave some organisms special status as designated model organisms. This article documents publication trends for these NIH-designated model organisms over the past 40 years. We find that being designated a model organism by the NIH does not guarantee an increasing publication trend. An analysis of model and nonmodel organisms included in GENETICS since 1960 does reveal a sharp decline in the number of publications using nonmodel organisms yet no decline in the overall species diversity. We suggest that organisms with successful publication records tend to share critical characteristics, such as being well developed as standardized, experimental systems and being used by well-organized communities with good networks of exchange and methods of communication. PMID:25381363

Accidents of Electrical and Mechanical Works for Public Sector Projects in Hong Kong.

PubMed

Wong, Francis K W; Chan, Albert P C; Wong, Andy K D; Hon, Carol K H; Choi, Tracy N Y

2018-03-10

A study on electrical and mechanical (E&M) works-related accidents for public sector projects provided the opportunity to gain a better understanding of the causes of accidents by analyzing the circumstances of all E&M works accidents. The research aims to examine accidents of E&M works which happened in public sector projects. A total of 421 E&M works-related accidents in the "Public Works Programme Construction Site Safety and Environmental Statistics" (PCSES) system were extracted for analysis. Two-step cluster analysis was conducted to classify the E&M accidents into different groups. The results identified three E&M accidents groups: (1) electricians with over 15 years of experience were prone to 'fall of person from height'; (2) electricians with zero to five years of experience were prone to 'slip, trip or fall on same level'; (3) air-conditioning workers with zero to five years of experience were prone to multiple types of accidents. Practical measures were recommended for each specific cluster group to avoid recurrence of similar accidents. The accident analysis would be vital for industry practitioners to enhance the safety performance of public sector projects. This study contributes to filling the knowledge gap of how and why E&M accidents occur and promulgating preventive measures for E&M accidents which have been under researched.

Accidents of Electrical and Mechanical Works for Public Sector Projects in Hong Kong

PubMed Central

Wong, Francis K. W.; Chan, Albert P. C.; Wong, Andy K. D.; Choi, Tracy N. Y.

2018-01-01

A study on electrical and mechanical (E&M) works-related accidents for public sector projects provided the opportunity to gain a better understanding of the causes of accidents by analyzing the circumstances of all E&M works accidents. The research aims to examine accidents of E&M works which happened in public sector projects. A total of 421 E&M works-related accidents in the “Public Works Programme Construction Site Safety and Environmental Statistics” (PCSES) system were extracted for analysis. Two-step cluster analysis was conducted to classify the E&M accidents into different groups. The results identified three E&M accidents groups: (1) electricians with over 15 years of experience were prone to ‘fall of person from height’; (2) electricians with zero to five years of experience were prone to ‘slip, trip or fall on same level’; (3) air-conditioning workers with zero to five years of experience were prone to multiple types of accidents. Practical measures were recommended for each specific cluster group to avoid recurrence of similar accidents. The accident analysis would be vital for industry practitioners to enhance the safety performance of public sector projects. This study contributes to filling the knowledge gap of how and why E&M accidents occur and promulgating preventive measures for E&M accidents which have been under researched. PMID:29534429

The important role of public-sector research in the United States.

PubMed

2013-02-01

Between 1970 and 2009, US public institutions participated in the research and development of 153 drugs, including 15 vaccines. Between 1990 and 2007, nearly 10% of all the new drugs and vaccines marketed in the US and about 20% of those representing a therapeutic advance originated in public institutions. The proportion of these drugs that represented a substantial therapeutic advance was over twice that of those produced exclusively by the private sector.

Health Care Public Sector Share and the U.S. Life Expectancy Lag: A Country-level Longitudinal Study.

PubMed

Reynolds, Megan M

2018-04-01

Growing research on the political economy of health has begun to emphasize sociopolitical influences on cross-national differences in population health above and beyond economic growth. While this research investigates the impact of overall public health spending as a share of GDP ("health care effort"), it has for the most part overlooked the distribution of health care spending across the public and private spheres ("public sector share"). I evaluate the relative contributions of health care effort, public sector share, and GDP to the large and growing disadvantage in U.S. life expectancy at birth relative to peer nations. I do so using fixed effects models with data from 16 wealthy democratic nations between 1960 and 2010. Results indicate that public sector share has a beneficial effect on longevity net of the effect of health care effort and that this effect is nonlinear, decreasing in magnitude as levels rise. Moreover, public sector share is a more powerful predictor of life expectancy at birth than GDP per capita. This study contributes to discussions around the political economy of health, the growth consensus, and the American lag in life expectancy. Policy implications vis-à-vis the U.S. Affordable Care Act are discussed.

The Evolving Private Military Sector: A Survey

DTIC Science & Technology

2008-04-23

PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Naval Postgraduate School,Graduate School of Business and Public Policy,Monterey,CA,93943 8...PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT...sector have a website which offers information about the organization . Using these and other resources, we assembled more detailed data on

Evaluation of Large-Scale Public-Sector Reforms: A Comparative Analysis

ERIC Educational Resources Information Center

Breidahl, Karen N.; Gjelstrup, Gunnar; Hansen, Hanne Foss; Hansen, Morten Balle

2017-01-01

Research on the evaluation of large-scale public-sector reforms is rare. This article sets out to fill that gap in the evaluation literature and argues that it is of vital importance since the impact of such reforms is considerable and they change the context in which evaluations of other and more delimited policy areas take place. In our…

The Speed of Obsolescence: Evidence from the Dutch Public Sector

ERIC Educational Resources Information Center

van Loo, Jasper B.

2007-01-01

HRD is extensively concerned with human capital investment, but only focuses on how skills and knowledge become obsolete to a limited extent. In this paper we look at the speed of obsolescence. Using data from a survey among Dutch public sector employees, we find that the yearly rate of skills obsolescence is 2.6%. Subsequent analyses show that…

Joint Solutions to Substance Abuse: Public Sector Employee Assistance Programs.

ERIC Educational Resources Information Center

State and Local Government Labor-Management Committee, Washington, DC.

This short booklet is a joint expression by public sector labor and management that recognizes that neither side has all the answers to the problems of employee substance abuse and that both share a common concern for a successful outcome. The booklet summarizes the dimension of substance abuse in today's workplace; and it tries to encourage…

Employment-based health benefits and public-sector coverage: opportunity for leadership.

PubMed

Darling, Helen

2006-01-01

In this commentary, Helen Darling, speaking from the large-employer perspective, responds to James Robinson's paper on the mature health insurance industry, which faces declining opportunities with employer-based health benefits and growing but less appealing public-sector opportunities for management and other services. The similar needs of public and private employers and payers provide an opportunity for leadership, accelerating innovation and using value-added services to improve safety, quality, and efficiency of health care for all.

IT Governance and the Public Sector: A Survey of Perceptions, Attitudes, and Knowledge of Federal Public Sector IT Employees

ERIC Educational Resources Information Center

Martin, David P.

2013-01-01

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.…

Doing more for less: identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis.

PubMed

Lince-Deroche, Naomi; Harries, Jane; Constant, Deborah; Morroni, Chelsea; Pleaner, Melanie; Fetters, Tamara; Grossman, Daniel; Blanchard, Kelly; Sinanovic, Edina

2018-02-01

To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright

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

PubMed

Vrangbaek, Karsten

2008-04-01

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

Developing Military Health Care Leaders: Insights from the Military, Civilian, and Government Sectors

DTIC Science & Technology

2011-01-01

6 mentoring, career counseling, feedback, and self- development . Organizations differ in terms of how much emphasis they place on particular...deliberate sample of health care organizations in the private sector that were most likely to offer lessons learned for DoD. Our interviews were conducted...the eight sampled organizations , for a total of eight interviews. VHA Case Study. In addition to the private - sector interviews, we examined public

Procurement of construction services: a case study on bidding competition in Singapore public sector contracts

NASA Astrophysics Data System (ADS)

Oo, B. L.; Yan, Y.

2018-04-01

There are many variables that public clients need to consider in their bidding procedure to enhance efficiency in their procurement for construction services. This paper focusses on the competitive bidding process for public sector procurement of construction services in Singapore. A distinctive feature of the Singapore government competitive bidding process is that full bidding feedback information is released to all competing bidders (and public). The specific objectives are: (i) to examine the degree of competition in the construction markets; and (ii) to examine the bidding performance of competing bidders. Based on a collection of bidding data for a 15-month period, the results show the market environment of the Singapore public sector construction contracting is highly competitive with long bidder lists. In selection of contractors, only 50% of the contracts were awarded to lowest bidders. The results also show that the competing contractors can be broadly classified into three groups based on their bidding performance in terms of number of bidding attempts, bidding success rate and bidding competitiveness. These results provide a useful insight into the bidding competition in the Singapore public sector construction contracting, especially to new market entrants and foreign contractors who want to bid for jobs in Singapore.

Health worker experiences of and movement between public and private not-for-profit sectors-findings from post-conflict Northern Uganda.

PubMed

Namakula, Justine; Witter, Sophie; Ssengooba, Freddie

2016-05-05

Northern Uganda suffered 20 years of conflict which devastated lives and the health system. Since 2006, there has been investment in reconstruction, which includes efforts to rebuild the health workforce. This article has two objectives: first, to understand health workers' experiences of working in public and private not-for-profit (PNFP) sectors during and after the conflict in Northern Uganda, and second, to understand the factors that influenced health workers' movement between public and PNFP sectors during and after the conflict. A life history approach was used with 26 health staff purposively selected from public and PNFP facilities in four districts of Northern Uganda. Staff with at least 10 years' experience were selected, which resulted in a sample which was largely female and mid-level. Two thirds were currently employed in the public sector and just over a third in the PNFP sector. A thematic data analysis was guided by the framework analysis approach, analysis framework stages and ATLAS.ti software version 7.0. Analysis reveals that most of the current staff were trained in the PNFP sector, which appears to offer higher quality training experiences. During the conflict period, the PNFP sector also functioned more effectively and was relatively better able to support its staff. However, since the end of the conflict, the public sector has been reconstructed and is now viewed as offering a better overall package for staff. Most reported movement has been in that direction, and many in the PNFP sector state intention to move to the public sector. While there is sectoral loyalty on both sides and some bonds created through training, the PNFP sector needs to become more competitive to retain staff so as to continue delivering services to deprived communities in Northern Uganda. There has been limited previous longitudinal analysis of how health staff perceive different sectors and why they move between them, particularly in conflict-affected contexts

The challenges of commercializing second-generation transgenic crop traits necessitate the development of international public sector research infrastructure.

PubMed

Rothstein, Steven J; Bi, Yong-Mei; Coneva, Viktoriya; Han, Mei; Good, Allen

2014-10-01

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. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Scoping study of integrated resource planning needs in the public utility sector

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

Garrick, C J; Garrick, J M; Rue, D R

Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

Adoption of Innovation from the Business Sector by Post-Primary Education Organizations

ERIC Educational Resources Information Center

Hazzan, Orit; Zelig, Dafna

2016-01-01

Business organizations adopt innovation with the objective of meeting competition and improving their business performance; education organizations, likewise, operate in a competitive environment, are evaluated by stakeholders, and adopt innovation. The research presented here links these two sectors; its objective was to characterize the process…

Mediating Education Policy: Making up the "Anti-Politics" of Third-Sector Participation in Public Education

ERIC Educational Resources Information Center

Williamson, Ben

2014-01-01

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…

Navigating Public-Private Partnerships: Introducing the Continuum of Control

ERIC Educational Resources Information Center

DiMartino, Catherine

2014-01-01

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…

Who Helps Public Schools? Public Education Support Organizations in 2010

ERIC Educational Resources Information Center

de Leon, Erwin; Roeger, Katie L.; De Vita, Carol J.; Boris, Elizabeth T.

2010-01-01

There are more than 19,000 nonprofit organizations devoted to supporting public education in the United States. These organizations include booster clubs, parent-teacher groups, public education funds, scholarship funds, high school alumni associations, and others. This report assesses the current status of education support organizations;…

Workplace violence against women nurses working in two public sector hospitals of Lahore, Pakistan.

PubMed

Jafree, Sara Rizvi

Cultural and structural forces help sustain workplace violence (WPV) against feminized professions like nursing in Pakistan. The purpose of this study was to identify the prevalence and patterns of workplace violence (WPV) against women nurses (more than 95% of entire nursing population) in two hospitals of Pakistan. A standardized international survey developed by the World Health Organization was used to collect cross-sectional data. Descriptive statistics, chi-square tests, and multivariate regression were used for data analysis. A total of 309 nurse respondents were sampled from two public sector tertiary care hospitals of Lahore. Findings show that 73.1% of nurses reported experiencing some sort of violence in the last 12 months; with 53.4% suffering from physical violence, 57.3% from verbal violence, and 26.9% from sexual violence. The main perpetrators were reported to be male coworkers, patients, and attendants. Higher risk for WPV includes single status, non-Punjabi provincial belonging, Islamic faith, staff and student nurse designations, temporary government contract, and working additional hours in the evening and night. The primary response to violence included not doing anything and remaining silent. It was also reported that nurse victims experienced moderate levels of emotional grievances after facing violence. The results of this study suggest that public sector hospitals in the region need to improve their policy for the protection and monitoring of WPV against female nurses. Reporting and counseling bodies need to be installed to encourage both complaints and the seeking of medical attention after victimization. Copyright © 2017 Elsevier Inc. All rights reserved.

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

PubMed

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

2016-01-01

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

Private Sector Engagement: An Approach

NASA Astrophysics Data System (ADS)

Benjamin, G.

2016-12-01

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

Hearing focuses on price of Norplant; Wyeth pledges discount for public sector.

PubMed

1993-11-23

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.

Subjective Performance Evaluation in the Public Sector: Evidence from School Inspections. CEE DP 135

ERIC Educational Resources Information Center

Hussain, Iftikhar

2012-01-01

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…

Bridging the Divide: Challenges and Opportunities for Public Sector Agricultural Professionals Working with Amish and Mennonite Producers on Conservation.

PubMed

Brock, Caroline; Ulrich-Schad, Jessica D; Prokopy, Linda

2018-05-01

As Amish and Old Order and Conservative Mennonite (i.e., Plain) farmers increase their presence in the agricultural sector, it is crucial for public sector agricultural professionals to effectively work with them to mediate nonpoint source pollution and address issues like the hypoxic zone in the Gulf of Mexico. However, there is a dearth of research on how public sector agricultural professionals can better work with Plain producers on environmental management. There are also few training resources for those working with this key, yet hard to reach, population. Additionally, due to their religious doctrines, Plain communities strive to live apart from the "world" and may be discouraged from working with government entities and attending non-Plain people events. This study analyzes interview data from 23 Amish farmers in one region of Indiana and 18 public sector agricultural professionals from a variety of backgrounds and geographies in areas of the U.S. with heavy Plain populations. Public sector agricultural professionals identified some key agronomic challenges on Plain farms related to issues like poor pasture and manure management as well as socio-cultural challenges such as restrictions on electronic and phone communication. Educators should design outreach strategies that take into consideration that faith convictions and conservation concerns may vary greatly based on the specificities of the particular Plain church group. By better understanding this population and how to work with them, public sector agricultural professionals can more effectively work towards addressing environmental problems with this under-served group.

Public-private health partnerships: a strategy for WHO.

PubMed Central

Buse, K.; Waxman, A.

2001-01-01

Following early success with a number of high-profile partnerships, WHO is increasingly working with the private for-profit sector. In so doing, the organization finds itself in the maelstrom of a vibrant debate on the roles of public, civic, and commercial entities in society and on the appropriate modes of interaction among them. This paper examines WHO's involvement with the commercial sector, particularly in partnerships. WHO's approach to this sector is outlined and the criticisms levelled at public-private partnerships are reviewed. An indication is given of the steps recently taken by WHO to confront the concerns that have been expressed. The paper argues that partnership between WHO and the commercial sector is inevitable and that it presents considerable opportunities, but also significant risks, for the organization and for public health. A strategy is proposed for directing the debate on issues critical to WHO and its role in the promotion and protection of public health. PMID:11545332

Financial interventions and movement restrictions for managing the movement of health workers between public and private organizations in low- and middle-income countries.

PubMed

Rutebemberwa, Elizeus; Kinengyere, Alison A; Ssengooba, Freddie; Pariyo, George W; Kiwanuka, Suzanne N

2014-02-11

Health workers move between public and private organizations in both urban and rural areas during the course of their career. Depending on the proportion of the population served by public or private organizations in a particular setting, this movement may result in imbalances in the number of healthcare providers available relative to the population receiving care from that sector. However, both public and private organizations are needed as each sector has unique contributions to make to the effective delivery of health services. To assess the effects of financial incentives and movement restriction interventions to manage the movement of health workers between public and private organizations in low- and middle-income countries. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (10 November 2012); EMBASE (7 June 2011); LILACS (9 June 2011); MEDLINE (10 November 2012); CINAHL (13 August 2012); and the British Nursing Index (13 August 2012). Randomized controlled trials and non-randomized controlled trials; controlled before-and-after studies if pre- and post-intervention periods for study and control groups were the same and there were at least two units included in both the intervention and control groups; uncontrolled and controlled interrupted time series studies if the point in time when the intervention occurred was clearly defined and there were at least three or more data points before and after the intervention. Interventions included payment of special allowances, increasing salaries, bonding health workers, offering bursary schemes, scholarships or lucrative terminal benefits, and hiring people on contract basis. Two review authors independently applied the criteria for inclusion and exclusion of studies to the titles and abstracts of all articles obtained from the search. The same two review authors independently screened the full reports of the selected citations. At each stage, we compared the results and resolved discrepancies

The Gateway Paper--health service delivery outside of the public sector in Pakistan.

PubMed

Nishtar, Sania

2006-12-01

As opposed to preventive healthcare where State mandated healthcare agencies play a pre-dominant role, a number of actors within the healthcare system other than the State play a role in providing personalized curative healthcare within the country. The sector constitutes a set of diverse group of doctors, nurses, pharmacists, traditional healers, drug venders as well as laboratory technicians, shopkeepers and unqualified practitioners. The services they produce include hospitals, nursing homes, maternity clinics, clinics run by a range of healthcare providers, diagnostic facilities and the sale of drugs from pharmacies and unqualified sellers. However, in some cases the distinction between public and private sector is not very clear as many public sector practitioners practice privately, legally and illegally. The sector is fragmented and characterized by a mixed ownership patterns, many types of providers and different systems of medicines. As a viewpoint on the configuration of a proposed health reform within Pakistan, the Gateway Paper flags key issues in relation to this sector. This encompasses lack of a formal regulatory mechanism for private sector providers and their delivery mechanisms, absence of a formal mechanism for building capacity and ensuring quality and absence accreditation arrangements for private hospitals and nursing homes. With this as a context recommendations focus on the nature of regulatory mechanisms and the institutional arrangements necessary support them with particular reference to quality and continuing medical. In regard to traditional medicines directions focus on exploring ways to harnessing the potential within the system in order to leverage its outreach and integrate it with the formal healthcare system. The Paper also stresses on the need to fully exploit the potential within behavioral change interventions in order improve health systems performance in Pakistan and to broaden its scope from lifestyle and prevention

Comparisons and Projections: The Teachers' Superannuation Fund in Relation to Public Sector Pension Plans.

ERIC Educational Resources Information Center

Atherton, P. J.; Chalcraft, J.

Data on public sector superannuation plans in Ontario provide the basis for this examination of the current situation regarding the pension funds for public employees and teachers. The report describes and compares the employee/employer contributions, basic benefits, rates of return, and ratio of beneficiaries to contributors in various public…

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

PubMed

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

2011-05-27

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

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

PubMed Central

2011-01-01

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

Contrasting Reasons for Discontinuation of Antiretroviral Therapy in Workplace and Public-Sector HIV Programs in South Africa

PubMed Central

Kielmann, Karina; Charalambous, Salome; Karstaedt, Alan S.; Hamilton, Robin; La Grange, Lettie; Fielding, Katherine L.; Churchyard, Gavin J.; Grant, Alison D.

2011-01-01

Abstract We investigated reasons for clinical follow-up and treatment discontinuation among HIV-infected individuals receiving antiretroviral therapy (ART) in a public-sector clinic and in a workplace clinic in South Africa. Participants in a larger cohort study who had discontinued clinical care by the seventh month of treatment were traced using previously provided locator information. Those located were administered a semistructured questionnaire regarding reasons for discontinuing clinical follow-up. Participants who had discontinued antiretroviral therapy were invited to participate in further in-depth qualitative interviews. Fifty-one of 144 (35.4%) in the workplace cohort had discontinued clinical follow-up by the seventh month of treatment. The median age of those who discontinued follow-up was 46 years and median educational level was five years. By contrast, only 16.5% (44/267) of the public-sector cohort had discontinued follow-up. Among them the median age was 37.5 years and median education was 11 years. Qualitative interviews were conducted with 17 workplace participants and 10 public-sector participants. The main reasons for attrition in the workplace were uncertainty about own HIV status and above the value of ART, poor patient–provider relationships and workplace discrimination. In the public sector, these were moving away and having no money for clinic transport. In the workplace, efforts to minimize the time between testing and treatment initiation should be balanced with the need to provide adequate baseline counseling taking into account existing concepts about HIV and ART. In the public sector, earlier diagnosis and ART initiation may help to reduce early mortality, while links to government grants may reduce attrition. PMID:21214378

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

PubMed

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

2015-02-24

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

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

ERIC Educational Resources Information Center

Alagaraja, Meera; Dooley, Larry M.

2005-01-01

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

Adaptation to Externally Driven Change: The Impact of Political Change on Job Satisfaction in the Public Sector

PubMed Central

Tabvuma, Vurain; Bui, Hong T M; Homberg, Fabian

2014-01-01

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

The construction and legitimation of workplace bullying in the public sector: insight into power dynamics and organisational failures in health and social care.

PubMed

Hutchinson, Marie; Jackson, Debra

2015-03-01

Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing. © 2014 John Wiley & Sons Ltd.

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

NASA Astrophysics Data System (ADS)

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

2014-02-01

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

How well can physicians manage tuberculosis? A public-private sector comparison from Karachi, Pakistan.

PubMed

Naseer, Maliha; Khawaja, Ali; Pethani, Amin S; Aleem, Salik

2013-10-25

Tuberculosis (TB) is endemic in Pakistan which ranks fifth amongst the twenty two countries designated to be highly burdened by TB according to the World Health Organization. However, there is paucity of data regarding the knowledge of diagnosis of TB and its management amongst public and private practitioners. In this study, we endeavor to identify this gap in knowledge regarding the diagnosis and management of TB between public and private doctors and the factors affecting these knowledge scores in urban Pakistan. This cross sectional survey was conducted between June and December 2011. Doctors from public hospitals, private hospitals and private clinics scattered in all eighteen towns of Karachi were included in the study. Qualified MBBS doctors working in any specialty were eligible to participate whereas doctors working in both the public and private sectors were excluded from the study. Vignette based clinical scenarios were given to assess the knowledge score regarding the diagnosis and management of TB. A total of 196 doctors participated in the study. There was a significant difference between private and public physicians in terms of age and years of practice (p-value <0.05). Significant differences in the proportion of knowledge scores were observed between the public and private doctors and National TB Control Program trained and untrained doctors in Karachi. Factors associated with inadequate knowledge scores were being female gender [OR: 2.76 (95% CI: 1.418-5.384)], private employment status [OR: 1.50 (95% CI: 1.258-2.439)], and not trained by NTP [OR: 2.98 (95% CI: 1.286-3.225)] on multivariate logistic regression analysis. It is concluded that a knowledge gap exists between the public and private doctors in Karachi. Strengthening of currently implemented public private mix model along with improvement in the trainings of public and private practitioners is highly recommended to control TB in Pakistan.

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

PubMed

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

2016-09-20

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

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

PubMed

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

2012-07-06

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

Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Walrath-Greene, Christine M

2009-12-31

The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

PubMed

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The

Public-Sector Managed Care for Children's Mental Health Services: Stakeholders' Perspectives. Symposium.

ERIC Educational Resources Information Center

Stangl, Dalene K.; Tweed, Dan L.; Farmer, Betsy; Langmeyer, David; Stelle, Lynn; Behar, Lenore B.; Gagliardi, Julia; Burns, Barbara J.

This paper presents contributions at a symposium about Carolina Alternatives (CA), a North Carolina program that blends capitated financing with public sector managed care for mental health and substance abuse services for children and youth eligible for Medicaid. The symposium focused on stakeholders' perspectives and on expenditure patterns of…

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2014-09-01

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

Strategic planning for public health practice using macroenvironmental analysis.

PubMed Central

Ginter, P M; Duncan, W J; Capper, S A

1991-01-01

Macroenvironmental analysis is the initial stage in comprehensive strategic planning. The authors examine the benefits of this type of analysis when applied to public health organizations and present a series of questions that should be answered prior to committing resources to scanning, monitoring, forecasting, and assessing components of the macroenvironment. Using illustrations from the public and private sectors, each question is examined with reference to specific challenges facing public health. Benefits are derived both from the process and the outcome of macroenvironmental analysis. Not only are data acquired that assist public health professionals to make decisions, but the analytical process required assures a better understanding of potential external threats and opportunities as well as an organization's strengths and weaknesses. Although differences exist among private and public as well as profit and not-for-profit organizations, macroenvironmental analysis is seen as more essential to the public and not-for-profit sectors than the private and profit sectors. This conclusion results from the extreme dependency of those areas on external environmental forces that cannot be significantly influenced or controlled by public health decision makers. PMID:1902305

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

PubMed Central

White, Julia N; Corker, Jamaica

2016-01-01

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

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

PubMed

White, Julia N; Corker, Jamaica

2016-08-11

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

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

PubMed

Khan, Jahangir Am; Mahumud, Rashidul Alam

2015-01-01

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

Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review.

PubMed

Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

2012-01-01

Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of "private sector" included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. "Competitive dynamics" for funding appeared between the two sectors, such

Towards Developing a Theoretical Framework for Measuring Public Sector Managers' Career Success

ERIC Educational Resources Information Center

Rasdi, Roziah Mohd; Ismail, Maimunah; Uli, Jegak; Noah, Sidek Mohd

2009-01-01

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…

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

ERIC Educational Resources Information Center

Mallett, Christopher A.

2013-01-01

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

School-Based Service Use by Youth with ADHD in Public-Sector Settings

ERIC Educational Resources Information Center

Leslie, Laurel K.; Lambros, Katina M.; Aarons, Gregory A.; Haine, Rachel A.; Hough, Richard L.

2008-01-01

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…

Challenge 21. Building Tomorrow's Public Service. Report of the Multilevel Public Sector Leadership Symposium (Lake Lanier Islands, Georgia, March 22-23, 1990).

ERIC Educational Resources Information Center

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…

Short-run and long-run elasticities of electricity demand in the public sector: A case study of the United States Navy bases

NASA Astrophysics Data System (ADS)

Choi, Jino

Numerous studies have examined the elasticities of electricity demand---residential as well as commercial and industrial---in the private sector. However, no one appears to have examined the behavior of the public sector demand. This study aims to fill that gap and to provide insights into the electricity demand in the public sector, using the U.S. Navy bases as a case study. This study examines electricity demand data of 38 Navy activities within the United States for a 16-year time period from 1985 through 2000. The Navy maintains a highly diverse shore infrastructure to conduct its mission and to support the fleet. The types of shore facilities include shipyards, air stations, aviation depots, hospital, and many others. These Navy activities are analogous to commercial or industrial organizations in the private sector. In this study, I used a number of analytical approaches to estimate short-run and long-run elasticities of electricity demand. Estimation using pooled data was rejected because it failed the test for homogeneity. Estimation using the time series data of each Navy activity had several wrong signs for coefficients. The Stein-rule estimator did not differ significantly from the separate cross-section estimates because of the strong rejection of the homogeneity assumption. The iterative Bayesian shrinkage estimator provided the most reasonable results. The empirical findings from this study are as follows. First, the Navy's electricity demand is price elastic. Second, the price elasticities appear to be lower than those of the private sector. The short-run price elasticities for the Navy activities ranged from -0.083 to -0.157. The long-run price elasticities ranged from -0.151 to -0.769.

Cost analysis of periodontitis management in public sector specialist dental clinics.

PubMed

Mohd-Dom, Tuti; Ayob, Rasidah; Mohd-Nur, Amrizal; Abdul-Manaf, Mohd R; Ishak, Noorlin; Abdul-Muttalib, Khairiyah; Aljunid, Syed M; Ahmad-Yaziz, Yuhaniz; Abdul-Aziz, Hanizah; Kasan, Noordin; Mohd-Asari, Ahmad S

2014-05-20

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. 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). 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. 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 analysis of Periodontitis management in public sector specialist dental clinics

PubMed Central

2014-01-01

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

Global Adoption of Genetically Modified (GM) Crops: Challenges for the Public Sector.

PubMed

Huesing, Joseph E; Andres, David; Braverman, Michael P; Burns, Andrea; Felsot, Allan S; Harrigan, George G; Hellmich, Richard L; Reynolds, Alan; Shelton, Anthony M; Jansen van Rijssen, Wilna; Morris, E Jane; Eloff, Jacobus N

2016-01-20

Advances in biotechnology continue to drive the development of a wide range of insect-protected, herbicide-tolerant, stress-tolerant, and nutritionally enhanced genetically modified (GM) crops, yet societal and public policy considerations may slow their commercialization. Such restrictions may disproportionately affect developing countries, as well as smaller entrepreneurial and public sector initiatives. The 2014 IUPAC International Congress of Pesticide Chemistry (San Francisco, CA, USA; August 2014) included a symposium on "Challenges Associated with Global Adoption of Agricultural Biotechnology" to review current obstacles in promoting GM crops. Challenges identified by symposium presenters included (i) poor public understanding of GM technology and the need for enhanced communication strategies, (ii) nonharmonized and prescriptive regulatory requirements, and (iii) limited experience with regulations and product development within some public sector programs. The need for holistic resistance management programs to enable the most effective use of insect-protected crops was also a point of emphasis. This paper provides details on the symposium discussion and provides background information that can be used in support of further adoption of beneficial GM crops. Overall, it emphasizes that global adoption of modern agricultural biotechnology has not only provided benefits to growers and consumers but has great potential to provide solutions to an increasing global population and diminishing agricultural land. This potential will be realized by continued scientific innovation, harmonized regulatory systems, and broader communication of the benefits of the high-yielding, disease-resistant, and nutritionally enhanced crops attainable through modern biotechnology.

Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector.

PubMed

Gordeev, Vladimir S; Pavlova, Milena; Groot, Wim

2011-10-01

This paper reviews the empirical evidence on the outcomes of the financial reforms in the Russian public healthcare sector. A systematic literature review identified 37 relevant publications that presented empirical evidence on changes in quality, equity, efficiency and sustainability in public healthcare provision due to the Russian public healthcare financial reforms. Evidence suggests that there are substantial inter-regional inequalities across income groups both in terms of financing and access to public healthcare services. There are large efficiency differences between regions, along with inter-regional variations in payment and reimbursement mechanisms. Informal and quasi-formal payments deteriorate access to public healthcare services and undermine the overall financing sustainability. The public healthcare sector is still underfinanced, although the implementation of health insurance gave some premises for future increases of efficiency. Overall, the available empirical data are not sufficient for an evidence-based evaluation of the reforms. More studies on the quality, equity, efficiency and sustainability impact of the reforms are needed. Future reforms should focus on the implementation of cost-efficiency and cost-control mechanisms; provide incentives for better allocation and distribution of resources; tackle problems in equity in access and financing; implement a system of quality controls; and stimulate healthy competition between insurance companies. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Nexus between preventive policy inadequacies, workplace bullying, and mental health: Qualitative findings from the experiences of Australian public sector employees.

PubMed

Hurley, John; Hutchinson, Marie; Bradbury, Joanne; Browne, Graeme

2016-02-01

Public sector organizations have been shown to have high levels of workplace bullying, despite widespread adoption of zero-tolerance policy. Given the level of harm that stems from bullying, it has been suggested that it might be one of the most serious problems facing modern organizations. The qualitative findings from a large cross sectional study of public servants in Australia are reported in the present study. The results highlight palpable mental distress and illness stemming from exposure to workplace bullying. This distress was exacerbated by failures in prohibitive workplace procedures. Reporting bullying through formal organization processes did not lead to resolution of the problem; it instead highlighted feelings of powerlessness and mistrust. In light of the findings, we suggest that an alternative discourse is required, one that gives attention to enhancing employee resilience and self-healing behaviours to the emotional trauma of workplaces. Organizations might be better placed investing resources in fostering the resilience and emotional intelligence of their workforce, rather than continuing to invest resources in prohibitive policies that fail to address the problem. Employees should be supported to prioritize responsibility for their own mental health, rather than an overreliance on organizational responses. © 2016 Australian College of Mental Health Nurses Inc.

Working with the private sector for child health.

PubMed

Waters, Hugh; Hatt, Laurel; Peters, David

2003-06-01

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

Inter-organizational collaboration projects in the public sector: a balance between integration and demarcation.

PubMed

Löfström, Mikael

2010-01-01

For several years, the development of the Swedish public sector has been accompanied by a discussion about inter-organizational collaboration, which has been examined in several national experiments. The experience, however, indicates significant difficulties in implementing collaboration in local authorities' regular activities. This article argues that organizing inter-organizational collaboration in projects tends to be counterproductive, since the purpose of this collaboration is to increase the integration of local authorities. This article is based on case studies of three different collaboration projects. Each project is analyzed in relation to the way collaboration is organized within the project and how the relationship to the local authorities' activities is designed. The outcome of these studies shows that while collaboration projects increase integration between the responsible authorities, the integration stays within the projects. This is due to the fact that the projects were designed as units separate from the responsible authorities. As a result, the collaboration that occurs in the projects is not implemented in the local authorities' activities, and the viability of the increased integration of different responsible authorities does not extend beyond the projects. Copyright (c) 2009 John Wiley & Sons, Ltd.

Rationality in Public Sector Salary Scales: The Case of Rural Teachers in Pakistan.

ERIC Educational Resources Information Center

Khan, Shahrukh Rafi

2002-01-01

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…

Facilitating the Evaluation of Complexity in the Public Sector: Learning from the NHS in Scotland

ERIC Educational Resources Information Center

Connolly, John; Reid, Garth; Mooney, Allan

2015-01-01

It is necessary for public managers to be able to evaluate programmes in the context of complexity. This article offers key learning and reflections based on the experience of facilitating the evaluation of complexity with a range of public sector partners in Scotland. There have been several articles that consider evaluating complexity and…

The effectiveness of the Danish Organic Action Plan 2020 to increase the level of organic public procurement in Danish public kitchens.

PubMed

Sørensen, Nina N; Tetens, Inge; Løje, Hanne; Lassen, Anne D

2016-12-01

To measure the effect of organic food conversion projects on the percentage of organic food used in Danish public kitchens participating in the Danish Organic Action Plan 2020. The current longitudinal study was based on measurements of organic food percentages in Danish public kitchens before and after kitchen employees participated in conversion projects. Public kitchens participating in the nine organic food conversion projects under the Danish Organic Action Plan 2020, initiated during autumn 2012 and spring 2013 and completed in summer 2015. A total of 622 public kitchens. The average (median) increase in organic food percentage from baseline to follow-up was 24 percentage points (P<0·001) during an overall median follow-up period of 1·5 years. When analysing data according to public kitchen type, the increase remained significant for seven out of eight kitchens. Furthermore, the proportion of public kitchens eligible for the Organic Cuisine Label in either silver (60-90 % organic food procurement) or gold (90-100 % organic food procurement) level doubled from 31 % to 62 %, respectively, during the conversion period. Conversion project curriculum mostly included elements of 'theory', 'menu planning', 'network' and 'Organic Cuisine Label method' to ensure successful implementation. The study reports significant increases in the level of organic food procurement among public kitchens participating in the Danish Organic Action Plan 2020. Recommendations for future organic conversion projects include adding key curriculum components to the project's educational content and measuring changes in organic food percentage to increase the chances of successful implementation.

The role of the public sector in the provision of housing supply in Turkey, 1950–2009.

PubMed

Özdemir, Dilek

2011-01-01

This study examines the changing role of the public sector in Turkey with regard to housing provision since 1950, and particularly since 2000, and seeks to clarify how public intervention has affected housing provision and urban development dynamics in major cities. Three periods may be identified, with central government acting as a regulator in a first period characterized by a ‘housing boom’. During the second period, from 1980 to 2000, a new mass housing law spurred construction activity, although the main beneficiaries of the housing fund tended to be the middle classes. After 2000, contrary to emerging trends in both Northern and Southern European countries, the public sector in Turkey became actively involved in housing provision. During this process, new housing estates were created on greenfield sites on the outskirts of cities, instead of efforts being made to rehabilitate, restore or renew existing housing stock in the cities. Meanwhile, the concept of ‘urban regeneration’ has been opportunistically incorporated into the planning agenda of the public sector, and — under the pretext of regenerating squatter housing areas — existing residents have been moved out, while channels for community participation have been bypassed.

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

PubMed

Kröger, H

2016-04-01

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

The first private sector health insurance company in Ghana.

PubMed

Huff-Rousselle, M; Akuamoah-Boateng, J

1998-01-01

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

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

ERIC Educational Resources Information Center

Al-Shehab, Ali Jasem

2010-01-01

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

Financial Management Reforms in the Health Sector: A Comparative Study Between Cash-based and Accrual-based Accounting Systems

PubMed Central

Abolhallaje, Masoud; Jafari, Mehdi; Seyedin, Hesam; Salehi, Masoud

2014-01-01

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

Financial Management Reforms in the Health Sector: A Comparative Study Between Cash-based and Accrual-based Accounting Systems.

PubMed

Abolhallaje, Masoud; Jafari, Mehdi; Seyedin, Hesam; Salehi, Masoud

2014-10-01

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. The current study aimed to analyze the movement from cash-based to accrual-based accounting in the health sector in Iran. 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. 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. There are advantages in applying accrual-based accounting in the public sector which certainly depends on how this system is implemented in the sector.

Intervention studies on rational use of drugs in public and private sector in Nepal.

PubMed

Kafle, Kumud Kumar; Shrestha, Naveen; Karkee, Shiba Bahadur; Prasad, Radha Raman; Bhuju, Gajendra Bahadur; Das, Prabhakar Lal

2005-06-01

In developing countries, inappropriate, inefficient and ineffective use of pharmaceuticals have resulted into the poor health and medical cares for the community people. For improving the situation, various interventions have been tested and proved effective in different settings. In Nepal also, various strategies have been tested and found effective to improve the prescribing and dispensing practices. This paper has examined the process and results of different studies. The educational intervention, the training has not been effective in improving the prescribing practices but has limited effect on dispensing practices in the public sector. However, it becomes effective in improving prescribing practices if combined with a managerial intervention e.g. peer-group discussion. In private sector, training alone is effective in changing the drug recommendation practices of retailers. But none of interventions have been found to be effective in improving dispensing practices. After examining the effectiveness of different interventions, training combined with peer-group discussion is recommended for piloting in all Primary Health Care (PHC) outlets of a district to improve the prescribing practices. For improving the dispensing practices in both public and private sector, additional studies have to be carried out using different strategies.

The crucial role of the private sector.

PubMed

Barberis, M; Paxman, J M

1986-12-01

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

Public sector refraction and spectacle dispensing in low-resource countries of the Western Pacific.

PubMed

Ramke, Jacqueline; du Toit, Rènée; Palagyi, Anna; Williams, Carmel; Brian, Garry

2008-05-01

Given that uncorrected refractive error is a frequent cause of vision impairment, and that there is a high unmet need for spectacles, an appraisal of public sector arrangements for the correction of refractive error was conducted in eight Pacific Island countries. Mixed methods (questionnaire and semi-structured interviews) were used to collect information from eye care personnel (from Fiji, Papua New Guinea, Solomon Islands, Vanuatu, Cook Islands, Samoa, Tonga and Tuvalu) attending a regional eye health workshop in 2005. Fiji, Tonga and Vanuatu had Vision 2020 eye care plans that included refraction services, but not spectacle provision. There was wide variation in public sector spectacle dispensing services, but, except in Samoa, ready-made spectacles and a full cost recovery pricing strategy were the mainstay. There were no systems for the registration of personnel, nor guidelines for clinical or systems management. The refraction staff to population ratio varied considerably. Solomon Islands, Tuvalu and Vanuatu had the best coverage by services, either fixed or outreach. Most services had little promotional activity or community engagement. To be successful, it would seem that public sector refraction services should answer a real and perceived need, fit within prevailing policy and legislation, value, train, retain and equip employees, be well managed, be accessible and affordable, be responsive to consumers, and provide ongoing good quality outcomes. To this end, a checklist to aid the initiation and maintenance of refraction and spectacle systems in low-resource countries has been constructed.

Mifepristone-misoprostol for menstrual regulation in public sector facilities in Bangladesh.

PubMed

Alam, Anadil; Lotarevich, Tatyana; Das, Tapash R; Reichenbach, Laura; Bracken, Hillary

2018-02-01

To examine the use of mifepristone and misoprostol for menstrual regulation among Bangladeshi women attending public sector facilities. In a prospective study, women (aged ≥18 years) with up to 9 weeks of amenorrhea were enrolled at 24 government health facilities in Bangladesh from November 2012 to June 2015. Paramedics or female welfare visitors provided most menstrual regulation care. Participants took 200 mg mifepristone followed by 800 μg buccal misoprostol after 24 hours, and were asked to return to the clinic 10-14 days later for clinical assessment and an exit interview. The primary outcome was successful evacuation of the uterus without need for surgical intervention. Women who completed follow-up were included in analyses for the primary outcome. Among 1744 enrolled participants, 1738 completed follow-up. Most (1674, 96.3%) had a successful uterine evacuation without the need for surgical intervention. A successful outcome was significantly more common in primary (724/744, 97.3%) and secondary facilities (861/895, 96.2%) than in the specialty hospital (89/99, 89.9%; P<0.001 and P=0.004, respectively). Menstrual regulation with mifepristone and misoprostol can be provided effectively in public sector facilities in Bangladesh. CLINICALTRIALS.GOV: NCT01798017. © 2017 International Federation of Gynecology and Obstetrics.

An Analysis of Three Curriculum Approaches to Teaching English in Public-Sector Schools

ERIC Educational Resources Information Center

Graves, Kathleen; Garton, Sue

2017-01-01

This article explores three current, influential English language teaching (ELT) curriculum approaches to the teaching of English in public-sector schools at the primary and secondary level and how the theory of each approach translates into curriculum practice. These approaches are communicative language teaching (CLT), genre-based pedagogy, and…

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

PubMed

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

2014-07-31

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

Charter School Competition, Organization, and Achievement in Traditional Public Schools

ERIC Educational Resources Information Center

Davis, Tomeka M.

2013-01-01

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…

Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review

PubMed Central

Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

2012-01-01

Introduction Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Methods and Findings Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of “private sector” included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. “Competitive dynamics” for

Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

ERIC Educational Resources Information Center

Beveridge, Scott; Garcia, Jorge; Siblo, Matt

2015-01-01

Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

[The Balanced Scorecard as a management tool in a public health organization].

PubMed

Villalbí, Joan R; Villalbí, Joan; Guix, Joan; Casas, Conrad; Borrell, Carme; Duran, Júlia; Artazcoz, Lucía; Camprubí, Esteve; Cusí, Meritxell; Rodríguez-Montuquín, Pau; Armengol, Josep M; Jiménez, Guy

2007-01-01

The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.

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

ERIC Educational Resources Information Center

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

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

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

PubMed

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

2015-08-01

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

Paradigm shifts and the interplay between state, business and civil sectors.

PubMed

Encarnação, Sara; Santos, Fernando P; Santos, Francisco C; Blass, Vered; Pacheco, Jorge M; Portugali, Juval

2016-12-01

The recent rise of the civil sector as a main player of socio-political actions, next to public and private sectors, has largely increased the complexity underlying the interplay between different sectors of our society. From urban planning to global governance, analysis of these complex interactions requires new mathematical and computational approaches. Here, we develop a novel framework, grounded on evolutionary game theory, to envisage situations in which each of these sectors is confronted with the dilemma of deciding between maintaining a status quo scenario or shifting towards a new paradigm. We consider multisector conflicts regarding environmentally friendly policies as an example of application, but the framework developed here has a considerably broader scope. We show that the public sector is crucial in initiating the shift, and determine explicitly under which conditions the civil sector-reflecting the emergent reality of civil society organizations playing an active role in modern societies-may influence the decision-making processes accruing to other sectors, while fostering new routes towards a paradigm shift of the society as a whole. Our results are shown to be robust to a wide variety of assumptions and model parametrizations.

Paradigm shifts and the interplay between state, business and civil sectors

NASA Astrophysics Data System (ADS)

Encarnação, Sara; Santos, Fernando P.; Santos, Francisco C.; Blass, Vered; Pacheco, Jorge M.; Portugali, Juval

2016-12-01

The recent rise of the civil sector as a main player of socio-political actions, next to public and private sectors, has largely increased the complexity underlying the interplay between different sectors of our society. From urban planning to global governance, analysis of these complex interactions requires new mathematical and computational approaches. Here, we develop a novel framework, grounded on evolutionary game theory, to envisage situations in which each of these sectors is confronted with the dilemma of deciding between maintaining a status quo scenario or shifting towards a new paradigm. We consider multisector conflicts regarding environmentally friendly policies as an example of application, but the framework developed here has a considerably broader scope. We show that the public sector is crucial in initiating the shift, and determine explicitly under which conditions the civil sector-reflecting the emergent reality of civil society organizations playing an active role in modern societies-may influence the decision-making processes accruing to other sectors, while fostering new routes towards a paradigm shift of the society as a whole. Our results are shown to be robust to a wide variety of assumptions and model parametrizations.

Towards a Stakeholder Model for the Co-Production of the Public-Sector Information System

ERIC Educational Resources Information Center

Correia, Zita P.

2005-01-01

Introduction: Proposes a systemic approach to Public Sector Information (PSI), defined as comprising entities in four categories--citizens, businesses, policymakers and administrations. This system also comprises four categories of information--on citizenship, economic and social development, policy and administration. Methods: A selective…

EXAMINING THE DIMENSIONALITY OF COLQUITT'S ORGANIZATIONAL JUSTICE SCALE IN A PUBLIC HEALTH SECTOR CONTEXT.

PubMed

Enoksen, Elisabeth

2015-06-01

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.

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

PubMed

Agha, Sohail; Do, Mai

2008-11-01

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

Effectiveness of Collaborative Care for Depression in Public-Sector Primary Care Clinics Serving Latinos.

PubMed

Lagomasino, Isabel T; Dwight-Johnson, Megan; Green, Jennifer M; Tang, Lingqi; Zhang, Lily; Duan, Naihua; Miranda, Jeanne

2017-04-01

Quality improvement interventions for depression care have been shown to be effective for improving quality of care and depression outcomes in settings with primarily insured patients. The aim of this study was to determine the impact of a collaborative care intervention for depression that was tailored for low-income Latino patients seen in public-sector clinics. A total of 400 depressed patients from three public-sector primary care clinics were enrolled in a randomized controlled trial of a tailored collaborative care intervention versus enhanced usual care. Social workers without previous mental health experience served as depression care specialists for the intervention patients (N=196). Depending on patient preference, they delivered a cognitive-behavioral therapy (CBT) intervention or facilitated antidepressant medication given by primary care providers or both. In enhanced usual care, patients (N=204) received a pamphlet about depression, a letter for their primary care provider stating that they had a positive depression screen, and a list of local mental health resources. Intent-to-treat analyses examined clinical and process-of-care outcomes at 16 weeks. Compared with patients in the enhanced usual care group, patients in the intervention group had significantly improved depression, quality of life, and satisfaction outcomes (p<.001 for all). Intervention patients also had significantly improved quality-of-care indicators, including the proportion of patients receiving either psychotherapy or antidepressant medication (77% versus 21%, p<.001). Collaborative care for depression can greatly improve care and outcomes in public-sector clinics. Social workers without prior mental health experience can effectively provide CBT and manage depression care.

Multi-sectoral action for child safety-a European study exploring implicated sectors.

PubMed

Scholtes, Beatrice; Schröder-Bäck, Peter; Förster, Katharina; MacKay, Morag; Vincenten, Joanne; Brand, Helmut

2017-06-01

Injury to children in Europe, resulting in both death and disability, constitutes a significant burden on individuals, families and society. Inequalities between high and low-income countries are growing. The World Health Organisation Health 2020 strategy calls for inter-sectoral collaboration to address injury in Europe and advocates the whole of government and whole of society approaches to wicked problems. In this study we explore which sectors (e.g. health, transport, education) are relevant for four domains of child safety (intentional injury, water, road and home safety). We used the organigraph methodology, originally developed to demonstrate how organizations work, to describe the governance of child safety interventions. Members of the European Child Safety Alliance, working in the field of child safety in 24 European countries, drew organigraphs of evidence-based interventions. They included the different actors involved and the processes between them. We analyzed the organigraphs by counting the actors presented and categorizing them into sectors using a pre-defined analysis framework. We received 44 organigraphs from participants in 24 countries. Twenty-seven sectors were identified across the four domains. Nine of the 27 identified sectors were classified as 'core sectors' (education, health, home affairs, justice, media, recreation, research, social/welfare services and consumers). This study reveals the multi-sectoral nature of child safety in practice. It provides information for stakeholders working in child safety to help them implement inter-sectoral child safety interventions taking a whole-of-government and whole-of-society approach to health governance. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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

PubMed

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

2008-06-01

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

Job satisfaction and motivation among public sector health workers: evidence from Ethiopia.

PubMed

Hotchkiss, David R; Banteyerga, Hailom; Tharaney, Manisha

2015-10-29

Although human resources for health have received increased attention by health systems decision-makers and researchers in recent years, insufficient attention has been paid to understanding the factors that influence the performance of health workers. This empirical study investigates the factors that are associated with health worker motivation over time among public sector primary health care workers in Ethiopia. The study is based on data from public sector health worker surveys collected through a convenience sample of 43 primary health care facilities in four regions (Addis Ababa, Oromia, Amhara, and Somali) at three points in time: 2003/04, 2006, and 2009. Using a Likert scale, respondents were asked to respond to statements regarding job satisfaction, pride in work, satisfaction with financial rewards, self-efficacy, satisfaction with facility resources, and self-perceived conscientiousness. Inter-reliability of each construct was assessed using Cronbach's alpha, and indices of motivational determinants and outcomes were calculated for each survey round. To explore the associations between motivational determinants and outcomes, bivariate and multivariate regression analyses were carried out based on a pooled dataset. Among the sample public sector health workers, several dimensions of health worker motivation significantly increased over the study period, including two indicators of motivational outcomes-overall job satisfaction and self-perceived conscientiousness-and two indicators of motivational determinants-pride and self-efficacy. However, two other dimensions of motivation-satisfaction with financial rewards and satisfaction with facility resources-significantly decreased. The multivariate analyses found that the constructs of pride, self-efficacy, satisfaction with financial rewards, and satisfaction with facility resources were significantly associated with the motivational outcomes, after controlling for other factors. Overall, the findings

Leadership Strategies of Performance Measures Impacts in Public Sector Management: A National Content Analysis.

ERIC Educational Resources Information Center

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…

Experiences and attitudes towards evidence-informed policy-making among research and policy stakeholders in the Canadian agri-food public health sector.

PubMed

Young, I; Gropp, K; Pintar, K; Waddell, L; Marshall, B; Thomas, K; McEwen, S A; Rajić, A

2014-12-01

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. �

[Transparency in public sector acquisitions. The case of hospitals in the City of Buenos Aires].

PubMed

Rossi, T; Murillo Fort, C; Puente Karolys, J C

2002-01-01

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

ITS standards : lessons learned from deployment : raising ITS standards IQ with a public sector workshop

DOT National Transportation Integrated Search

2000-01-01

This document contains information about a Public Sector Workshop held in Minnesota that focused on increasing the awareness of Intelligent Transportation Systems (ITS) standards. It gives an overview of how the workshop proceeded, which topics were ...

Public Relations and Publicity: Tools and Techniques for Student Organizations.

ERIC Educational Resources Information Center

DeFeo, Carol Jean

Based on the idea that to be successful, a student organization must have a sound public relations and publicity program, this handbook considers techniques of internal communication that establish good public relations with various special groups: the student body, the administration, the faculty, and the staff. The handbook states that…

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka

PubMed Central

Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S.; Tozan, Yeşim

2016-01-01

Background Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. Methods We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health’s perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. Results The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216–609 for pediatric cases and between US$196–866 for adult cases according to disease severity and treatment setting. Conclusions This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka. PMID:26910907

Costs of Dengue Control Activities and Hospitalizations in the Public Health Sector during an Epidemic Year in Urban Sri Lanka.

PubMed

Thalagala, Neil; Tissera, Hasitha; Palihawadana, Paba; Amarasinghe, Ananda; Ambagahawita, Anuradha; Wilder-Smith, Annelies; Shepard, Donald S; Tozan, Yeşim

2016-02-01

Reported as a public health problem since the 1960s in Sri Lanka, dengue has become a high priority disease for public health authorities. The Ministry of Health is responsible for controlling dengue and other disease outbreaks and associated health care. The involvement of large numbers of public health staff in dengue control activities year-round and the provision of free medical care to dengue patients at secondary care hospitals place a formidable financial burden on the public health sector. We estimated the public sector costs of dengue control activities and the direct costs of hospitalizations in Colombo, the most heavily urbanized district in Sri Lanka, during the epidemic year of 2012 from the Ministry of Health's perspective. The financial costs borne by public health agencies and hospitals are collected using cost extraction tools designed specifically for the study and analysed retrospectively using a combination of activity-based and gross costing approaches. The total cost of dengue control and reported hospitalizations was estimated at US$3.45 million (US$1.50 per capita) in Colombo district in 2012. Personnel costs accounted for the largest shares of the total costs of dengue control activities (79%) and hospitalizations (46%). The results indicated a per capita cost of US$0.42 for dengue control activities. The average costs per hospitalization ranged between US$216-609 for pediatric cases and between US$196-866 for adult cases according to disease severity and treatment setting. This analysis is a first attempt to assess the economic burden of dengue response in the public health sector in Sri Lanka. Country-specific evidence is needed for setting public health priorities and deciding about the deployment of existing or new technologies. Our results suggest that dengue poses a major economic burden on the public health sector in Sri Lanka.

Approaches to organizing public relations functions in healthcare.

PubMed

Guy, Bonnie; Williams, David R; Aldridge, Alicia; Roggenkamp, Susan D

2007-01-01

This article provides health care audiences with a framework for understanding different perspectives of the role and functions of public relations in healthcare organizations and the resultant alternatives for organizing and enacting public relations functions. Using an example of a current issue receiving much attention in US healthcare (improving rates of organ donation), the article provides examples of how these different perspectives influence public relations goals and objectives, definitions of 'public', activities undertaken, who undertakes them and where they fit into the organizational hierarchy.

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

PubMed

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

2011-07-01

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

Family planning: pitting the private sector against a public problem.

PubMed

Harvey, P D

1975-01-01

A most promising recent international development has been the harnessing of commercial marketing techniques to promote family planning. Although most projects of this type are government approved and subsidized by international funding organizations, they are a striking departure from traditional government-operated, medically oriented programs. Results have often been dramatic because of certain attributes of the commercial sector, such as 1) marketing, management, finance, distribution, and logistics skills; 2) awareness of and sensitivity to consumers' needs; and 3) the consistent and self-sustaining motivation of profit.

Transition of Higher Education Graduates to the Labour Market: Are Employment Procedures More Meritocratic in the Public Sector?

ERIC Educational Resources Information Center

Berggren, Caroline

2011-01-01

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…

Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

PubMed

Ntuli, Samuel T; Maboya, Edwin

2017-09-27

The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

Factors influencing the retention of midwives in the public sector in Afghanistan: a qualitative assessment of midwives in eight provinces.

PubMed

Wood, Molly E; Mansoor, G Farooq; Hashemy, Pashton; Namey, Emily; Gohar, Fatima; Ayoubi, Saadia Fayeq; Todd, Catherine S

2013-10-01

to examine factors that affect retention of public sector midwives throughout their career in Afghanistan. qualitative assessment using semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs). health clinics in eight provinces in Afghanistan, midwifery education schools in three provinces, and stakeholder organisations in Kabul. purposively sampled midwifery profession stakeholders in Kabul (n=14 IDIs); purposively selected community midwifery students in Kabul (n=3 FGDs), Parwan (n=1 FGD) and Wardak (n=1 FGD) provinces (six participants per FGD); public sector midwives, health facility managers, and community health workers from randomly selected clinics in eight provinces (n=48 IDIs); midwives who had left the public sector midwifery service (n=5 IDIs). several factors affect a midwife throughout her career in the public sector, including her selection as a trainee, the training itself, deployment to her pre-assigned post, and working in clinics. Overall, appropriate selection is the key to ensuring deployment and retention later on in a midwife's career. Other factors that affect retention of midwives include civil security concerns in rural areas, support of family and community, salary levels, professional development opportunities and workplace support, and inefficient human resources planning in the public sector. Factors affecting midwife retention are linked to problems within the community midwifery education (CME) programme and those reflecting the wider Afghan context. Civil insecurity and traditional attitudes towards women were major factors identified that negatively affect midwifery retention. Factors such as civil insecurity and traditional attitudes towards women require a multisectoral response and innovative strategies to reduce their impact. However, factors inherent to midwife career development also impact retention and may be more readily modified. © 2013 Elsevier Ltd. All rights reserved.

Inpatient satisfaction at different public sector hospitals of a metropolitan city in Pakistan: a comparative cross-sectional study.

PubMed

Hussain, Mehwish; Rehman, Rehana; Ikramuddin, Zia; Asad, Nava; Farooq, Ayesha

2018-04-01

To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P < 0.0001). Highest satisfaction with treatment was observed among inpatients of hospital running by medical institute (P < 0.0001). Comparison with respect to different departments revealed significant difference for treatment satisfaction of medicine and surgery units. Patients who were admitted from emergency mode acquired lowest satisfaction in all aspects. Response of inpatients from public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.

Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage.

PubMed

Nandi, Sulakshana; Schneider, Helen; Dixit, Priyanka

2017-01-01

Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India's National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

Scaling-up public sector childhood diarrhea management program: Lessons from Indian states of Gujarat, Uttar Pradesh and Bihar.

PubMed

Kumar, Sanjeev; Roy, Rajashree; Dutta, Sucharita

2015-12-01

Diarrhea remains a leading cause of death among children under five in India. Public health sector is an important source for diarrhea treatment with oral rehydration salts (ORS) and zinc. In 2010, Micronutrient Initiative started a project to improve service delivery for childhood diarrhea management through public health sector in Gujarat, Uttar Pradesh (UP) and Bihar. This paper aims to highlight feasible strategies, experiences and lessons learned from scaling-up zinc and ORS for childhood diarrhea management in the public sector in three Indian states. The project was implemented in six districts of Gujarat, 12 districts of UP and 15 districts of Bihar, which includes 10.5 million children. Program strategies included capacity building of health care providers, expanding service delivery through community health workers (CHWs), providing supportive supervision to CHWs, ensuring supplies and conducting monitoring and evaluation. The lessons described in this paper are based on program data, government documents and studies that were used to generate evidence and inform program scale-up. 140 000 health personnel, including CHWs, were trained in childhood diarrhea management. During three years, CHWs had sustained knowledge and have treated and reported more than three million children aged 2-59 months having diarrhea, of which 84% were treated with both zinc and ORS. The successful strategies were scaled-up. It is feasible and viable to introduce and scale-up zinc and ORS for childhood diarrhea treatment through public sector. Community-based service delivery, timely and adequate supplies, trained staff and pro-active engagement with government were essential for program success.

Quantity and quality of information, education and communication during antenatal visit at private and public sector hospitals of Bahawalpur, Pakistan.

PubMed

Mahar, Benazeer; Kumar, Ramesh; Rizvi, Narjis; Bahalkani, Habib Akhtar; Haq, Mahboobul; Soomro, Jamila

2012-01-01

Information, education and communication (IEC) by health care provider to pregnant woman during the antenatal visit are very crucial for healthier outcome of pregnancy. This study analysed the quality and quantity of antenatal visit at a private and a public hospital of Bahawalpur, Pakistan. An exit interview was conducted from 216 pregnant women by using validated, reliable and pre-tested adapted questionnaire. First sample was selected by simple random sampling, for rest of the sample selection systematic random sampling was adapted by selecting every 7th women for interview. Ethical considerations were taken. Average communication time among pregnant woman and her healthcare provider was 3 minute in public and 8 minutes in private hospital. IEC mainly focused on diet and nutrition in private (86%) and (53%) public, advice for family planning after delivery was discussed with 13% versus 7% in public and private setting. None of the respondents in both facilities got advice or counselling on breastfeeding and neonatal care. Birth preparedness components were discussed, woman in public and private hospital respectively. In both settings antenatal clients were not received information and education communication according to World Health Organization guidelines. Quality and quantity of IEC during antenatal care was found very poor in both public and private sector hospitals of urban Pakistan.

Entrepreneurial Mindset in Department of Defense (DoD) Organizations: Antecedents and Outcomes

DTIC Science & Technology

2004-03-01

60 Appendix: Entrepreneurship in DoD...of behaviors based on their experience as entrepreneurs, scholars in the fields of entrepreneurship and strategic management, and consultants 2...public sector organizations; especially within DoD. Research on public sector entrepreneurship has included examinations of inventors in national

Enabling private and public sector organizations as agents of homeland security

NASA Astrophysics Data System (ADS)

Glassco, David H. J.; Glassco, Jordan C.

2006-05-01

Homeland security and defense applications seek to reduce the risk of undesirable eventualities across physical space in real-time. With that functional requirement in mind, our work focused on the development of IP based agent telecommunication solutions for heterogeneous sensor / robotic intelligent "Things" that could be deployed across the internet. This paper explains how multi-organization information and device sharing alliances may be formed to enable organizations to act as agents of homeland security (in addition to other uses). Topics include: (i) using location-aware, agent based, real-time information sharing systems to integrate business systems, mobile devices, sensor and actuator based devices and embedded devices used in physical infrastructure assets, equipment and other man-made "Things"; (ii) organization-centric real-time information sharing spaces using on-demand XML schema formatted networks; (iii) object-oriented XML serialization as a methodology for heterogeneous device glue code; (iv) how complex requirements for inter / intra organization information and device ownership and sharing, security and access control, mobility and remote communication service, tailored solution life cycle management, service QoS, service and geographic scalability and the projection of remote physical presence (through sensing and robotics) and remote informational presence (knowledge of what is going elsewhere) can be more easily supported through feature inheritance with a rapid agent system development methodology; (v) how remote object identification and tracking can be supported across large areas; (vi) how agent synergy may be leveraged with analytics to complement heterogeneous device networks.

Availability of medicines in public sector health facilities of two North Indian States.

PubMed

Prinja, Shankar; Bahuguna, Pankaj; Tripathy, Jaya Prasad; Kumar, Rajesh

2015-12-23

Access to free essential medicines is a critical component of universal health coverage. However availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. We undertook this study to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities. The present study was carried out in 80 public health facilities across 12 districts in Haryana and Punjab states. Overall, within each state 1 MC, 6 DHs, 11 CHCs and 22 PHCs were selected for the study. Drug procurement mechanisms in both the states were studied through document reviews and in-depth interviews with key stakeholders. Stock registers were reviewed to collect data on availability of a basket of essential medicines -92 at Primary Health Centre (PHC) level, 132 at Community Health Centre (CHC) level and 160 at tertiary care (District Hospital/Medical College) level. These essential medicines were selected based on the Essential Medicine List (EML) of the Department of Health (DOH). Overall availability of medicines was 45.2% and 51.1% in Punjab and Haryana respectively. Availability of anti-hypertensives was around 60% in both the states whereas for anti-diabetics it was 44% and 47% in Punjab and Haryana respectively. Atleast one drug in each of the categories including analgesic/antipyretic, anti-helminthic, anti-spasmodic, anti-emetic, anti-hypertensive and uterotonics were nearly universally available in public sector facilities. On the contrary, medicines such as thrombolytics, anti-cancer and endocrine medicines were available in less

Scope of Public Sector Bargaining in 14 Selected States. Special Report 25. Update.

ERIC Educational Resources Information Center

Academic Collective Bargaining Information Service, Washington, DC.

As faculty and other public sector unions become more sophisticated in collective bargaining, they tend to lay a greater variety of demands on the table. This, in turn, forces the employer to ask, Do I really have to bargain about these subjects? As more employers refuse to bargain, more unions charge them with failing to bargain in good faith,…

Arrival and Departure Patterns of Public Sector Employees before and after Implementation of Flexitime.

ERIC Educational Resources Information Center

Ronen, Simcha

1981-01-01

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)

Do doctors have a moral duty to work in the public health sector? Ethical considerations regarding the social obligations of medicine.

PubMed

Aguilera Dreyse, Bernardo; López Gaete, Gonzalo

2017-12-22

This article discusses whether physicians have social obligations and whether these obligations imply a moral duty to work in the public sector. The article focuses on the context of the Chilean health system, which has an unequal distribution of physicians to the detriment of the public sector, thus making the issue a particularly pressing one. After addressing arguments from different ethical theories and some empirical evidence, the article concludes that the physician has some social obligations in relation to a fair distribution of health resources, and that professional excellence should incorporate cultivating virtues related to social justice. In addition, it is argued that the moral duty to work in the public sector can be placed in the context of prima facie obligations which admit exceptions and allow the possibility of conflict with other professional obligations.

One-year assessment of joint procurement of pharmaceuticals in the public health sector in Jordan.

PubMed

Al-Abbadi, Ibrahim; Qawwas, Abdelraouf; Jaafreh, Mahmoud; Abosamen, Taher; Saket, Maisa

2009-06-01

About 10% of the gross domestic product in Jordan is spent on health care, and almost one third of that is spent on pharmaceuticals. The public health sector in Jordan has 4 main governmental parties that purchase medicines independently through annual tenders (ie, the process of bidding, being awarded, ordering, paying for, and receiving drugs) issued in the generic (or scientific) name of the medicines or therapeutic groups. Double purchasing is a problem that leads to higher spending on drugs and poor availability of medicines throughout the year. To remedy this problem, a joint procurement process was established in Jordan in 2004 and went into practice in 2006. The aim of this research was to assess the first year of purchasing pharmaceuticals in the public health sector in Jordan through the joint procurement process for the 4 participating parties in comparison with purchasing pharmaceuticals independently before the institution of joint procurement. The first tender under the joint procurement process was issued in 2007 for antibiotics, anti-HIV medications, and antituberculosis agents, which represent 15% of the annual pharmaceutical public-sector purchases in Jordan. A research committee solicited lists of purchased quantities and final purchase prices of these pharmaceuticals obtained in 2006 by each participating group and in 2007 through the joint procurement process. The quantity-comparison method was used to compare the costs of drugs purchased in 2006 and 2007, and estimated cost savings were calculated for each product for each party for 2006 and 2007 under the assumption that the same quantities purchased by each participating party in 2006 would be purchased through joint procurement (prices of 2007). Purchasing through the joint procurement process achieved an estimated savings of 2.4%. This savings increased to 8.9% after excluding 1 item (a cephalosporin), the raw material price of which increased markedly in 2007 compared with 2006 because of

[Orientation of patients referred by their general practionner to the public or private hospital sector in France: A prospective epidemiologic study].

PubMed

Reuter, P-G; Kernéis, S; Turbelin, C; Souty, C; Arena, C; Gavazzi, G; Sarazin, M; Blanchon, T; Hanslik, T

2012-12-01

In-patients characteristics generate cost differences between hospitals. In France, there are few data on the characteristics on the patients referred to hospitals by their general practitioners (GPs) and none on the predictors of referral to the public or for-profit hospitals. The aim of this study was to analyze those characteristics and the predictors of referral to the public or for-profit hospitals. We collected, prospectively, the request for hospitalizations made by the GPs of the Sentinelles network in France, from 2007 to 2009. Patients' characteristics and also the reasons for that request were analyzed. A logistic regression was used to compare the population between local hospitals. Ten thousand seven hundred and eighteen statements were collected. The median age was 73 years. Patients were women in 51% of the cases, and only 14% of the hospitalizations had been planned. Hospitalization in the public sector was preferred for young children and the elderly (P<0.001). When compared to the patients referred to the private sector, patients addressed to the public sector were more often seen for emergencies (OR: 2.3 [2.0-2.8]), by a doctor different from their referring GP (OR: 1.7 [1.4-2.1]) and out of the GP's office. The reasons for hospital admission were different depending on the sector of hospitalization (P<0.001), patients addressed to the public sector hospitals presented with greater comorbidity or more complex diagnosis (for example: feeling ill, fainting or syncope and fever) or a greater disability (for example: stroke, neurological and psychiatric diseases). This study suggests that GPs send their patients to the public or for-profit hospitals according to criteria of severity, comorbidity and disability. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Scaling up the health workforce in the public sector: the role of government fiscal policy.

PubMed

Vujicic, Marko

2010-01-01

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.

[Public sector participation in the supply of dyslipidemia medication in a population-based study].

PubMed

Petris, Airton José; Souza, Regina Kazue Tanno de; Bortoletto, Maira Sayuri Sakay

2016-12-01

The use of medications for the treatment of dyslipidemia is relevant in the control of cardiovascular disease. This article aims to analyze the prevalence, the use and the participation of the public sector in the supply of medication for adults aged 40 years and above using pharmacotherapy for dyslipidemia control living in a city in the southern region of Brazil. A cross-sectional, population-based study was conducted. Household interviews were staged with 1180 individuals aged over 40 living in Cambé, State of Paraná, of which 967 took laboratory examinations. The prevalence of dyslipidemia was 69.2%, of which 16.1% were taking medication. Among individuals undergoing treatment for dyslipidemia, 22.2% had adequate test results. Lipid-lowering medication used were simvastatin (81.5%) and bezafibrate (6.5%), mainly obtained by direct payment to private pharmacies and drug stores (52.2%) and NHS services (33.6%). A high prevalence of dyslipidemias was observed in population terms, together with a low level of dyslipidemia control and low participation of the public sector regarding the supply of medication compared to acquisition through direct payment for medication in private pharmacies. These results suggest a limited range of public policy for control of dyslipidemia.

Health worker (internal customer) satisfaction and motivation in the public sector in Ghana.

PubMed

Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana

2004-01-01

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.

Unemployment, public-sector healthcare spending and stomach cancer mortality in the European Union, 1981-2009.

PubMed

Maruthappu, Mahiben; Painter, Annabelle; Watkins, Johnathan; Williams, Callum; Ali, Raghib; Zeltner, Thomas; Faiz, Omar; Sheth, Hemant

2014-11-01

We sought to determine the association between changes in unemployment, healthcare spending and stomach cancer mortality. Multivariate regression analysis was used to assess how changes in unemployment and public-sector expenditure on healthcare (PSEH) varied with stomach cancer mortality in 25 member states of the European Union from 1981 to 2009. Country-specific differences in healthcare infrastructure and demographics were controlled for 1- to 5-year time-lag analyses and robustness checks were carried out. A 1% increase in unemployment was associated with a significant increase in stomach cancer mortality in both men and women [men: coefficient (R)=0.1080, 95% confidence interval (CI)=0.0470-0.1690, P=0.0006; women: R=0.0488, 95% CI=0.0168-0.0809, P=0.0029]. A 1% increase in PSEH was associated with a significant decrease in stomach cancer mortality (men: R=-0.0009, 95% CI=-0.0013 to -0.005, P<0.0001; women: R=-0.0004, 95% CI=-0.0007 to -0.0001, P=0.0054). The associations remained when economic factors, urbanization, nutrition and alcohol intake were controlled for, but not when healthcare resources were controlled for. Time-lag analysis showed that the largest changes in mortality occurred 3-4 years after any changes in either unemployment or PSEH. Increases in unemployment are associated with a significant increase in stomach cancer mortality. Stomach cancer mortality is also affected by public-sector healthcare spending. Initiatives that bolster employment and maintain public-sector healthcare expenditure may help to minimize increases in stomach cancer mortality during economic downturns.

Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health coverage

PubMed Central

Schneider, Helen; Dixit, Priyanka

2017-01-01

Research on impact of publicly financed health insurance has paid relatively little attention to the nature of healthcare provision the schemes engage. India’s National Health Insurance Scheme or RSBY was made universal by Chhattisgarh State in 2012. In the State, public and private sectors provide hospital services in a context of extensive gender, social, economic and geographical inequities. This study examined enrolment, utilization (public and private) and out of pocket (OOP) expenditure for the insured and uninsured, in Chhattisgarh. The Chhattisgarh State Central sample (n = 6026 members) of the 2014 National Sample Survey (71st Round) on Health was extracted and analyzed. Variables of enrolment, hospitalization, out of pocket (OOP) expenditure and catastrophic expenditure were descriptively analyzed. Multivariate analyses of factors associated with enrolment, hospitalization (by sector) and OOP expenditure were conducted, taking into account gender, socio-economic status, residence, type of facility and ailment. Insurance coverage was 38.8%. Rates of hospitalization were 33/1000 population among the insured and 29/1000 among the uninsured. Of those insured and hospitalized, 67.2% utilized the public sector. Women, rural residents, Scheduled Tribes and poorer groups were more likely to utilize the public sector for hospitalizations. Although the insured were less likely to incur out of pocket (OOP) expenditure, 95.1% of insured private sector users and 66.0% of insured public sector users, still incurred costs. Median OOP payments in the private sector were eight times those in the public sector. Of households with at least one member hospitalized, 35.5% experienced catastrophic health expenditures (>10% monthly household consumption expenditure). The study finds that despite insurance coverage, the majority still incurred OOP expenditure. The public sector was nevertheless less expensive, and catered to the more vulnerable groups. It suggests the need to

The Danish Organic Action Plan 2020: assessment method and baseline status of organic procurement in public kitchens.

PubMed

Sørensen, Nina N; Lassen, Anne D; Løje, Hanne; Tetens, Inge

2015-09-01

With political support from the Danish Organic Action Plan 2020, organic public procurement in Denmark is expected to increase. In order to evaluate changes in organic food procurement in Danish public kitchens, reliable methods are needed. The present study aimed to compare organic food procurement measurements by two methods and to collect and discuss baseline organic food procurement measurements from public kitchens participating in the Danish Organic Action Plan 2020. Comparison study measuring organic food procurement by applying two different methods, one based on the use of procurement invoices (the Organic Cuisine Label method) and the other on self-reported procurement (the Dogme method). Baseline organic food procurement status was based on organic food procurement measurements and background information from public kitchens. Public kitchens participating in the six organic food conversion projects funded by the Danish Organic Action Plan 2020 during 2012 and 2013. Twenty-six public kitchens (comparison study) and 345 public kitchens (baseline organic food procurement status). A high significant correlation coefficient was found between the two organic food procurement measurement methods (r=0·83, P<0·001) with measurements relevant for the baseline status. Mean baseline organic food procurement was found to be 24 % when including measurements from both methods. The results indicate that organic food procurement measurements by both methods were valid for the baseline status report of the Danish Organic Action Plan 2020. Baseline results in Danish public kitchens suggest there is room for more organic as well as sustainable public procurement in Denmark.

Workplace romance in the public sector: sex differences in reactions to the Clinton-Lewinsky affair.

PubMed

Powell, G N

2000-12-01

This study examined reactions of part-time MBA students (n = 199) and undergraduate business students (n = 220) to the affair involving U.S. President Bill Clinton and White House intern Monica Lewinsky prior to Clinton's impeachment by the House of Representatives. Consistent with research on attitudes toward workplace romance in the private sector, women believed that this affair occurring in the public sector represented a more serious problem for the nation and more than men were inclined to prefer that some type of action, e.g., resignation or impeachment, be taken. Implications of the results are discussed.

Rise in cesarean section rate over a 20-year period in a public sector hospital in northern Thailand.

PubMed

Charoenboon, Chitrakan; Srisupundit, Kasemsri; Tongsong, Theera

2013-01-01

To determine a trend of cesarean section rate (CSR) and main contributing factors in a public sector hospital, representing northern part of Thailand. A retrospective descriptive analysis was conducted by assessing the database of maternal-fetal medicine unit, which had prospectively been collected for 20 years. Trends were evaluated using data for the years 1992-2011. Private sector patients were excluded. A total of 50,872 public sector patients were available for analysis. The number of deliveries was gradually decreased from 3,802 in 1992 to 1,748 in 2011. Of them, 7,480 underwent cesarean section, CSR of 14.7 %. However, the CSR was significantly increased from 11.3 % in 1992 to 23.6 % in 2011 (p value <0.001). The CSRs indicated by cephalopelvic disproportion (CPD) and previous CSs were mainly responsible for a marked increase over the study period. CSR due to CPD was increased from 3.2 % in 1992 to 7.9 % in 2011 (p value <0.0001). While CSR due to other indications either breech presentation, fetal distress and twin pregnancies were only slightly, but significantly increased in the last decades but they are relatively constant in the recent years. In our public sector, CSR has gradually increased. The main reasons of such an increase were likely to be associated with over-diagnosis of CPD and subsequent repeated CS, while other indications played only a minimal role. To achieve the appropriate CSR, audit system for diagnosis of CPD must be instituted.

Educational Management Organizations as High Reliability Organizations: A Study of Victory's Philadelphia High School Reform Work

ERIC Educational Resources Information Center

Thomas, David E.

2013-01-01

This executive position paper proposes recommendations for designing reform models between public and private sectors dedicated to improving school reform work in low performing urban high schools. It reviews scholarly research about for-profit educational management organizations, high reliability organizations, American high school reform, and…

Organization Development and Change in Universities

ERIC Educational Resources Information Center

Torraco, Richard J.; Hoover, Richard E.; Knippelmeyer, Sheri A.

2005-01-01

Organization development is an approach to planned change that is used in the private, public, and nonprofit sectors. However, relatively little is known about OD in universities. This paper examines the challenges associated with the use of OD in universities that may not be present in the private sector and other non-university settings. Five…

Indian medical students in public and private sector medical schools: are motivations and career aspirations different? - studies from Madhya Pradesh, India.

PubMed

Diwan, Vishal; Minj, Christie; Chhari, Neeraj; De Costa, Ayesha

2013-09-15

In recent years, there has been a massive growth in the private medical education sector in South Asia. India's large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions.

Cost and affordability of non-communicable disease screening, diagnosis and treatment in Kenya: Patient payments in the private and public sectors

PubMed Central

Gakunga, Robai; Kibachio, Joseph; Gathecha, Gladwell; Edwards, Patrick; Ogola, Elijah; Yonga, Gerald; Busakhala, Naftali; Munyoro, Esther; Chakaya, Jeremiah; Ngugi, Nancy; Mwangi, Nyawira; Von Rege, Daniel; Wangari, Lili-Marie; Wata, David; Makori, Robert; Mwangi, Julius; Mwanda, Walter

2018-01-01

Introduction The prevalence of non-communicable diseases (NCDs) is rising in low- and middle-income countries, including Kenya, disproportionately to the rest of the world. Our objective was to quantify patient payments to obtain NCD screening, diagnosis, and treatment services in the public and private sector in Kenya and evaluate patients’ ability to pay for the services. Methods and findings We collected payment data on cardiovascular diseases, diabetes, breast and cervical cancer, and respiratory diseases from Kenyatta National Hospital, the main tertiary public hospital, and the Kibera South Health Center—a public outpatient facility, and private sector practitioners and hospitals. We developed detailed treatment frameworks for each NCD and used an itemization cost approach to estimate payments. Patient affordability metrics were derived from Kenyan government surveys and national datasets. Results compare public and private costs in U.S. dollars. NCD screening costs ranged from $4 to $36, while diagnostic procedures, particularly for breast and cervical cancer, were substantially more expensive. Annual hypertension medication costs ranged from $26 to $234 and $418 to $987 in public and private facilities, respectively. Stroke admissions ($1,874 versus $16,711) and dialysis for chronic kidney disease ($5,338 versus $11,024) were among the most expensive treatments. Cervical and breast cancer treatment cost for stage III (curative approach) was about $1,500 in public facilities and more than $7,500 in the private facilities. A large proportion of Kenyans aged 15 to 49 years do not have health insurance, which makes NCD services unaffordable for most people given the overall high cost of services relative to income (average household expenditure per adult is $413 per annum). Conclusions There is substantial variation in patient costs between the public and private sectors. Most NCD diagnosis and treatment costs, even in the public sector, represent a

Information technology systems in public sector health facilities in developing countries: the case of South Africa

PubMed Central

2013-01-01

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

Information technology systems in public sector health facilities in developing countries: the case of South Africa.

PubMed

Cline, Gregory B; Luiz, John M

2013-01-24

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. 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. 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. 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.

Ethical controversies in public solicitations for organs.

PubMed

Wright, Linda

2008-07-01

The increased shortage of organs for transplantation has led to a widening of the living donor pool and to innovations in how and where people seek living donors. Transplant programs are being asked to reconsider practice in light of new situations. Public solicitations for organs have grown as people have become more desperate to find organs. The expansion of the media, particularly the Internet, into our everyday lives has offered an additional method for the dissemination of information and requests for organs. This article discusses public solicitations from living kidney donors, examines the ethical issues therein, and makes suggestions as to how transplant teams might consider addressing this issue.

Robotic and open radical prostatectomy in the public health sector: cost comparison.

PubMed

Hall, Rohan Matthew; Linklater, Nicholas; Coughlin, Geoff

2014-06-01

During 2008, the Royal Brisbane and Women's Hospital became the first public hospital in Australia to have a da Vinci Surgical Robot purchased by government funding. The cost of performing robotic surgery in the public sector is a contentious issue. This study is a single centre, cost analysis comparing open radical prostatectomy (RRP) and robotic-assisted radical prostatectomy (RALP) based on the newly introduced pure case-mix funding model. A retrospective chart review was performed for the first 100 RALPs and the previous 100 RRPs. Estimates of tangible costing and funding were generated for each admission and readmission, using the Royal Brisbane Hospital Transition II database, based on pure case-mix funding. The average cost for admission for RRP was A$13 605, compared to A$17 582 for the RALP. The average funding received for a RRP was A$11 781 compared to A$5496 for a RALP based on the newly introduced case-mix model. The average length of stay for RRP was 4.4 days (2-14) and for RALP, 1.2 days (1-4). The total cost of readmissions for RRP patients was A$70 487, compared to that of the RALP patients, A$7160. These were funded at A$55 639 and A$7624, respectively. RALP has shown a significant advantage with respect to length of stay and readmission rate. Based on the case-mix funding model RALP is poorly funded compared to its open equivalent. Queensland Health needs to plan on how robotic surgery is implemented and assess whether this technology is truly affordable in the public sector. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

Organizational factors influencing successful primary care and public health collaboration.

PubMed

Valaitis, Ruta; Meagher-Stewart, Donna; Martin-Misener, Ruth; Wong, Sabrina T; MacDonald, Marjorie; O'Mara, Linda

2018-06-07

Public health and primary care are distinct sectors within western health care systems. Within each sector, work is carried out in the context of organizations, for example, public health units and primary care clinics. Building on a scoping literature review, our study aimed to identify the influencing factors within these organizations that affect the ability of these health care sectors to collaborate with one another in the Canadian context. Relationships between these factors were also explored. We conducted an interpretive descriptive qualitative study involving in-depth interviews with 74 key informants from three provinces, one each in western, central and eastern Canada, and others representing national organizations, government, or associations. The sample included policy makers, managers, and direct service providers in public health and primary care. Seven major organizational influencing factors on collaboration were identified: 1) Clear Mandates, Vision, and Goals; 2) Strategic Coordination and Communication Mechanisms between Partners; 3) Formal Organizational Leaders as Collaborative Champions; 4) Collaborative Organizational Culture; 5) Optimal Use of Resources; 6) Optimal Use of Human Resources; and 7) Collaborative Approaches to Programs and Services Delivery. While each influencing factor was distinct, the many interactions among these influences are indicative of the complex nature of public health and primary care collaboration. These results can be useful for those working to set up new or maintain existing collaborations with public health and primary care which may or may not include other organizations.

Compensating wage differentials and the impact of health insurance in the public sector on wages and hours.

PubMed

Qin, Paige; Chernew, Michael

2014-12-01

This paper examines the trade-off between wages and employer spending on health insurance for public sector workers, and the relationship between coverage and hours worked. Our primary approach compares trends in wages and hours for public employees with and without state/local government provided health insurance using individual-level micro-data from the 1992-2011 CPS. To adjust for differences between insured and uninsured public sector employees, we create a matched sample based on an employee's propensity to receive health insurance. We assess the relationship between state contribution to the health plan premium, state-level healthcare spending, and the wages and hours of state and local government employees. We find modest reductions in wages are associated with having employer-sponsored health insurance (ESHI), although this effect is not precisely measured. The reduction in wages associated with having ESHI is larger among non-unionized workers. Further, we find little evidence that provision of health insurance increases hours worked. Copyright © 2014 Elsevier B.V. All rights reserved.

Organization of work in the agricultural, forestry, and fishing sector in the US southeast: implications for immigrant workers' occupational safety and health.

PubMed

Grzywacz, Joseph G; Lipscomb, Hester J; Casanova, Vanessa; Neis, Barbara; Fraser, Clermont; Monaghan, Paul; Vallejos, Quirina M

2013-08-01

There is widespread agreement that work organization is an important element of occupational safety and health, but the health effects of many aspects of work organization are likely to vary considerably across different sectors of work and geographies. We examined existing employment policies and work organization-related research relevant specifically to immigrant workers in the Agriculture, Forestry, and Fishing (AgFF) Sector of the US workforce focusing, when possible, on the southeastern US. A number of specific aspects of work organization within AgFF subsectors have been described, but most of this literature exists outside the purview of occupational health. There are few studies that directly examine how attributes of work organization relevant to the AgFF Sector affect workers', much less immigrant workers', occupational health exposures and outcomes. In contrast to the broader literature, research linking occupational health outcomes to work organization in the AgFF Sector is limited and weak. A systematic program of research and intervention is needed to develop strategies that eliminate or substantially mitigate the deleterious health effects of occupational exposures whose origins likely lie in the organization of AgFF work. Copyright © 2013 Wiley Periodicals, Inc.

Public-Private Partnerships in China’s Urban Water Sector

PubMed Central

Mol, Arthur P. J.; Fu, Tao

2008-01-01

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

Factors influencing the adoption of a healthy eating campaign by federal cross-sector partners: a qualitative study.

PubMed

Fernandez, Melissa Anne; Desroches, Sophie; Turcotte, Mylène; Marquis, Marie; Dufour, Joëlle; Provencher, Véronique

2016-08-30

The Eat Well Campaign (EWC) was a social marketing campaign developed by Health Canada and disseminated to the public with the help of cross-sector partners. The purpose of this study was to describe factors that influenced cross-sector partners' decision to adopt the EWC. Thematic content analysis, based primarily on an a priori codebook of constructs from Roger's diffusion of innovations decision process model, was conducted on hour-long semi-structured telephone interviews with Health Canada's cross-sector partners (n = 18). Dominant themes influencing cross-sector partners' decision to adopt the EWC were: high compatibility with the organization's values; being associated with Health Canada; and low perceived complexity of activities. Several adopters indicated that social norms (e.g., knowing that other organizations in their network were involved in the collaboration) played a strong role in their decision to participate, particularly for food retailers and small organizations. The opportunity itself to work in partnership with Health Canada and other organizations was seen as a prominent relative advantage by many organizations. Adopters were characterized as having high social participation and positive attitudes towards health, new ideas and Health Canada. The lack of exposure to the mass media channels used to diffuse the campaign and reserved attitudes towards Health Canada were prominent obstacles identified by a minority of health organizations, which challenged the decision to adopt the EWC. Most other barriers were considered as minor challenges and did not appear to impede the adoption process. Understanding factors that influence cross-sector adoption of nutrition initiatives can help decision makers target the most appropriate partners to advance public health objectives. Government health agencies are likely to find strong partners in organizations that share the same values as the initiative, have positive attitudes towards health, are

African American Patients Seeking Treatment in the Public Sector: Characteristics of Buprenorphine v. Methadone Patients

PubMed Central

Mitchell, Shannon Gwin; Kelly, Sharon M.; Gryczynski, Jan; Myers, C. Patrick; Jaffe, Jerome H.; O’Grady, Kevin E.; Olsen, Yngvild K.; Schwartz, Robert P.

2011-01-01

Background To expand its public-sector treatment capacity, Baltimore City made buprenorphine treatment accessible to low-income, largely African American residents. This study compares the characteristics of patients entering methadone treatment v. buprenorphine treatment to determine whether BT was attracting different types of patients. Methods Participants consisted of two samples of adult heroin-dependent African Americans. The first sample was newly-admitted to a health center or a mental health center providing buprenorphine (N=200), and the second sample was newly-admitted to one of two hospital-based methadone programs (N=178). The Addiction Severity Index (ASI) and the Friends Supplemental Questionnaire were administered at treatment entry and data were analyzed with logistic regression. Results BT participants were more likely to be female (p=.017) and less likely to inject (p=.001). Participants with only prior buprenorphine treatment experience were nearly five time more likely to enter buprenorphine than methadone treatment (p<.001). Those with experience with both treatments were more than twice as likely to enter BT (OR=2.7, 95% CI=1.11–6.62; p=.028). In the 30 days prior to treatment entry, BT participants reported more days of medical problems (p=.002) and depression (p=.044), and were more likely to endorse a lifetime history of depression (p<.001). Conclusion Methadone and buprenorphine treatment provided in the public sector may attract different patient subpopulations. Providing buprenorphine treatment through drug treatment programs co-located with a health and mental health center may have accounted for their higher rates of medical and psychiatric problems and appears to be useful in attracting a diverse group of patients into public-sector funded treatment. PMID:21962726

Psychoemotional stress of employees and workers in the public and real sectors of national economy in Bulgaria.

PubMed

Hristov, Zheliazko I

2009-01-01

Stress is a universal biologically based phenomenon that places adaptive demands on the changes in the environment. It is a set of non-specific mental, physiologic and behavioural responses of a human being to the impact of environmental stimuli. The effect of many of these environmental stimuli in Bulgaria has been intensified by the recent drastic changes (political, social, professional, and in the labour market). The severity and manifestation of stress changed as a result. To assess and measure these changes we conducted a nationwide study applying original methodological approach and using original quantitation parameters. To determine the type, duration and level (intensity) of stress; we attempted to determine the factors causing stress in seven major professions in the public and real sectors of economy. We studied stress and the factors causing it in a nationwide representative study which included 4892 employees and workers practicing seven different professions (physicians, teachers, office workers, miners, public transport drivers, metal workers, and train drivers). A battery of survey methods and original statistical and mathematical methods (including the method of weighted mean intensity of action and manifestation) were employed in the study to determine the type, manifestations, intensity and duration of stress and the stressogenic factors causing it. We found that 70.7% of the workers and employees exhibited symptoms of affective stress and 25.7%--of depressive stress. Affective stress was the most common type of stress in office workers (76.9%) and drivers (73.5%), and the least common--in physicians (65.9%) and teachers (63.3%). The level of stress was high and very high for 25.3% of the study contingent. Affective stress had the highest intensity in miners (0.5226) and drivers (0.4654), and the lowest - in physicians (0.3072). Affective stress was a permanent state in 24.12% of the people working in the public sector and 16.37% of those in the

Strengthening of partnerships between the public sector and faith-based groups.

PubMed

Duff, Jean F; Buckingham, Warren W

2015-10-31

The sharpening focus on global health and the growing recognition of the capacities and scope of faith-based groups for improving community health outcomes suggest an intentional and systematic approach to forging strong, sustained partnerships between public sector agencies and faith-based organisations. Drawing from both development and faith perspectives, this Series paper examines trends that could ground powerful, more sustainable partnerships and identifies new opportunities for collaboration based on respective strengths and existing models. This paper concludes with five areas of recommendations for more effective collaboration to achieve health goals. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

ERIC Educational Resources Information Center

Scanlan, Martin; Tichy, Karen

2014-01-01

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

Advancing the business creed? The framing of decisions about public sector managed care.

PubMed

Waitzkin, Howard; Yager, Joel; Santos, Richard

2012-01-01

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. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

A Guide to the Changing Court Rulings on Union Security in the Public Sector: An Introduction.

ERIC Educational Resources Information Center

Jascourt, Hugh D.

1985-01-01

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)

Crossing the public-private sector divide with reproductive health in Cambodia: out-patient services in a local NGO and the national MCH clinic.

PubMed

Huff-Rousselle, M; Pickering, H

2001-01-01

Set within the context of recent literature on the private-public divide in the health sector of developing countries generally and Asia specifically, this study considers the major government and the major indigenous non-government clinics offering out-patient reproductive health services in Phnom Penh, Cambodia. Reproductive health is of critical importance in Cambodia, which has one of the highest levels of unmet need for family planning in the developing world and suffers from what is arguably the most severe STD and HIV/AIDS problem in Asia. The study is unusual in that it examines and compares aspects of service delivery and pricing along with the socio-economic profile and health-seeking behaviour of clients self-selecting services in the two settings. The socio-economic status of clients was much higher than the norm in Cambodia but did not differ significantly between the two clinics. A few service indicators suggested that the quality of care was better in the NGO clinic. Underlying variables--such as the broader mandate of the public sector institution and the significant discrepancy between public and private sector salaries--offer an obvious explanation for these differences. The Ministry of Health in Cambodia has been developing policies related to the NGO sector, which has expanded rapidly in Cambodia during the 1990s, and it is struggling to increase staff remuneration within the public sector.

Does hospital ownership affect patient experience? An investigation into public-private sector differences in England.

PubMed

Pérotin, Virginie; Zamora, Bernarda; Reeves, Rachel; Bartlett, Will; Allen, Pauline

2013-05-01

Using patient experience survey data, the paper investigates whether hospital ownership affects the level of quality reported by patients whose care is funded by the National Health Service in areas other than clinical quality. We estimate a switching regression model that accounts for (i) some observable characteristics of the patient and the hospital episode; (ii) selection into private hospitals; and (iii) unmeasured hospital characteristics captured by hospital fixed effects. We find that the experience reported by patients in public and private hospitals is different, i.e. most dimensions of quality are delivered differently by the two types of hospitals, with each sector offering greater quality in certain specialties or to certain groups of patients. However, the sum of all ownership effects is not statistically different from zero at sample means. In other words, hospital ownership in and of itself does not affect the level of quality of the average patient's reported experience. Differences in mean reported quality levels between the private and public sectors are entirely attributable to patient characteristics, the selection of patients into public or private hospitals and unobserved characteristics specific to individual hospitals, rather than to hospital ownership. Copyright © 2013 Elsevier B.V. All rights reserved.

Significance of the Hygiene Charter towards different sectors in Hong Kong.

PubMed

Lee, A; Cheng, F F K; Yuen, H S K; Ho, M; Ngan, W P; Suen, Y P; Au, S M Y; Li, S N; Tso, C Y; Ng, P P Y; Wong, Y P; Keung, M W; Lo, A S C; Wong, W S; Siu, D C H; Yuen, W K; Mok, K K; Fung, W Y; Wong, K K

2004-01-01

The occurrence of SARS in March 2003 has resulted in an increased interest, worldwide in emerging infectious diseases. The SARS experience provided us a lesson on the importance of promoting hygienic practices among individuals and different working sectors. In Hong Kong, a voluntary organization called the UNITE proposed a Hygiene Charter which aimed at taking hygiene to new levels. This action has been supported by individuals and different sectors including the Personal and Family, Management, Buildings, Catering, Education, Finance and Commercial, Industrial, Medical and Health, Public Transportation, Social Welfare, Sports and Culture and Tourism. As promotion and maintenance of environmental health requires input from different sectors, the signing of the Hygiene Charter provides an opportunity for individuals and the public to show their pledge and commitment to good hygiene practices. As a result, with environment improvement and good infectious disease control measures, prevention of epidemics of infectious diseases is deemed to be possible.

Geropsychology Post-Doctoral Training in Public Sector Service Delivery: The USF/Tampa VA Fellowship Model

ERIC Educational Resources Information Center

Molinari, Victor; Chiriboga, David A.; Schonfeld, Lawrence; Haley, William E.; Schinka, John A.; Hyer, Kathy; Dupree, Larry W.

2005-01-01

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…

Assessing gaps and poverty-related inequalities in the public and private sector family planning supply environment of urban Nigeria.

PubMed

Levy, Jessica K; Curtis, Sian; Zimmer, Catherine; Speizer, Ilene S

2014-02-01

Nigeria is the most populous country in Africa, and its population is expected to double in <25 years (Central Intelligence Agency 2012; Fotso et al. 2011). Over half of the population already lives in an urban area, and by 2050, that proportion will increase to three quarters (United Nations, Department of Economic and Social Affairs, Population Division 2012; Measurement Learning & Evaluation Project, Nigerian Urban Reproductive Health Initiative, National Population Commission 2012). Reducing unwanted and unplanned pregnancies through reliable access to high-quality modern contraceptives, especially among the urban poor, could make a major contribution to moderating population growth and improving the livelihood of urban residents. This study uses facility census data to create and assign aggregate-level family planning (FP) supply index scores to 19 local government areas (LGAs) across six selected cities of Nigeria. It then explores the relationships between public and private sector FP services and determines whether contraceptive access and availability in either sector is correlated with community-level wealth. Data show pronounced variability in contraceptive access and availability across LGAs in both sectors, with a positive correlation between public sector and private sector supply environments and only localized associations between the FP supply environments and poverty. These results will be useful for program planners and policy makers to improve equal access to contraception through the expansion or redistribution of services in focused urban areas.

The Institutionalization of Private Sector Strategic Planning Methods in a Public Sector Research & Development Organization: The Naval Surface Warfare Center Case 1982-1989

DTIC Science & Technology

1990-02-01

infancy during Cycle I, at the novice level during Cycle II, and at the advanced beginner level during Cycle III. The next two sections and Chapters 6...5 Table 1 - 1983 NSWC Planning Activities . . . . . . . 14 Table 1A - Planning Activity Flowchart . . . . . . . 14.1 Table 2 - Sector/SBU

Behavioural Indicators of Perceived Managerial and Leadership Effectiveness within Romanian and British Public Sector Hospitals

ERIC Educational Resources Information Center

Hamlin, Robert G.; Patel, Taran

2012-01-01

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:…

Training in the Public Sector in a Period of Austerity: The Case of the UK

ERIC Educational Resources Information Center

Jewson, Nick; Felstead, Alan; Green, Francis

2015-01-01

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…

Utilization and Value of Public Sector Information for Knowledge Development: The Case of South Africa

ERIC Educational Resources Information Center

Sharif, Raed M.

2013-01-01

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…

Reflecting the Context of MPA Education in the Time of Economic Crisis in Public Sectors in Britain and the Netherlands

ERIC Educational Resources Information Center

Oldfield, Chrissie; Berg, Mireille van den

2013-01-01

The reality of the economic crisis and subsequent cuts in public sector funding in some European countries means that the context for public management education is significantly changing. In a period of economic constraint there is the obvious questioning of the cost of public management education programmes and even more of their relevance and…