Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC.

PubMed

Riley, Christina; Garfinkel, Danielle; Thanel, Katherine; Esch, Keith; Workalemahu, Endale; Anyanti, Jennifer; Mpanya, Godéfroid; Binanga, Arsène; Pope, Jen; Longfield, Kim; Bertrand, Jane; Shaw, Bryan

2018-01-01

An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector's role in increasing contraceptive coverage and choice. In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price. Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 41% of modern contraceptive stocking outlets were in the private sector compared with approximately 80% in Nigeria and DRC where drug shops were dominant. Ninety-five percent of private sector outlets in Ethiopia had modern contraceptive methods available; 37% had three or more methods. In Nigeria and DRC, only 54% and 42% of private sector outlets stocked modern contraceptives with 5% and 4% stocking three or more methods, respectively. High prices in Nigeria and DRC create barriers to consumer access and choice. There is a missed opportunity to provide modern contraception through the private sector, particularly drug shops. Subsidies and interventions, like social marketing and social franchising, could leverage the private sector's role in increasing access to a range of contraceptives. Achieving global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private sector and improvement of decisions around funding streams of countries with large populations and high unmet need like Ethiopia, Nigeria, and DRC.

Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

PubMed Central

2011-01-01

Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs) staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are important providers. PHCC services are indeed free, with little evidence of informal payments to providers. PMID:22176866

Contractor Past Performance Information (PPI) in Source Selection: A Comparison Study of Public and Private Sector

DTIC Science & Technology

2005-03-17

private sector . However, along the way, Government and private sector industry have begun to disagree about how PPI is collected and how PPI is used. Industry prefers a passive system of collecting delivery and quality data during contract performance, while the Federal Government uses both a passive system (similar to industry) as well as an active system of pulling PPI during contract performance. Industry uses PPI to establish and maintain a preferred vendor list from which to solicit bids, quotes, or proposals, while government uses PPI to assess

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.

Case-mix and quality indicators in Chinese elder care homes: are there differences between government-owned and private-sector facilities?

PubMed

Liu, Chang; Feng, Zhanlian; Mor, Vincent

2014-02-01

To assess the association between ownership of Chinese elder care facilities and their performance quality and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Cross-sectional study. Census of elder care homes surveyed in Nanjing (2009) and Tianjin (2010). Elder care facilities located in urban Nanjing (n = 140, 95% of all) and urban Tianjin (n = 157, 97% of all). A summary case-mix index based on activity of daily living (ADL) limitations and cognitive impairment was created to measure levels of care needs of residents in each facility. Structure, process, and outcome measures were selected to assess facility-level quality of care. A structural quality measure, understaffing relative to resident levels of care needs, which indicates potentially inadequate staffing given resident case-mix, was also developed. Government-owned homes had significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but served residents who, on average, have fewer ADL and cognitive functioning limitations than those in private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages of either ownership type, although when staffing-to-resident ratio is gauged relative to resident case-mix, private-sector facilities were more likely to be understaffed than government-owned facilities. In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer on average than those in government facilities. It is likely that the case-mix differences are the result of selective admission policies that favor healthier residents in government facilities than in private-sector homes. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Pricing and availability of some essential child specific medicines in Odisha

PubMed Central

Swain, Trupti Rekha; Rath, Bandana; Dehury, Suhasini; Tarai, Anjali; Das, Priti; Samal, Rajashree; Samal, Satyajit; Nayak, Harshavardhan

2015-01-01

Objectives: Continuous availability of affordable medicines in appropriate formulations is essential to reduce morbidity and mortality in children. Odisha an eastern Indian state records very high mortality of children. The study aims at documenting the availability and prices paid for purchasing essential child-specific medicines. Materials and Methods: The survey of 34 essential medicines was conducted in six randomly selected districts of Odisha. Data were collected from medicine outlets of the public, private, and other sector (Nongovernmental Organization [NGO]/mission sectors) of six randomly selected districts, using WHO/Health Action International medicine price collection methodology. For each medicine surveyed, data were collected on the highest and lowest-priced formulations available in each facility. Results: Both public sector and other sector health facilities procure only one brand of medicines, mean percentage availability of medicines being 17% and 21.8%, respectively. In the private sector, the mean percentage availability of the high and lowest-priced medicines for a particular drug product was 10.8% and 38.5%, respectively. The public sector procurement price is 48% lower than international reference prices. In the private sector, high-priced, and low-priced products are sold at 1.83 and 1.46 times the international reference price, respectively. Substantial price variation was observed for some medicines across individual outlets. Medicines were found to cost 2.08 times their international reference price in NGO/mission sector facilities. Conclusions: The availability of children's medicines in public sector facilities of Odisha state is poor. Medicines for children cost relatively high in both private and NGO sectors compared to the international reference price. The availability medicines should be improved on an urgent basis to improve access of medicines for children of Odisha. PMID:26600637

Pricing and availability of some essential child specific medicines in Odisha.

PubMed

Swain, Trupti Rekha; Rath, Bandana; Dehury, Suhasini; Tarai, Anjali; Das, Priti; Samal, Rajashree; Samal, Satyajit; Nayak, Harshavardhan

2015-01-01

Continuous availability of affordable medicines in appropriate formulations is essential to reduce morbidity and mortality in children. Odisha an eastern Indian state records very high mortality of children. The study aims at documenting the availability and prices paid for purchasing essential child-specific medicines. The survey of 34 essential medicines was conducted in six randomly selected districts of Odisha. Data were collected from medicine outlets of the public, private, and other sector (Nongovernmental Organization [NGO]/mission sectors) of six randomly selected districts, using WHO/Health Action International medicine price collection methodology. For each medicine surveyed, data were collected on the highest and lowest-priced formulations available in each facility. Both public sector and other sector health facilities procure only one brand of medicines, mean percentage availability of medicines being 17% and 21.8%, respectively. In the private sector, the mean percentage availability of the high and lowest-priced medicines for a particular drug product was 10.8% and 38.5%, respectively. The public sector procurement price is 48% lower than international reference prices. In the private sector, high-priced, and low-priced products are sold at 1.83 and 1.46 times the international reference price, respectively. Substantial price variation was observed for some medicines across individual outlets. Medicines were found to cost 2.08 times their international reference price in NGO/mission sector facilities. The availability of children's medicines in public sector facilities of Odisha state is poor. Medicines for children cost relatively high in both private and NGO sectors compared to the international reference price. The availability medicines should be improved on an urgent basis to improve access of medicines for children of Odisha.

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 Cross-National Analysis of the Relations of School Choice and Effectiveness Differences between Private-Dependent and Public Schools

ERIC Educational Resources Information Center

Dronkers, Jaap; Avram, Silvia

2010-01-01

We apply propensity score matching to the estimation of differential school effectiveness between the publicly funded private sector and the public sector in a sample of 26 countries. This technique allows us to distinguish between school choice and school effectiveness processes and thus to account for selectivity issues involved in the…

Space Projects: Improvements Needed in Selecting Future Projects for Private Financing

NASA Technical Reports Server (NTRS)

1990-01-01

The Office of Management and Budget (OMB) and NASA jointly selected seven projects for commercialization to reduce NASA's fiscal year 1990 budget request and to help achieve the goal of increasing private sector involvement in space. However, the efforts to privately finance these seven projects did not increase the commercial sector's involvement in space to the extent desired. The General Accounting Office (GAO) determined that the projects selected were not a fair test of the potential of increasing commercial investment in space at an acceptable cost to the government, primarily because the projects were not properly screened. That is, neither their suitability for commercialization nor the economic consequences of seeking private financing for them were adequately evaluated before selection. Evaluations and market tests done after selection showed that most of the projects were not viable candidates for private financing. GAO concluded that projects should not be removed from NASA's budget for commercial development until after careful screening has been done to determine whether adequate commercial demand exists, development risks are commercially acceptable and private financing is found or judged to be highly likely, and the cost effectiveness of such a decision is acceptable. Premature removal of projects from NASA's budget ultimately can cause project delays and increased costs when unsuccessful commercialization candidates must be returned to the budget. NASA also needs to ensure appropriate comparisons of government and private financing options for future commercialization projects.

Getting to FP2020: Harnessing the private sector to increase modern contraceptive access and choice in Ethiopia, Nigeria, and DRC

PubMed Central

Garfinkel, Danielle; Thanel, Katherine; Esch, Keith; Workalemahu, Endale; Anyanti, Jennifer; Mpanya, Godéfroid; Binanga, Arsène; Pope, Jen; Longfield, Kim; Bertrand, Jane; Shaw, Bryan

2018-01-01

Background An estimated 214 million women have unmet need for family planning in developing regions. Improved utilization of the private sector is key to achieving universal access to a range of safe and effective modern contraceptive methods stipulated by FP2020 and SDG commitments. Until now, a lack of market data has limited understanding of the private sector’s role in increasing contraceptive coverage and choice. Methods In 2015, the FPwatch Project conducted representative outlet surveys in Ethiopia, Nigeria, and DRC using a full census approach in selected administrative areas. Every public and private sector outlet with the potential to sell or distribute modern contraceptives was approached. In outlets with modern contraceptives, product audits and provider interviews assessed contraceptive market composition, availability, and price. Findings Excluding general retailers, 96% of potential outlets in Ethiopia, 55% in Nigeria, and 41% in DRC had modern contraceptive methods available. In Ethiopia, 41% of modern contraceptive stocking outlets were in the private sector compared with approximately 80% in Nigeria and DRC where drug shops were dominant. Ninety-five percent of private sector outlets in Ethiopia had modern contraceptive methods available; 37% had three or more methods. In Nigeria and DRC, only 54% and 42% of private sector outlets stocked modern contraceptives with 5% and 4% stocking three or more methods, respectively. High prices in Nigeria and DRC create barriers to consumer access and choice. Discussion There is a missed opportunity to provide modern contraception through the private sector, particularly drug shops. Subsidies and interventions, like social marketing and social franchising, could leverage the private sector’s role in increasing access to a range of contraceptives. Achieving global FP2020 commitments depends on the expansion of national contraceptive policies that promote greater partnership and cooperation with the private sector and improvement of decisions around funding streams of countries with large populations and high unmet need like Ethiopia, Nigeria, and DRC. PMID:29444140

Is the practice of public or private sector doctors more evidence-based? A qualitative study from Vellore, India.

PubMed

Akinyemi, Oluwaseun O; Martineau, Tim; Tharyan, Prathap

2015-06-01

The literature on the use of evidence-based practice is sparse, both in the public and private sectors in middle-and low-income countries, and the present literature shows that physician understanding and use of evidence-based practice is poor. The study aimed to explore the perception of medical practitioners in the private for-profit, private not-for-profit and government sectors in Vellore, India, on evidence-based practice, in order to explain the factors affecting the use of evidence-based practice among the practitioners and to inform local policy and management decisions for improvement in quality of care. Qualitative methodology was employed in the study. Sixteen in-depth and two key informant interviews were carried out with medical practitioners selected by purposive sampling in the private for-profit, private not-for-profit and government sectors. The interviews explored participants' knowledge of evidence-based practice, factors affecting its use and possible ways of improving the use of evidence-based practice among physicians in all the health sectors. Data from the in-depth and key informant interviews were analyzed with the NVIVO (version 8) software package using the framework approach. Although most practitioners interviewed have heard of evidence-based practice, knowledge about evidence-based practice seems inadequate. However, doctors in the private not-for-profit sector seem to be more familiar with the concept of evidence-based practice. Also, practitioners in the private not-for profit sector appear to use medical evidence more in their practices compared to government practitioners or doctors in the private for-profit sector. Perceived factors affecting physician use of evidence-based practice include lack of personal time for literature appraisal as a result of high case load, weak regulatory system, pressure from patients, caregivers and pharmaceutical companies, as well as financial considerations. Opinions of the respondents are that use of evidence-based practice is mostly found among practitioners in the private not-for-profit health sector. Better training in evidence-based practice, improved regulatory system and greater collaboration between the public, private for-profit and private not-for-profit sectors with regards to training in evidence-based practice - literature search and critical appraisal skills - were suggested as needed to improve the present situation.

Preliminary enquiry into the availability, price and quality of malaria rapid diagnostic tests in the private health sector of six malaria-endemic countries.

PubMed

Albertini, A; Djalle, D; Faye, B; Gamboa, D; Luchavez, J; Mationg, M L; Mwangoka, G; Oyibo, W; Bennett, J; Incardona, S; Lee, E

2012-02-01

This enquiry aimed to provide a snap-shot of availability, price and quality of malaria rapid diagnostic tests (RDTs) in private health facilities at selected sites in six malaria-endemic countries in Africa, South East Asia and South America. In each study site, data collectors surveyed private healthcare facilities which were selected based on accessibility from their home institution. Using a questionnaire, information was recorded about the facility itself and the malaria RDT(s) available. Where possible, a small number of RDTs were procured and quality control tested using a standardized procedure. Of the 324 private healthcare facilities visited, 35 outlets (mainly private clinics and hospitals) were found to supply 10 different types of RDTs products. RDT prices across the six countries ranged from US$1.00 to $16.81. Five of the 14 malaria RDTs collected failed quality control testing. In the private outlets sampled, the availability of RDTs was limited. Some of the RDTs whose quality we tested demonstrated inadequate sensitivity. This presents a number of risks. Given the more widespread distribution of antimalarials currently planned for private sector facilities, parasite-based diagnosis in this sector will be essential to adhere to the WHO guidelines for effective case management of malaria. Considerable regulation and quality control are also necessary to assure the availability of accurate and reliable RDTs, as well as adequate case management and provider adherence to RDT results. Public sector engagement is likely to be essential in this process. © 2011 Blackwell Publishing Ltd.

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.

Private sector involvement in civil space remote sensing. Volume 1: Report

NASA Technical Reports Server (NTRS)

1979-01-01

A survey of private sector developers, users, and interpreters of Earth resources data was conducted in an effort to encourage private investment and participation in remote sensing systems. Results indicate positive interest in participation beyond the current hardware contracting level, however, there is a substantial gap between current market levels and system costs. Issues identified include the selection process for an operating entity, the public/private interface, data collection and access policies, price and profit regulation in a subsidized system, international participation, and the responsibility for research and development. It was agreed that the cost, complexity, and security implications of integrated systems need not be an absolute bar to their private operation.

Use of net present value analysis to evaluate a publicly funded biomass-to-ethanol research, development, and demonstration program and valuate expected private sector participation.

PubMed

Hinman, N D; Yancey, M A

1998-01-01

One of the functions of government is to invest tax dollars in programs, projects, and properties that will result in greater public benefit than would have resulted from leaving the tax dollars in the private sector or using them to pay off the public debt. This paper describes the use of Net Present Value (NPV) as an approach to analyze and select investment opportunities for government money in public research, development, and demonstration (RD&D) programs and to evaluate potential private sector participation in the programs. This approach is then applied to a specific biomass-to-ethanol opportunity in California.

Foreign Assistance: Enterprise Funds’ Contributions to Private Sector Development Vary.

DTIC Science & Technology

1999-09-01

private sector development in selected countries of Central and Eastern Europe as they transition from centrally planned to market-oriented economies. The funds, which are private, nonprofit U.S. corporations, are supposed to make loans to, or investments in, small- and medium-sized businesses in which other financial institutions are reluctant to invest. With the breakup of the Soviet Union in 1991, enterprise funds were subsequently established in the newly independent states. Currently, 10 funds operate in Central Europe and the former Soviet Union, covering 19

Case-Mix and Quality Indicators in Chinese Elder Care Homes: Are There Differences between Government-owned and Private-sector Facilities?

PubMed Central

Liu, Chang

2015-01-01

Objective To assess the association between ownership of Chinese elder care facilities and their performance quality; and to compare the case-mix profile of residents and facility characteristics in government-owned and private-sector homes. Design Cross-sectional study. Setting Census of elder care homes surveyed in Nanjing (in 2009) and Tianjin (in 2010). Population 140 (or 95% of all) elder care facilities located in urban Nanjing, and 157 (or 97% of all) facilities in urban Tianjin. Main study outcome measures We created a summary case-mix index based on activities of daily living (ADL) limitations and cognitive impairment to measure levels of care needs among residents in each facility. We selected structure, process, and outcome measures to assess facility-level quality of care. We also developed a structural quality measure, under-staffing relative to residents’ levels of care needs, which indicates potentially inadequate staffing given the residents’ case-mix. Results Government-owned homes have significantly higher occupancy rates, presumably reflecting popular demand for publicly subsidized beds, but they serve residents who, on average, have fewer ADL and cognitive functioning limitations than do private-sector facilities. Across a range of structure, process, and outcome measures of quality, there is no clear evidence suggesting advantages or disadvantages to either ownership type. However, when staffing to resident ratio is gauged relative to residents’ case-mix, private-sector facilities were more likely to be under-staffed than government-owned facilities. Conclusions In Nanjing and Tianjin, private-sector homes were more likely to be understaffed, although their residents were sicker and frailer, on average, than those in government facilities. The case-mix differences are likely the result of selective admission policies that favor relatively healthier residents in government facilities than in private-sector homes. PMID:24433350

Effectively engaging the private sector through vouchers and contracting - A case for analysing health governance and context.

PubMed

Nachtnebel, Matthias; O'Mahony, Ashleigh; Pillai, Nandini; Hort, Kris

2015-11-01

Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more useful frame than generalizable outcomes of effectiveness. Copyright © 2015 Elsevier Ltd. All rights reserved.

A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand.

PubMed

Reynolds, Jaratdao; Wisaijohn, Thunthita; Pudpong, Nareerut; Watthayu, Nantiya; Dalliston, Alex; Suphanchaimat, Rapeepong; Putthasri, Weerasak; Sawaengdee, Krisada

2013-04-12

The demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries. A scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy. The review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions. Strategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced.

A literature review: the role of the private sector in the production of nurses in India, Kenya, South Africa and Thailand

PubMed Central

2013-01-01

Background The demand for nurses is growing and has not yet been met in most developing countries, including India, Kenya, South Africa, and Thailand. Efforts to increase the capacity for production of professional nurses, equitable distribution and better retention have been given high strategic priority. This study examines the supply of, demand for, and policy environment of private nurse production in four selected countries. Methods A scoping systematic review was undertaken to assess the evidence for the role of private sector involvement in the production of nurses in India, Kenya, South Africa, and Thailand. An electronic database search was performed, and grey literature was also captured from the websites of Human Resources for Health (HRH)-related organizations and networks. The articles were reviewed and selected according to relevancy. Results The review found that despite very different ratios of nurses to population ratios and differing degrees of international migration, there was a nursing shortage in all four countries which were struggling to meet growing demand. All four countries saw the private sector play an increasing role in nurse production. Policy responses varied from modifying regulation and accreditation schemes in Thailand, to easing regulation to speed up nurse production and recruitment in India. There were concerns about the quality of nurses being produced in private institutions. Conclusion Strategies must be devised to ensure that private nursing graduates serve public health needs of their populations. There must be policy coherence between producing nurses for export and ensuring sufficient supply to meet domestic needs, in particular in under-served areas. This study points to the need for further research in particular assessing the contributions made by the private sector to nurse production, and to examine the variance in quality of nurses produced. PMID:23587128

Expanding the Private School Sector: Government Policy and Private Secondary Schools in Hong Kong, 1988-2001

ERIC Educational Resources Information Center

Cheung, Alan C. K.; Randall, E. Vance; Tam, Man-Kwan

2005-01-01

This paper addresses the extent to which government policy has helped increase the number and diversity of private secondary schools in Hong Kong, which, in turn, has expanded the options for parental choice. Five indicators were selected to measure this objective. They are as follows: (1) Number of private schools and students enrolled; (2) Types…

Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

PubMed

Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J

2016-01-01

Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers. This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes. Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS. Health providers generally perceive the NHIS to have had a largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.

Health Insurance: Comparison of Coverage for Federal and Private Sector Employees. Briefing Report to the Chairman, Subcommittee on Civil Service, Post Office, and General Services, Committee on Governmental Affairs, U.S. Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Div. of Human Resources.

This briefing report was developed to provide a Senate subcommittee with information concerning certain benefit features of the Federal Employees Health Benefits Program (FEHBP). It compares coverage for selected health benefits in the federal and private sectors for a 6-year period (1980-1985). A description of methodology states that information…

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.

Insurance coverage and socioeconomic differences in patient choice between private and public health care providers in China.

PubMed

Wang, Qing; Zhang, Donglan; Hou, Zhiyuan

2016-12-01

The private health care sector has become an increasingly important complement to China's health care system. During the health care reform in 2009, China's central government established multiple initiatives to relax constraints on the growth of the private health care sector. However, private health services have not been growing as rapidly as private health care facilities. Using data from the China Health and Retirement Longitudinal Study collected between 2011 and 2013, this study investigated patient choice between private and public providers for outpatient care and estimated its relationship with health insurance and socioeconomic status (SES). The Heckman sample selection model was applied to address the problem of selection bias caused by a lack of awareness of provider ownership. We found that 82.1% of the outpatient care users were aware of their provider's ownership, and 23.8% chose private health care providers. Although patients with health insurance and higher SES were more likely to be aware of their provider's ownership, they preferred public providers over private providers. For example, having Urban Employee Basic Medical Insurance was associated with a 16.5% lower probability of choosing private providers than no health insurance. Respondents with the highest level of household expenditure had a 7.5% lower probability of choosing private providers than those with the lowest level of expenditure. The probability of choosing private providers were significantly lower by 4.0% among respondents with an education level of junior high school and above than those with no formal education. For private providers to play an effective role in the health care system, policies that have constrained the growth of the private sector should be changed, and more effort should be directed toward equalizing health insurance coverage for both types of providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of an expansion in private sector provision of contraceptive supplies on horizontal inequity in modern contraceptive use: evidence from Africa and Asia

PubMed Central

2011-01-01

Background One strategic approach available to policy makers to improve the availability of reproductive and child health care supplies and services as well as the sustainability of programs is to expand the role of the private sector in providing these services. However, critics of this approach argue that increased reliance on the private sector will not serve the needs of the poor, and could lead to increases in socio-economic disparities in the use of health care services. The purpose of this study is to investigate whether the expansion of the role of private providers in the provision of modern contraceptive supplies is associated with increased horizontal inequity in modern contraceptive use. Methods The study is based on multiple rounds of Demographic and Health Survey data from four selected countries (Nigeria, Uganda, Bangladesh, and Indonesia) in which there was an increase in the private sector supply of contraceptives. The methodology involves estimating concentration indices to assess the degree of inequality and inequity in contraceptive use by wealth groups across time. In order to measure inequity in the use of modern contraceptives, the study uses multivariate methods to control for differences in the need for family planning services in relation to household wealth. Results The results suggest that the expansion of the private commercial sector supply of contraceptives in the four study countries did not lead to increased inequity in the use of modern contraceptives. In Nigeria and Uganda, inequity actually decreased over time; while in Bangladesh and Indonesia, inequity fluctuated. Conclusions The study results do not offer support to the hypothesis that the increased role of the private commercial sector in the supply of contraceptive supplies led to increased inequity in modern contraceptive use. PMID:21854584

Effect of an expansion in private sector provision of contraceptive supplies on horizontal inequity in modern contraceptive use: evidence from Africa and Asia.

PubMed

Hotchkiss, David R; Godha, Deepali; Do, Mai

2011-08-19

One strategic approach available to policy makers to improve the availability of reproductive and child health care supplies and services as well as the sustainability of programs is to expand the role of the private sector in providing these services. However, critics of this approach argue that increased reliance on the private sector will not serve the needs of the poor, and could lead to increases in socio-economic disparities in the use of health care services. The purpose of this study is to investigate whether the expansion of the role of private providers in the provision of modern contraceptive supplies is associated with increased horizontal inequity in modern contraceptive use. The study is based on multiple rounds of Demographic and Health Survey data from four selected countries (Nigeria, Uganda, Bangladesh, and Indonesia) in which there was an increase in the private sector supply of contraceptives. The methodology involves estimating concentration indices to assess the degree of inequality and inequity in contraceptive use by wealth groups across time. In order to measure inequity in the use of modern contraceptives, the study uses multivariate methods to control for differences in the need for family planning services in relation to household wealth. The results suggest that the expansion of the private commercial sector supply of contraceptives in the four study countries did not lead to increased inequity in the use of modern contraceptives. In Nigeria and Uganda, inequity actually decreased over time; while in Bangladesh and Indonesia, inequity fluctuated. The study results do not offer support to the hypothesis that the increased role of the private commercial sector in the supply of contraceptive supplies led to increased inequity in modern contraceptive use.

How do countries regulate the health sector? Evidence from Tanzania and Zimbabwe.

PubMed

Kumaranayake, L; Mujinja, P; Hongoro, C; Mpembeni, R

2000-12-01

The health sectors in many low- and middle-income countries have been characterized in recent years by extensive private sector activity. This has been complemented by increasing public-private linkages, such as the contracting-out of selected services or facilities, development of new purchasing arrangements, franchising and the introduction of vouchers. Increasingly, however, experience with the private sector has indicated a number of problems with the quality, price and distribution of private health services, and thus led to a growing focus on the role of government in regulation. This paper presents the existing network of regulations governing private activity in the health sectors of Tanzania and Zimbabwe, and their appropriateness in the context of emerging market realities. It draws on a comparative mapping exercise reviewing the complexity of the variables currently being regulated, the level of the health system at which they apply, and the specific instruments being used. Findings indicate that much of the existing regulation occurs through legislation. There is still very much a focus on the 'social' rather than 'economic' aspects of regulation within the health sector. Recent changes have attempted to address aspects of private health provision, but some very key gaps remain. In particular, current regulations in Tanzania and Zimbabwe: (1) focus on individual inputs rather than health system organizations; (2) aim to control entry and quality rather than explicitly quantity, price or distribution; and (3) fail to address the market-level problems of anti-competitive practices and lack of patient rights. This highlights the need for additional measures to promote consumer protection and address the development of new private markets such as for health insurance or laboratory and other ancillary services.

NASA's commercial space program - Initiatives for the future

NASA Technical Reports Server (NTRS)

Rose, James T.; Stone, Barbara A.

1990-01-01

NASA's commercial development of the space program aimed at the stimulation and assistance of expanded private sector involvement and investment in civil space activities is discussed, focusing on major new program initiatives and their implementation. NASA's Centers for the Commercial Development of Space (CCDS) program, composed of competitively selected consortia of universities, industries, and government involved in early research and testing phases of potentially commercially viable technologies is described. The 16 centers concentrate on seven different technical areas such as automation and robotics; remote sensing; life sciences; and space power, propulsion, and structures. Private sector participation, CCDS technology development, government and commercially supplied access to space in support of CCDS programs, CCDS hardware development, and CCDS spinoffs are discussed together with various cooperative and reimbursable agreements between NASA and the private sector.

Quality of private and public ambulatory health care in low and middle income countries: systematic review of comparative studies.

PubMed

Berendes, Sima; Heywood, Peter; Oliver, Sandy; Garner, Paul

2011-04-01

In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options. We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred. Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases.

Exploring the characteristics of nursing agencies in South Africa.

PubMed

Olojede, Omolola I; Rispel, Laetitia C

2015-01-01

Nursing agencies are temporary employment service providers or labour brokers that supply nurses to health establishments. This study was conducted to determine the characteristics of nursing agencies and their relationship with clients in the health sector. During 2011, a cross-sectional national survey of 106 nursing agencies was conducted. After obtaining informed consent, telephone interviews were conducted with a representative of the selected nursing agency using a pretested structured questionnaire. Questions focused on the following: ownership, date of establishment, province of operation, distribution of clients across private and public health facilities; existence of a code of conduct; nature of the contractual relationship between nursing agencies and their clients, and numbers and cadres of nurses contracted. The survey data were analysed using STATA(®) 12. Fifty-two nursing agencies participated in the survey, representing a 49% response rate. The study found that 32 nursing agencies (62%) served private-sector clients only, which included private hospitals, homes for elderly people, patients in private homes, and private industry/company clinics, and only four (8%) of the agencies served the public sector only. Twenty-seven percent of nursing agencies provided services to homes for elderly individuals. Nursing agencies were more likely to have contracts with private-sector clients (84%) than with public-sector clients (16%) (p = 0.04). Although 98% of nursing agencies reported that they had a code of conduct, the proportion was higher for private-sector clients (73%) compared to public-sector clients (27%). In terms of quality checks and monitoring, 81% of agencies agreed with a statement that they checked the nursing council registration of nurses, 82% agreed with a statement that they requested certified copies of a nurse's qualifications. Only 21% indicated that they conducted reference checks of nurses with their past employers. Nursing agencies should enhance their quality assurance mechanisms when engaging contracted staff. Overall, the study findings suggest the need for improved governance and management of nursing agencies in South Africa.

Exploring the characteristics of nursing agencies in South Africa

PubMed Central

Olojede, Omolola I.; Rispel, Laetitia C.

2015-01-01

Background Nursing agencies are temporary employment service providers or labour brokers that supply nurses to health establishments. Objective This study was conducted to determine the characteristics of nursing agencies and their relationship with clients in the health sector. Methods During 2011, a cross-sectional national survey of 106 nursing agencies was conducted. After obtaining informed consent, telephone interviews were conducted with a representative of the selected nursing agency using a pretested structured questionnaire. Questions focused on the following: ownership, date of establishment, province of operation, distribution of clients across private and public health facilities; existence of a code of conduct; nature of the contractual relationship between nursing agencies and their clients, and numbers and cadres of nurses contracted. The survey data were analysed using STATA® 12. Results Fifty-two nursing agencies participated in the survey, representing a 49% response rate. The study found that 32 nursing agencies (62%) served private-sector clients only, which included private hospitals, homes for elderly people, patients in private homes, and private industry/company clinics, and only four (8%) of the agencies served the public sector only. Twenty-seven percent of nursing agencies provided services to homes for elderly individuals. Nursing agencies were more likely to have contracts with private-sector clients (84%) than with public-sector clients (16%) (p = 0.04). Although 98% of nursing agencies reported that they had a code of conduct, the proportion was higher for private-sector clients (73%) compared to public-sector clients (27%). In terms of quality checks and monitoring, 81% of agencies agreed with a statement that they checked the nursing council registration of nurses, 82% agreed with a statement that they requested certified copies of a nurse's qualifications. Only 21% indicated that they conducted reference checks of nurses with their past employers. Conclusions Nursing agencies should enhance their quality assurance mechanisms when engaging contracted staff. Overall, the study findings suggest the need for improved governance and management of nursing agencies in South Africa. PMID:25971401

Private sector contribution to childhood immunization: Sri Lankan experience.

PubMed

Agampodi, S B; Amarasinghe, D A C L

2007-04-01

The main service provider for childhood immunization in Sri Lanka is the government sector. However, utilization of private sector for childhood immunization is increasing rapidly. Existing national immunization data does not routinely include statistics on private sector immunization delivery adequately. To estimate the proportion of children immunized in the private sector; describe socio-demographic characteristics of private sector users and compare these with government sector users. A community-based crosssectional descriptive study was conducted using a pre-tested interviewer-administered structured questionnaire. This was done in the Colombo municipal council area using the WHO 30 cluster methodology. The total number of households in the sample was 553. Out of the 5,028 total immunizations reported in the present study, around one-third (2,544) was obtained through the private sector. Nineteen percent (104) of children were exclusively immunized from the private sector. The distribution of usual immunization provider was - government sector 72.3% (400) and private sector 27.7% (153). Significant differences were observed (P < 0.001) between private and government sector users with regard to family income, social class, ethnicity, religion and educational level of the mother. The age-appropriate immunization among the 12- to 23-month age group was 92.3% (144) in the government sector, whereas it was 95% (38) in the private sector. Among the 24- to 35-month age group, it was 91.7% (121) and 92.7% (76) respectively. The age-adjusted immunization coverage rates were almost same among the government and private sector users except for the measles vaccine, where the private sector users had significantly (P = 0.016) higher coverage. Utilization of private sector immunization services is high in the Colombo municipal council area.

Regulating the for-profit private health sector: lessons from East and Southern Africa.

PubMed

Doherty, Jane E

2015-03-01

International evidence shows that, if poorly regulated, the private health sector may lead to distortions in the type, quantity, distribution, quality and price of health services, as well as anti-competitive behaviour. This article provides an overview of legislation governing the for-profit private health sector in East and Southern Africa. It identifies major implementation problems and suggests strategies Ministries of Health could adopt to regulate the private sector more effectively and in line with key public health objectives. This qualitative study was based on a document review of existing legislation in the region, and seven semi-structured interviews with individuals selected purposively on the basis of their experience in policymaking and legislation. Legislation was categorized according to its objectives and the level at which it operates. A thematic content analysis was conducted on interview transcripts. Most legislation focuses on controlling the entry of health professionals and organizations into the market. Most countries have not developed adequate legislation around behaviour following entry. Generally the type and quality of services provided by private practitioners and facilities are not well-regulated or monitored. Even where there is specific health insurance regulation, provisions seldom address open enrolment, community rating and comprehensive benefit packages (except in South Africa). There is minimal control of prices. Several countries are updating and improving legislation although, in most cases, this is without the benefit of an overarching policy on the private sector, or reference to wider public health objectives. Policymakers in the East and Southern African region need to embark on a programme of action to strengthen regulatory frameworks and instruments in relation to private health care provision and insurance. They should not underestimate the power of the private health sector to undermine efforts for increased regulation. Consequently they should conduct careful stakeholder analyses and build alliances to help drive through reform. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

7 CFR 652.23 - Certification process for private-sector entities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Certification process for private-sector entities. 652... ASSISTANCE Certification § 652.23 Certification process for private-sector entities. (a) A private sector... individual basis as part of the private-sector entity's certification and ensures that the requirements set...

Evaluation of Immunization Knowledge, Practices, and Service-delivery in the Private Sector in Cambodia

PubMed Central

Soeung, Sann Chan; Grundy, John; Morn, Cheng; Samnang, Chham

2008-01-01

A study of private-sector immunization services was undertaken to assess scope of practice and quality of care and to identify opportunities for the development of models of collaboration between the public and the private health sector. A questionnaire survey was conducted with health providers at 127 private facilities; clinical practices were directly observed; and a policy forum was held for government representatives, private healthcare providers, and international partners. In terms of prevalence of private-sector provision of immunization services, 93% of the private inpatient clinics surveyed provided immunization services. The private sector demonstrated a lack of quality of care and management in terms of health workers’ knowledge of immunization schedules, waste and vaccine management practices, and exchange of health information with the public sector. Policy and operational guidelines are required for private-sector immunization practices that address critical subject areas, such as setting of standards, capacity-building, public-sector monitoring, and exchange of health information between the public and the private sector. Such public/private collaborations will keep pace with the trends towards the development of private-sector provision of health services in developing countries. PMID:18637533

Measuring Access to Medicines: A Survey of Prices, Availability and Affordability in Shaanxi Province of China

PubMed Central

Jiang, Minghuan; Yang, Shimin; Yan, Kangkang; Liu, Jun; Zhao, Jun; Fang, Yu

2013-01-01

Objective To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Methods Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Findings The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day’s wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days’ wages for losartan. For originator brands, the costs rise to 1.2 days’ wages for salbutamol inhaler and 15.6 days’ wages for omeprazole. Conclusions The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions. PMID:23936471

Measuring access to medicines: a survey of prices, availability and affordability in Shaanxi province of China.

PubMed

Jiang, Minghuan; Yang, Shimin; Yan, Kangkang; Liu, Jun; Zhao, Jun; Fang, Yu

2013-01-01

To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day's wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days' wages for losartan. For originator brands, the costs rise to 1.2 days' wages for salbutamol inhaler and 15.6 days' wages for omeprazole. The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions.

76 FR 3650 - Renewal and Revision of Information Collection, OMB Control Number 1004-0009

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

... collection of information from individuals, State and local governments, and the private sector in... governments, 286 typical responses from the private sector, and 10 complex responses from the private sector... typical responses from the private sector, and 1,200 hours for complex responses from the private sector...

Competition, regulation, and energy efficiency options in the electricity sector: Opportunities and challenges in developing countries

NASA Astrophysics Data System (ADS)

Phadke, Amol Anant

This dissertation explores issues related to competition in and regulation of electricity sectors in developing countries on the backdrop of fundamental reforms in their electricity sectors. In most cases, electricity sector reforms promoted privatization based on the rationale that it will lower prices and improve quality. In Chapter 2, I analyze this rationale by examining the stated capital cost of independent (private) power producer's (IPPs) power projects in eight developing countries and find that the stated capital cost of projects selected via competitive bidding is on an average about 40% to 60% lower than that of the projects selected via negotiations, which, I argue, represents the extent to which the costs of negotiated projects are overstated. My results indicate that the policy of promoting private sector without an adequate focus on improving competition or regulation has not worked in most cases in terms of getting competitively priced private sector projects. Given the importance of facilitating effective competition or regulation, In Chapter 3, I examine the challenges and opportunities of establishing a competitive wholesale electricity market in a developing country context. I model a potential wholesale electricity market in Maharashtra (MH) state, India and find that it would be robustly competitive even in a situation of up-to five percent of supply shortage, when opportunities for demand response are combined with policies such as divestiture and requiring long-term contracts. My results indicate that with appropriate policies, some developing countries could establish competitive wholesale electricity markets. In Chapter 4, I focus on the demand side and analyze the cost effectiveness of improving end-use efficiency in an electricity sector with subsidized tariffs and electricity shortages and show that they offer the least expensive way of reducing shortages in Maharashtra State, India. In Chapter 5, I examine the costs of reducing carbon dioxide emissions in the Indian power sector and find that the costs are higher than those in the US because of mark-ups in the Indian gas based power projects. Overall, this dissertation shows the importance of facilitating effective competition and regulation and pursuing end-use efficiency improvements in electricity sectors of developing countries.

Quality of Private and Public Ambulatory Health Care in Low and Middle Income Countries: Systematic Review of Comparative Studies

PubMed Central

Berendes, Sima; Heywood, Peter; Oliver, Sandy; Garner, Paul

2011-01-01

Background In developing countries, the private sector provides a substantial proportion of primary health care to low income groups for communicable and non-communicable diseases. These providers are therefore central to improving health outcomes. We need to know how their services compare to those of the public sector to inform policy options. Methods and Findings We summarised reliable research comparing the quality of formal private versus public ambulatory health care in low and middle income countries. We selected studies against inclusion criteria following a comprehensive search, yielding 80 studies. We compared quality under standard categories, converted values to a linear 100% scale, calculated differences between providers within studies, and summarised median values of the differences across studies. As the results for for-profit and not-for-profit providers were similar, we combined them. Overall, median values indicated that many services, irrespective of whether public or private, scored low on infrastructure, clinical competence, and practice. Overall, the private sector performed better in relation to drug supply, responsiveness, and effort. No difference between provider groups was detected for patient satisfaction or competence. Synthesis of qualitative components indicates the private sector is more client centred. Conclusions Although data are limited, quality in both provider groups seems poor, with the private sector performing better in drug availability and aspects of delivery of care, including responsiveness and effort, and possibly being more client orientated. Strategies seeking to influence quality in both groups are needed to improve care delivery and outcomes for the poor, including managing the increasing burden of non-communicable diseases. Please see later in the article for the Editors' Summary PMID:21532746

Re-treatment decisions for failed posterior fillings by Finnish general practitioners.

PubMed

Heinikainen, Mia; Vehkalahti, Miira; Murtomaa, Heikki

2002-06-01

To evaluate treatment decisions of general dental practitioners (GDPs) in the private and public sector in cases of re-treatment of failed posterior fillings. A questionnaire on six cases from 400 GDPs, selected by stratified randomisation by gender, and main occupation (public vs. private sector). Others were all full-time dental teachers (DTs; n=47) representing clinical disciplines other than surgery and orthodontics. Restorative cases were described in detail, including figures drawn on four subcases involving the first permanent upper molar where the filling to be replaced increased in size from occlusal filling to the entire clinical crown. For each case, respondents chose the optimal treatment from eight alternatives, later re-classified as amalgam restoration, direct composite restoration, prosthetic restoration (indirect composite, cast gold inlay/onlay, ceramic inlay/onlay, ceramic crown, or bridge construction following tooth extraction). For re-treatment of the occlusal filling, composite restoration was preferred both by GDPs (92%) and DTs (83%). For three-surface fillings, prosthetic restorations were dominant in the private sector (OR=2.3; 95% CI: 1.4, 3.8; P<0.001). In total loss of the clinical crown, prosthetic restoration was chosen by all the DTs, public-sector dentists, and 95% of private-sector dentists. No more than 10% of GDPs chose amalgam and 2% gold; the rest chose composites. Treatment decisions were similar in public and private sectors for cases with the smallest and largest fillings. Wide variation in cases of medium-sized restorations indicated a lack of generally accepted guidelines of good clinical practice and of evidence-based treatment practice.

Role of emerging private hospitals in a post-Soviet mixed health system: a mixed methods comparative study of private and public hospital inpatient care in Mongolia.

PubMed

Tsevelvaanchig, Uranchimeg; Gouda, Hebe; Baker, Peter; Hill, Peter S

2017-05-01

The collapse of the Soviet Union in 1990 severely impacted the health sector in Mongolia. Limited public funding for the post-Soviet model public system and a rapid growth of poorly regulated private providers have been pressing issues for a government seeking to re-establish universal health coverage. However, the evidence available on the role of private providers that would inform sector management is very limited. This study analyses the current contribution of private hospitals in Mongolia for the improvement of accessibility of health care and efficiency. We used mixed research methods. A descriptive analysis of nationally representative hospital admission records from 2013 was followed by semi-structured interviews that were carried out with purposively selected key informants (N = 45), representing the main actors in Mongolia's mixed health system. Private-for-profit hospitals are concentrated in urban areas, where their financial model is most viable. The result is the duplication of private and public inpatient services, both in terms of their geographical location and the range of services delivered. The combination of persistent inpatient-oriented care and perverse financial incentives that privilege admission over outpatient management, have created unnecessary health costs. The engagement of the private sector to improve population health outcomes is constrained by a series of issues of governance, regulation and financing and the failure of the state to manage the private sector as an integral part of its health system planning. For a mixed system like in Mongolia, a comprehensive policy and plan which defines the complementary role of private providers to optimize private public service mix is critical in the early stages of the private sector development. It further supports the importance of a system perspective that combines regulation and incentives in consistent policy, rather than an isolated approach to provide regulation. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Thailand--Secondary Education for Employment, Volume II: Background Papers.

ERIC Educational Resources Information Center

World Bank, Washington, DC.

This report, a series of three background papers, was prepared as part of the Thailand Secondary Vocational Education Sector Study. The first background paper, "Intro Changing Workplaces, Changing Skills: Views from the Thai Private Sector on Work-Organization, Employee Recruitment and Selection" (Charles Abelmann, Lee Kian Chang,…

Commercialization of the land remote sensing system: An examination of mechanisms and issues

NASA Technical Reports Server (NTRS)

Cauley, J. K.; Gaelick, C.; Greenberg, J. S.; Logsdon, J.; Monk, T.

1983-01-01

In September 1982 the Secretary of Commerce was authorized (by Title II of H.R. 5890 of the 97th Congress) to plan and provide for the management and operation of the civil land remote sensing satellite systems, to provide for user fees, and to plan for the transfer of the ownership and operation of future civil operational land remote sensing satellite systems to the private sector. As part of the planning for transfer, a number of approaches were to be compared including wholly private ownership and operation of the system by an entity competitively selected, mixed government/private ownership and operation, and a legislatively-chartered privately-owned corporation. The results of an analysis and comparison of a limited number of financial and organizational approaches for either transfer of the ownership and operation of the civil operational land remote sensing program to the private sector or government retention are presented.

Driving to contract management in health care institutes of developing countries.

PubMed

Vatankhah, S; Barati, O; Maleki, M R; Tofighi, Sh; Rafii, S

2012-04-01

Public hospitals can privatize management activities by contracting with a private organization or person to perform the work. Management contract is a method which uses private sector for major government projects like hospitals. This study evaluates contract management in health care institutes of developing countries. Information has been collected by reviewing the management contract condition of selected countries. Different forms of public private partnership for private participation in hospitals were surveyed. The effects of management contract is expanding market opportunities to include public sector clients, capturing a market to be protected from competitors and providing a reliable and timely source of revenue. Contracting with non-governmental entities will provide better results than government provision of the same services. Contracting initiatives must be regulated and monitored at the highest level of government by experienced and astute policy makers, economists and operational personnel.

Performance of private sector health care: implications for universal health coverage.

PubMed

Morgan, Rosemary; Ensor, Tim; Waters, Hugh

2016-08-06

Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. Copyright © 2016 Elsevier Ltd. All rights reserved.

What are private sector physiotherapists' perceptions regarding interprofessional and intraprofessional work for managing low back pain?

PubMed

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

2018-03-28

In the last decades, interactions between health professionals have mostly been discussed in the context of interprofessional teamwork where professionals work closely together and share a team identity. Comparatively, little work has been done to explore interactions that occur between professionals in contexts where traditionally formal structures have been less supporting the implementation of interprofessional teamwork, such as in the private healthcare sector. The objective of this study was to identify private sector physiotherapists' perceptions of interprofessional and intraprofessional work regarding interventions for adults with low back pain. This was a cross-sectional survey of 327 randomly-selected physiotherapists. Data were analysed using descriptive statistics. A majority of physiotherapists reported positive effects of interprofessional work for their clients, themselves and their workplaces. Proximity of physiotherapists with other professionals, clinical workloads, and client's financial situation were perceived as important factors influencing the implementation of interprofessional work. Low back pain is a highly prevalent and disabling condition. The results of this study indicate that integrating interprofessional work in the management of low back pain in the private sector is warranted. Furthermore, the implementation of interprofessional work is viewed by practicing physiotherapists as dependent upon certain client-, professional- and organizational-level factors.

Evaluation of Workload and its Impact on Satisfaction Among Pharmacy Academicians in Southern India.

PubMed

Ahmad, Akram; Khan, Muhammad Umair; Srikanth, Akshaya B; Patel, Isha; Nagappa, Anantha Naik; Jamshed, Shazia Qasim

2015-06-01

The purpose of this study was to determine the level of workload among pharmacy academicians working in public and private sector universities in India. The study also aimed to assess the satisfaction of academicians towards their workload. A cross-sectional study was conducted for a period of 2 months among pharmacy academicians in Karnataka state of Southern India. Convenience sampling was used to select a sample and was contacted via email and/or social networking sites. Questionnaire designed by thorough review literature was used as a tool to collect data on workload (teaching, research, extracurricular services) and satisfaction. Of 214 participants, 95 returned the filled questionnaire giving the response rate of 44.39%. Private sector academicians had more load of teaching (p=0.046) and they appeared to be less involved in research activities (p=0.046) as compared to public sector academicians. More than half of the respondents (57.9%) were satisfied with their workload with Assistant Professors were least satisfied as compared to Professors (p=0.01). Overall, private sector academicians are more burdened by teaching load and also are less satisfied of their workload. Revision of private universities policies may aid in addressing this issue.

Role of the private sector in vaccination service delivery in India: evidence from private-sector vaccine sales data, 2009-12.

PubMed

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

2016-09-01

India's Universal Immunization Programme (UIP) provides basic vaccines free-of-cost in the public sector, yet national vaccination coverage is poor. The Government of India has urged an expanded role for the private sector to help achieve universal immunization coverage. We conducted a state-by-state analysis of the role of the private sector in vaccinating Indian children against each of the six primary childhood diseases covered under India's UIP. We analyzed IMS Health data on Indian private-sector vaccine sales, 2011 Indian Census data and national household surveys (DHS/NFHS 2005-06 and UNICEF CES 2009) to estimate the percentage of vaccinated children among the 2009-12 birth cohort who received a given vaccine in the private sector in 16 Indian states. We also analyzed the estimated private-sector vaccine shares as function of state-specific socio-economic status. Overall in 16 states, the private sector contributed 4.7% towards tuberculosis (Bacillus Calmette-Guérin (BCG)), 3.5% towards measles, 2.3% towards diphtheria-pertussis-tetanus (DPT3) and 7.6% towards polio (OPV3) overall (both public and private sectors) vaccination coverage. Certain low income states (Uttar Pradesh, Rajasthan, Madhya Pradesh, Orissa, Assam and Bihar) have low private as well as public sector vaccination coverage. The private sector's role has been limited primarily to the high income states as opposed to these low income states where the majority of Indian children live. Urban areas with good access to the private sector and the ability to pay increases the Indian population's willingness to access private-sector vaccination services. In India, the public sector offers vaccination services to the majority of the population but the private sector should not be neglected as it could potentially improve overall vaccination coverage. The government could train and incentivize a wider range of private-sector health professionals to help deliver the vaccines, especially in the low income states with the largest birth cohorts. We recommend future studies to identify strengths and limitations of the public and private health sectors in each Indian state. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia

PubMed Central

Ron Levey, Ilana; Wang, Wenjuan

2014-01-01

Background Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. Methods The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. Results The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. Conclusion The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. PMID:25012796

Unravelling the quality of HIV counselling and testing services in the private and public sectors in Zambia.

PubMed

Ron Levey, Ilana; Wang, Wenjuan

2014-07-01

Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. The study used five primary data collection methods to gauge quality of VCT services: closed-ended client interviews with clients exiting VCT sites; open-ended client interviews; interviews with facility managers; review of service statistics; and an observation of the physical environment for VCT by site. Over 400 clients and 87 facility managers were interviewed from almost 90 facilities. Sites were randomly selected and results are generalizable at the provincial level. The study shows concerning levels of underperformance in VCT services across the sectors. It reveals serious underperformance in counselling about key risk-reduction methods. Less than one-third of clients received counselling on reducing number of sexual partners and only approximately 5% of clients received counselling about disclosing test results to partners. In terms of client profiles, the NGO sector attracts the most educated clients and less educated Zambians seek VCT services at very low rates (7%). The private for-profit performs equally or sometimes better than other sectors even though this sector is not adequately integrated into the Zambian national response to HIV. The private for-profit sector provides VCT services on par in quality with the other sectors. Most clients did not receive counselling on partner reduction or disclosure of HIV test results to partners. In a generalized HIV epidemic where multiple concurrent sexual partners are a significant problem for transmitting the disease, risk-reduction methods and discussion should be a main focus of pre-test and post-test counselling. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Inter-Professional Practices of Private-Sector Physiotherapists for Low Back Pain Management: Who, How, and When?

PubMed

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

Purpose : Although there have been increasing demands for health care providers to take part in inter-professional practices in recent years, very little attention has been paid to the actualization of such practices in the private sector. This study describes private-sector physiotherapists' inter-professional practices regarding low back pain (LBP) management and identifies organizational and provider-level variables associated with the intensity of such practices. Method : A total of 327 randomly selected physiotherapists were surveyed in the province of Quebec. Data were analyzed using descriptive and multiple regression analyses. Results : Physiotherapists reported frequent interactions with other physiotherapists (daily/weekly for 52.6%), family physicians (51.0%), and physiotherapy (PT) assistants (45.2%), but infrequent interactions with psychologists (3.6%), neurosurgeons (0.9%), and chiropractors (0.3%). Frequently reported means of interactions were written and oral messages sent through clients (55.1% and 24.1%, respectively), face-to-face unplanned discussions (41.9%), and faxed or mailed letters (23.2%). Variables associated with the intensity of inter-professional practices (mean of 6.7 [ SD 1.7] out of 10 on the Intensity of Interprofessional Practices Questionnaire for Private Sector Physiotherapists) were related to physiotherapists' clientele, social activities with other providers, and perceptions of inter-professional practices as well as organizational models, vision, and provision of PT training. Conclusions: There is room to improve inter-professional practices with private-sector physiotherapists involved in managing LBP. Targets for action include physiotherapists and their workplaces.

Private sector participation in domestic waste management in informal settlements in Lagos, Nigeria.

PubMed

Opoko, Akunnaya P; Oluwatayo, Adedapo A

2016-12-01

Lagos is one of the fastest growing cities in Africa, which is grappling with the challenges of poorly managed urbanisation. With an estimated population of about 17.5 million, solid waste management is one of the most pressing environmental challenges currently faced in the city. It is estimated that more than 9071847.4kg of urban waste is generated every day in the city. The city lacks the capacity to deal with such magnitude of waste. Consequently, the city has involved the private sector (private sector participation) in its waste management drive. This article examines the effectiveness of this public-private sector collaboration model in waste management in informal settlements in Lagos using empirical data. Major findings of the article include the irregularity of waste collection owing to a poor road network, an inadequate transport infrastructure and the desire to maximise profit, as well as poor waste handling and disposal methods by the private sector participation operators who are not chosen based on competence and capacity to perform. Another major finding is the lack of cooperation from residents evidenced in non-payment of bills and poor packaging of wastes, resulting in wastes being littered. The article concludes on the need to restructure the scheme through proper sensitisation of residents, selection of operators with demonstrable delivery capacity and provision of a well-maintained road network to facilitate access of operators to settlements. © The Author(s) 2016.

Treatment and prevention of malaria in pregnancy in the private health sector in Uganda: implications for patient safety.

PubMed

Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip

2016-04-14

Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality of care in the private sector that provides almost a half of health services in Uganda. A survey was conducted from August to October 2014 within 57 parishes in Mukono district, central Uganda. The selected parishes had a minimum of 200 households and at least one registered drug shop, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. A total of 241 private health facilities were surveyed; 70.5 % were registered drug shops, 24.5 % private clinics and 5.0 % pharmacies. Treatment of fever among pregnant women in accordance with the national treatment guidelines was poor: 40.7 % in private clinics, decreasing to 28.2 % in drug shops and 16.7 % at pharmacies. Anti-malarial monotherapies sulphadoxine-pyrimethamine and quinine were commonly prescribed, often without consideration of gestational age. The majority of providers (>75 %) at all private facilities prescribed SP for intermittent preventive treatment but artemisinin-based combination therapy was prescribed: 8.3, 6.9 and 8.3 % respectively at drug shops, private clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were the factors that most influenced correct treatment of fever in pregnancy. Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health sector in Uganda.

Statistical Bulletin: Annual Report On Economic Indicators, 1979.

ERIC Educational Resources Information Center

American Samoa Development Planning Office, Pago Pago.

Designed to serve as the basis for systematic collection of statistical information for government and the private sector, this bulletin presents a wide variety of economic indicators in tabular form. The data, selected to facilitate government and private planning efforts, are displayed in 25 tables and 27 graphs. Information is organized under…

The Impact of Military Training on Veterans’ Earnings in the Private Sector: Is there Complimentarity Between Military and Private Training for Veterans

DTIC Science & Technology

1994-03-01

thesis analyzed the complimentarity between military and post-military private sector training and the effect of military training on private sector wages...of data. The results of the thesis indicate that military training increases post-military private sector earnings of Veterans by 0.18 percent per...between military and post-service private sector training. When type of occupation is included in the models, the wage effect of military training fell to

Leveraging the private health sector to enhance HIV service delivery in lower-income countries.

PubMed

Rao, Pamela; Gabre-Kidan, Tesfai; Mubangizi, Deus Bazira; Sulzbach, Sara

2011-08-01

Evidence that the private health sector is a key player in delivering health services and impacting health outcomes, including those related to HIV/AIDS, underscores the need to optimize the role of the private health sector to scale up national HIV responses in lower-income countries. This article reviews findings on the types of HIV/AIDS services provided by the private health sector in developing countries and elaborates on the role of private providers of HIV services in Ethiopia. Drawing on data from the nation's innovative Private Health Sector Project, a pilot project that has demonstrated the feasibility of public-private partnerships in this area, the article highlights the potential for national governments to scale up HIV/AIDS services by leveraging private health sector resources, innovations, and expertise while working to regulate quality and cost of services. Although concerns about uneven quality and affordability of private sector health services must be addressed through regulation, policy, or other innovative approaches, we argue that the benefits of leveraging the private sector outweigh these challenges, particularly in light of finite donor and public domestic resources.

Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings.

PubMed

Bennett, Adam; Avanceña, Anton L V; Wegbreit, Jennifer; Cotter, Chris; Roberts, Kathryn; Gosling, Roly

2017-06-14

In malaria elimination settings, all malaria cases must be identified, documented and investigated. To facilitate complete and timely reporting of all malaria cases and effective case management and follow-up, engagement with private providers is essential, particularly in settings where the private sector is a major source of healthcare. However, research on the role and performance of the private sector in malaria diagnosis, case management and reporting in malaria elimination settings is limited. Moreover, the most effective strategies for private sector engagement in malaria elimination settings remain unclear. Twenty-five experts in malaria elimination, disease surveillance and private sector engagement were purposively sampled and interviewed. An extensive review of grey and peer-reviewed literature on private sector testing, treatment, and reporting for malaria was performed. Additional in-depth literature review was conducted for six case studies on eliminating and neighbouring countries in Southeast Asia and Southern Africa. The private health sector can be categorized based on their commercial orientation or business model (for-profit versus nonprofit) and their regulation status within a country (formal vs informal). A number of potentially effective strategies exist for engaging the private sector. Conducting a baseline assessment of the private sector is critical to understanding its composition, size, geographical distribution and quality of services provided. Facilitating reporting, referral and training linkages between the public and private sectors and making malaria a notifiable disease are important strategies to improve private sector involvement in malaria surveillance. Financial incentives for uptake of rapid diagnostic tests and artemisinin-based combination therapy should be combined with training and community awareness campaigns for improving uptake. Private sector providers can also be organized and better engaged through social franchising, effective regulation, professional organizations and government outreach. This review highlights the importance of engaging private sector stakeholders early and often in the development of malaria elimination strategies.

Trends in Private Sector Development in World Bank Education Projects. Policy Research Working Paper Series.

ERIC Educational Resources Information Center

Sosale, Shobhana

The private sector is playing an increasingly important role in financing and providing educational services in many countries. (Often the term "private sector" encompasses households' out-of-pocket expenses rather than describing for-profit or not-for-profit sectors.) Private sector development has not arisen primarily through public…

75 FR 34148 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency...) announces its adoption of three standards for the Voluntary Private Sector Accreditation and Certification... DHS to develop and implement a Voluntary Private Sector Preparedness Accreditation and Certification...

22 CFR 201.23 - Procurement under private sector procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procurement under private sector procedures... § 201.23 Procurement under private sector procedures. (a) General requirements. Procurements under private sector procedures will normally be carried out by importers using negotiated procurement...

75 FR 60773 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... concerns in the Voluntary Private Sector Accreditation and Certification Preparedness Program (PS-Prep...-53 (the 9/11 Act) mandated DHS to establish a voluntary private sector preparedness accreditation and...

78 FR 77426 - Notice of Vacancies on the U.S. Section of the U.S.-Iraq Business Dialogue

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... a bilateral forum to facilitate private sector business growth in Iraq and to strengthen trade and... Section consists of members from the private sector, representing the views and interests of the private... reflect private sector views, needs, and concerns regarding private sector business development in Iraq...

Role of the private sector in the provision of immunization services in low- and middle-income countries.

PubMed

Levin, Ann; Kaddar, Miloud

2011-07-01

The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization services in low- and middle-income countries.

Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps.

PubMed

Awor, Phyllis; Miller, Jane; Peterson, Stefan

2014-12-01

Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community-acquired malaria, pneumonia or diarrhoea. We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were "malaria", "pneumonia", "diarrhoea", "private sector" and "community case management". A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM-related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM-related studies in the public sector directly reported on community case management of 2 or more of the illnesses. While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non-malaria-associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in conjunction with private sector intervention programs.

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…

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

Schatz, Glenn

Higher education uses less energy per square foot than most commercial building sectors. However, higher education campuses house energy-intensive laboratories and data centers that may spend more than this average; laboratories, in particular, are disproportionately represented in the higher education sector. The Commercial Building Partnership (CBP), a public/private, cost-shared program sponsored by the U.S. Department of Energy (DOE), paired selected commercial building owners and operators with representatives of DOE, its national laboratories, and private-sector technical experts. These teams explored energy-saving measures across building systems–including some considered too costly or technologically challenging–and used advanced energy modeling to achieve peak whole-building performance.more » Modeling results were then included in new construction or retrofit designs to achieve significant energy reductions.« less

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.

Privacy Issues and the Private Sector,

DTIC Science & Technology

1976-07-01

GUIDE represents a large portion of the private sector of this country; at the moment, of course, the recordkeeping processes of non-Federal...the Privacy Protection Study Commission to examine the private sector and non-Federal government. The Commission is to recommend to Congress and the...President first, what aspects of the 1974 Act should be applied to the private sector ; secondly, to recommend to Congress and the President what further legislative safeguards are indicated for the private sector .

Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

PubMed

Grépin, Karen A

2016-07-01

There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. Project HOPE—The People-to-People Health Foundation, Inc.

High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India.

PubMed

Singh, Priyanka; Hashmi, Gulfam; Swain, Prafulla Kumar

2018-05-10

Worldwide rising cesarean section (CS) births is an issue of concern. In India, with increase in institutional deliveries there has also been an increase in cesarean section births. Aim of the study is to quantify the prevalence of cesarean section births in public and private health facility, and also to determine the factors associated with cesarean section births. We analyzed data from district level household survey data 4 (DLHS-4) combined individual level dataset for 19 states/UTs of India comprising 24,398 deliveries resulting in 22,111 live births for year 2011. The percentages and Chi-square has been computed for the select variables viz. Socio demographic, maternal, antenatal care and delivery related based on type of births (CS Vs normal births). The multiple logistic regression model has been used to identify the potential risk factors associated with CS births. Of 22,111 live birth analyzed 49.2% were delivered at public sector, 31.9% at private sector and 18.9% were home deliveries. Prevalence of CS births were 13.7% (95% CI; 13.0- 14.3%) and 37.9% (95% CI; 36.7- 39.0%) in the public and private sectors, respectively. Higher odds of CS births were observed with- delivery at private health facility (OR 3.79; 95% C.I 3.06-4.72), urban residence (OR 1.15; 95% C.I 1.00- 1.35), first delivery after 35 years of maternal age (OR 5.5; 95% C.I 1.85- 16.4), hypertension in pregnancy (OR 1.32; 95% C.I 1.06- 1.65) and breach presentation (OR 2.37; 95% C.I. 1.63- 3.43). Our findings shows that CS births are nearly three times more in private as compared to public sector health facilities.The higher rates of CS births, especially in private sector, not only increase the cost of care but may pose unnecessary risks to women (when there is no indications for CS). The government of India need to take measures to strengthen existing public health facilities as well as ensure that cesarean sections are performed based upon medical indications in both public and private sector health facilities.

The malaria testing and treatment market in Kinshasa, Democratic Republic of the Congo, 2013.

PubMed

Mpanya, Godéfroid; Tshefu, Antoinette; Likwela, Joris Losimba

2017-02-28

The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation's capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector. A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and private sector were screened for eligibility. Among outlets with anti-malarials or malaria rapid diagnostic tests (RDT) in stock, a full audit of all available products was conducted. Information collected included product information (e.g. active ingredients, brand name), amount reportedly distributed to patients in the past week, and retail price. In total, 3364 outlets were screened for inclusion across Kinshasa and 1118 outlets were eligible for the study. Among all screened outlets in the private sector only about one in ten (12.1%) were stocking quality-assured Artemisinin-based Combination Therapy (ACT) medicines. Among all screened public sector facilities, 24.5% had both confirmatory testing and quality-assured ACT available, and 20.2% had sulfadoxine-pyrimethamine (SP) available for intermittent preventive therapy during pregnancy (IPTp). The private sector distributed the majority of anti-malarials in Kinshasa (96.7%), typically through drug stores (89.1% of the total anti-malarial market). Non-artemisinin therapies were the most commonly distributed anti-malarial (50.1% of the total market), followed by non quality-assured ACT medicines (38.5%). The median price of an adult quality-assured ACT was $6.59, and more expensive than non quality-assured ACT ($3.71) and SP ($0.44). Confirmatory testing was largely not available in the private sector (1.1%). While the vast majority of anti-malarial medicines distributed to patients in Kinshasa province are sold within the private sector, availability of malaria testing and appropriate treatment for malaria is alarmingly low. There is a critical need to improve access to confirmatory testing and quality-assured ACT in the private sector. Widespread availability and distribution of non quality-assured ACT and non-artemisinin therapies must be addressed to ensure effective malaria case management.

Evaluation of Workload and its Impact on Satisfaction Among Pharmacy Academicians in Southern India

PubMed Central

Khan, Muhammad Umair; Srikanth, Akshaya B.; Patel, Isha; Nagappa, Anantha Naik; Jamshed, Shazia Qasim

2015-01-01

Objective The purpose of this study was to determine the level of workload among pharmacy academicians working in public and private sector universities in India. The study also aimed to assess the satisfaction of academicians towards their workload. Materials and Methods A cross-sectional study was conducted for a period of 2 months among pharmacy academicians in Karnataka state of Southern India. Convenience sampling was used to select a sample and was contacted via email and/or social networking sites. Questionnaire designed by thorough review literature was used as a tool to collect data on workload (teaching, research, extracurricular services) and satisfaction. Results Of 214 participants, 95 returned the filled questionnaire giving the response rate of 44.39%. Private sector academicians had more load of teaching (p=0.046) and they appeared to be less involved in research activities (p=0.046) as compared to public sector academicians. More than half of the respondents (57.9%) were satisfied with their workload with Assistant Professors were least satisfied as compared to Professors (p=0.01). Conclusion Overall, private sector academicians are more burdened by teaching load and also are less satisfied of their workload. Revision of private universities policies may aid in addressing this issue. PMID:26266133

48 CFR 37.112 - Government use of private sector temporaries.

Code of Federal Regulations, 2010 CFR

2010-10-01

... use of private sector temporaries. Contracting officers may enter into contracts with temporary help service firms for the brief or intermittent use of the skills of private sector temporaries. Services... part 300, subpart E, Use of Private Sector Temporaries, and agency procedures. [56 FR 55380, Oct. 25...

75 FR 80082 - State, Local, Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-21

..., Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: Information Security Oversight... State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC). The SLTPS-PAC will..., Tribal, and Private Sector Entities, as specified in Executive Order 13549 and its implementing directive...

78 FR 65218 - Defense Federal Acquisition Regulation Supplement: Private Sector Notification Requirements of In...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-31

... Federal Acquisition Regulation Supplement: Private Sector Notification Requirements of In-Sourcing Actions... Supplement (DFARS) to implement a section of the National Defense Authorization Act regarding private sector... section 938 of the National Defense Authorization Act (NDAA) for Fiscal Year 2012 regarding private sector...

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.

Systematic literature review of integrated community case management and the private sector in Africa: Relevant experiences and potential next steps

PubMed Central

Awor, Phyllis; Miller, Jane; Peterson, Stefan

2014-01-01

Background Despite substantial investments made over the past 40 years in low income countries, governments cannot be viewed as the principal health care provider in many countries. Evidence on the role of the private sector in the delivery of health services is becoming increasingly available. In this study, we set out to determine the extent to which the private sector has been utilized in providing integrated care for sick children under 5 years of age with community–acquired malaria, pneumonia or diarrhoea. Methods We reviewed the published literature for integrated community case management (iCCM) related experiences within both the public and private sector. We searched PubMed and Google/Google Scholar for all relevant literature until July 2014. The search terms used were “malaria”, “pneumonia”, “diarrhoea”, “private sector” and “community case management”. Results A total of 383 articles referred to malaria, pneumonia or diarrhoea in the private sector. The large majority of these studies (290) were only malaria related. Most of the iCCM–related studies evaluated introduction of only malaria drugs and/or diagnostics into the private sector. Only one study evaluated the introduction of drugs and diagnostics for malaria, pneumonia and diarrhoea in the private sector. In contrast, most iCCM–related studies in the public sector directly reported on community case management of 2 or more of the illnesses. Conclusions While the private sector is an important source of care for children in low income countries, little has been done to harness the potential of this sector in improving access to care for non–malaria–associated fever in children within the community. It would be logical for iCCM programs to expand their activities to include the private sector to achieve higher population coverage. An implementation research agenda for private sector integrated care of febrile childhood illness needs to be developed and implemented in conjunction with private sector intervention programs. PMID:25520804

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

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 other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors.

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 misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors. PMID:21619572

American Higher Education and Income Inequality

ERIC Educational Resources Information Center

Hill, Catharine B.

2016-01-01

This paper demonstrates that increasing income inequality can contribute to the trends we see in American higher education, particularly in the selective, private nonprofit and public sectors. Given these institutions' selective admissions and commitment to socioeconomic diversity, the paper demonstrates how increasing income inequality leads to…

Intellectual wellness awareness: a neglected area in medical universities of Pakistan.

PubMed

Naz, Ayesha Saba; Rehman, Rehana; Katpar, Shah Jahan; Hussain, Mehwish

2014-09-01

To compare the presence of intellectual wellness awareness in students of public and private sector medical colleges in a metropolitan city. The cross-sectional questionnaire-based survey was conducted from March to November 2011 at Bahria University Medical and Dental College, Karachi, and overall covered five private and 3 public sector medical colleges of the city.The study randomly selected 800 medical students.The responses - never, sometimes, mostly and always (numbered 0-4)--were analysed in terms of frequency, proportion and percentages using Predictive Analysis Software version 18. Of the 800 forms distributed, 736 (92%) completed forms were analysed. Among the respondents, 526 (71.5%) were females. Besides, 450 (61%) belonged to private medical colleges and 236 (39) were from public medical colleges. The participants of private medical colleges had taken part in intellectual discussions actively compared to those from public colleges (p < 0.001). Habit of reading books to acquire knowledge was found in 126 (44%) private college students compared to 149 (33%) in public colleges (p < 0.004). The importance of creative mental activities (p = 0.954) and current information about local and international affairs (p < 0.564) was deficient in both sets of students. Students of private medical colleges were better in terms of presence of intellectual wellness awareness, took active participation in class discussions, had good reading habits and carefully selected television programmes and movies.

76 FR 80971 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

..., Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records... made for the committee meeting of the State, Local, Tribal, and Private Sector Policy Advisory..., Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on January 18, 2012, 10 a.m...

78 FR 75376 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC) AGENCY: National Archives... (NARA) announces a meeting of the State, Local, Tribal, and Private Sector Policy Advisory Committee... Information Program for State, Local, Tribal, and Private Sector Entities. The meeting will be open to the...

Career Education: Collaboration with the Private Sector. Information Series No. 246.

ERIC Educational Resources Information Center

Bhaerman, Robert D.

This paper reviews three aspects of career education-private sector collaboration: (1) the general and specific approaches that have been utilized during the past 10 years by the career education movement and the private sector in developing career education collaboration in the private sector; (2) the major results of these activities, focusing…

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.

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.

Private sector participation and health system performance in sub-saharan Africa.

PubMed

Yoong, Joanne; Burger, Nicholas; Spreng, Connor; Sood, Neeraj

2010-10-07

The role of the private health sector in developing countries remains a much-debated and contentious issue. Critics argue that the high prices charged in the private sector limits the use of health care among the poorest, consequently reducing access and equity in the use of health care. Supporters argue that increased private sector participation might improve access and equity by bringing in much needed resources for health care and by allowing governments to increase focus on underserved populations. However, little empirical exists for or against either side of this debate. We examine the association between private sector participation and self-reported measures of utilization and equity in deliveries and treatment of childhood respiratory disease using regression analysis, across a sample of nationally-representative Demographic and Health Surveys from 34 SSA economies. We also examine the correlation between private sector participation and key background factors (socioeconomic development, business environment and governance) and use multivariate regression to control for potential confounders. Private sector participation is positively associated with greater overall access and reduced disparities between rich and poor as well as urban and rural populations. The positive association between private sector participation and improved health system performance is robust to controlling for confounders including per capita income and maternal education. Private sector participation is positively correlated with measures of socio-economic development and favorable business environment. Greater participation is associated with favorable intermediate outcomes in terms of access and equity. While these results do not establish a causal link between private sector participation and health system performance, they suggest that there is no deleterious link between private sector participation and health system performance in SSA.

Quality of anti-malarials collected in the private and informal sectors in Guyana and Suriname

PubMed Central

2012-01-01

Background Despite a significant reduction in the number of malaria cases in Guyana and Suriname, this disease remains a major problem in the interior of both countries, especially in areas with gold mining and logging operations, where malaria is endemic. National malaria control programmes in these countries provide treatment to patients with medicines that are procured and distributed through regulated processes in the public sector. However, availability to medicines in licensed facilities (private sector) and unlicensed facilities (informal sector) is common, posing the risk of access to and use of non-recommended treatments and/or poor quality products. Methods To assess the quality of circulating anti-malarial medicines, samples were purchased in the private and informal sectors of Guyana and Suriname in 2009. The sampling sites were selected based on epidemiological data and/or distance from health facilities. Samples were analysed for identity, content, dissolution or disintegration, impurities, and uniformity of dosage units or weight variation according to manufacturer, pharmacopeial, or other validated method. Results Quality issues were observed in 45 of 77 (58%) anti-malarial medicines sampled in Guyana of which 30 failed visual & physical inspection and 18 failed quality control tests. The proportion of monotherapy and ACT medicines failing quality control tests was 43% (13/30) and 11% (5/47) respectively. A higher proportion of medicines sampled from the private sector 34% (11/32) failed quality control tests versus 16% (7/45) in the informal sector. In Suriname, 58 medicines were sampled, of which 50 (86%) were Artecom®, the fixed-dose combination of piperaquine-dihydroartemisinin-trimethoprim co-blistered with a primaquine phosphate tablet. All Artecom samples were found to lack a label claim for primaquine, thus failing visual and physical inspection. Conclusions The findings of the studies in both countries point to significant problems with the quality of anti-malarial medicines available in private and informal sector facilities as well as the availability of therapy not compliant with national treatment guidelines. They also stress the need to strengthen regulatory control efforts on the availability of anti-malarial medicines in these sectors and in endemic areas. PMID:22704709

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study.

PubMed

Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Srivastava, Ashish; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

2017-06-22

Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes-specifically Janani Suraksha Yojana (JSY)-for maternity service delivery. Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. The major factors serving as barriers to participation of private practitioners in JSY-which emerged on thematic analysis-were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public-private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Facilitators and barriers to participation of private sector health facilities in government-led schemes for maternity services in India: a qualitative study

PubMed Central

Yadav, Vikas; Kumar, Somesh; Balasubramaniam, Sudharsanam; Pallipamula, Suranjeen; Memon, Parvez; Singh, Dinesh; Bhargava, Saurabh; Sunil, Greeshma Ann; Sood, Bulbul

2017-01-01

Objective Despite provision of accreditation of private sector health providers in government-led schemes for maternity services in India, their participation has been low. This has led to an underutilisation of their presence, resources and expertise for providing quality maternal and newborn health services. This study explores the perception of various stakeholders on expectations, benefits, barriers and facilitators to private sector participation in government-led schemes—specifically Janani Suraksha Yojana (JSY)—for maternity service delivery. Design Narrative-based qualitative study. Face-to-face in-depth interviews were conducted with study participants. The interviews were transcribed, translated and analysed using a reflexive and inductive approach to allow codes, categories and themes to emerge from within the data. Setting Private obstetricians, government health officials and FOGSI (Federation of Obstetrics and Gynaecological Societies of India) members, Jharkhand and Uttar Pradesh, India. Participants Eighteen purposefully selected private obstetricians from 9 cities across states of Uttar Pradesh and Jharkhand, 11 government health officials and 2 FOGSI members. Results The major factors serving as barriers to participation of private practitioners in JSY—which emerged on thematic analysis—were low reimbursement amounts, delayed reimbursements, process of interaction with the government and administrative issues, previous experiences and trust deficit, lack of clarity on the accreditation process and patient-level barriers. On the other hand, factors which were facilitators to participation of private practitioners were ease of process, better communication, branding, motivation of increasing clientele as well as satisfaction of doing social service. Conclusion Factors such as financial processes and administrative delays, mistrust between the stakeholders, ambiguity in processes, lack of transparency and lack of ease in the process of empanelment of private sector are hindering effective public–private partnerships under JSY. Simplifying and strengthening the processes, communication strategies and branding can help revitalise it. PMID:28645984

What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries.

PubMed

Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Cavagnero, Eleonora; Zhao, Hongwen

2016-08-06

Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners-both unlicensed and licensed-to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa. Copyright © 2016 Elsevier Ltd. All rights reserved.

77 FR 41204 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

..., Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: Information Security Oversight..., announcement is made for the committee meeting of the State, Local, Tribal, and Private Sector Policy Advisory..., Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on July 25, 2012, 10:00 a.m...

20 CFR 641.660 - Who is eligible to participate in section 502(e) private sector training activities?

Code of Federal Regulations, 2010 CFR

2010-04-01

...(e) private sector training activities? 641.660 Section 641.660 Employees' Benefits EMPLOYMENT AND... PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.660 Who is eligible to participate in section 502(e) private sector training activities? The same eligibility criteria used in the...

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.

Privatization of solid waste collection services: Lessons from Gaborone

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

Bolaane, Benjamin, E-mail: bolaaneb@mopipi.ub.bw; Isaac, Emmanuel, E-mail: eisaac300@gmail.com

Highlights: • We compared efficiency and effectiveness of waste collection by the public and private sector. • Public sector performs better than private sector in some areas and vice versa. • Outsourcing waste collection in developing countries is hindered by limited capacity on contractual issues. • Outsourcing collection in developing countries is hampered by inadequate waste information. • There is need to build capacity in the public sector of developing countries to support outsourcing. - Abstract: Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste managementmore » experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process.« less

Private sector role, readiness and performance for malaria case management in Uganda, 2015.

PubMed

Kaula, Henry; Buyungo, Peter; Opigo, Jimmy

2017-05-25

Several interventions have been put in place to promote access to quality malaria case management services in Uganda's private sector, where most people seek treatment. This paper describes evidence using a mixed-method approach to examine the role, readiness and performance of private providers at a national level in Uganda. These data will be useful to inform strategies and policies for improving malaria case management in the private sector. The ACTwatch national anti-malarial outlet survey was conducted concurrently with a fever case management study. The ACTwatch nationally representative anti-malarial outlet survey was conducted in Uganda between May 18th 2015 and July 2nd 2015. A representative sample of sub-counties was selected in 14 urban and 13 rural clusters with probability proportional to size and a census approach was used to identify outlets. Outlets eligible for the survey met at least one of three criteria: (1) one or more anti-malarials were in stock on the day of the survey; (2) one or more anti-malarials were in stock in the 3 months preceding the survey; and/or (3) malaria blood testing (microscopy or RDT) was available. The fever case management study included observations of provider-patient interactions and patient exit interviews. Data were collected between May 20th and August 3rd, 2015. The fever case management study was implemented in the private sector. Potential outlets were identified during the main outlet survey and included in this sub-sample if they had both artemisinin-based combination therapy (ACT) [artemether-lumefantrine (AL)], in stock on the day of survey as well as diagnostic testing available. A total of 9438 outlets were screened for eligibility in the ACTwatch outlet survey and 4328 outlets were found to be stocking anti-malarials and were interviewed. A total of 9330 patients were screened for the fever case management study and 1273 had a complete patient observation and exit interview. Results from the outlet survey illustrate that the majority of anti-malarials were distributed through the private sector (54.3%), with 31.4% of all anti-malarials distributed through drug stores and 14.4% through private for-profit health facilities. Availability of different anti-malarials and diagnostic testing in the private sector was: ACT (80.7%), quality-assured (QA) ACT (72.0%), sulfadoxine-pyrimethamine (SP) (47.1%), quinine (73.2%) and any malaria blood testing (32.9%). Adult QAACT ($1.62) was three times more expensive than SP ($0.48). The results from the fever case management study found 44.4% of respondents received a malaria test, and among those who tested positive for malaria, 60.0% received an ACT, 48.5% received QAACT; 14.4% a non-artemisinin therapy; 14.9% artemether injection, and 42.5% received an antibiotic. The private sector plays an important role in malaria case management in Uganda. While several private sector initiatives have improved availability of QAACT, there are gaps in malaria diagnosis and distribution of non-artemisinin monotherapies persists. Further private sector strategies, including those focusing on drug stores, are needed to increase coverage of parasitological testing and removal of non-artemisinin therapies from the marketplace.

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.

Roundtable discussion: what is the future role of the private sector in health?

PubMed

Stallworthy, Guy; Boahene, Kwasi; Ohiri, Kelechi; Pamba, Allan; Knezovich, Jeffrey

2014-06-24

The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage.This roundtable discussion offers diverse perspectives from a range of stakeholders--a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company--on what the future may hold for the private sector in health. The first perspective comes from a health funder, who argues that the discussion about the future role of the private sector has been bogged down in language. He argues for a 'both/and' approach rather than an 'either/or' when it comes to talking about health service provision in low- and middle-income countries.The second perspective is offered by an implementer of health insurance in sub-Saharan Africa. The piece examines the comparative roles of public sector actors, private sector actors and funding agencies, suggesting that they must work together to mobilize domestic resources to fund and deliver health services in the longer term.Thirdly, a special advisor working in the federal government of Nigeria considers the situation in that country. He notes that the private sector plays a significant role in funding and delivering health services there, and that the government must engage the private sector or forever be left behind.Finally, a representative from a multi-national pharmaceutical corporation gives an overview of global shifts that are creating opportunities for the private sector in health markets. Overall, the roundtable discussants agree that the private sector will play an important role in future health systems. But we must agree a common language, work together, and identify key issues and gaps that might be more effectively filled by the private sector.

Comparison of Navy and Private-Sector Construction Costs

DTIC Science & Technology

1997-09-01

contracts are comparable to private - sector construction costs. This report compares those costs. The report includes a description of the methodology...costs of complying with federal contracting requirements as compared with the costs of similar projects completed under typical private - sector contracts...The study found that the costs of facilities constructed under Navy contracts compare favorably to private - sector construction costs for similar

20 CFR 641.670 - May an eligible individual be enrolled simultaneously in section 502(e) private sector training...

Code of Federal Regulations, 2010 CFR

2010-04-01

... simultaneously in section 502(e) private sector training activities operated by one grantee and a community... EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.670 May an eligible individual be enrolled simultaneously in section 502(e) private sector training activities operated by one...

31 CFR 50.33 - Entities that do not share profits and losses with private sector insurers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and losses with private sector insurers. 50.33 Section 50.33 Money and Finance: Treasury Office of the...' Compensation Funds § 50.33 Entities that do not share profits and losses with private sector insurers. (a... share profits and losses with a private sector insurer is deemed to be a separate insurer under the...

20 CFR 641.640 - How do the private sector training activities authorized under section 502(e) differ from other...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How do the private sector training activities... COMMUNITY SERVICE EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.640 How do the private sector training activities authorized under section 502(e) differ from other...

Career development. Private lives.

PubMed

Hunt, Louise; Mooney, Helen

2009-01-22

Ensure the private sector job fits your career aims--don't simply take the first offer. Moving to the private sector can bring more freedom, but also more pressure to be entrepeneurial. A stint in the private sector can prepare you for roles back in the NHS.

Exploring the public-private and company size differences in employees' work characteristics and burnout: data analysis of a nationwide survey in Taiwan.

PubMed

Yeh, Wan-Yu; Yeh, Ching-Ying; Chen, Chiou-Jong

2018-05-15

Distinct differences exist between public-private sector organizations with respect to the market environment and operational objectives; furthermore, among private sector businesses, organizational structures and work conditions often vary between large- and small-sized companies. Despite these obvious structural distinctions, however, sectoral differences in employees' psychosocial risks and burnout status in national level have rarely been systematically investigated. Based on 2013 national employee survey data, 15,000 full-time employees were studied. Sector types were classified into "public," "private enterprise-large (LE)," and "private enterprise-small and medium (SME);" based on the definition of SMEs by Taiwan Ministry of Economic Affairs, and the associations of sector types with self-reported burnout status (measured by the Chinese version of Copenhagen Burnout Inventory) were examined, taking into account other work characteristics and job instability indicators. Significantly longer working hours and higher perceived job insecurity were found among private sector employees than their public sector counterparts. With further consideration of company size, greater dissatisfaction of job control and career prospect were found among SME employees than the other two sector type workers. This study explores the pattern of public-private differences in work conditions and employees' stress-related problems to have policy implications for supporting mechanism for disadvantaged workers in private sectors.

The value from investments in health information technology at the U.S. Department of Veterans Affairs.

PubMed

Byrne, Colene M; Mercincavage, Lauren M; Pan, Eric C; Vincent, Adam G; Johnston, Douglas S; Middleton, Blackford

2010-04-01

We compare health information technology (IT) in the Department of Veterans Affairs (VA) to norms in the private sector, and we estimate the costs and benefits of selected VA health IT systems. The VA spent proportionately more on IT than the private health care sector spent, but it achieved higher levels of IT adoption and quality of care. The potential value of the VA's health IT investments is estimated at $3.09 billion in cumulative benefits net of investment costs. This study serves as a framework to inform efforts to measure and calculate the benefits of federal health IT stimulus programs.

Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

PubMed

Bustreo, Flavia; Harding, April; Axelsson, Henrik

2003-01-01

The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations.

Can developing countries achieve adequate improvements in child health outcomes without engaging the private sector?

PubMed Central

Bustreo, Flavia; Harding, April; Axelsson, Henrik

2003-01-01

The private sector exerts a significant and critical influence on child health outcomes in developing countries, including the health of poor children. This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector's influence on child health outcomes. This influence goes beyond service provision by private providers and nongovernmental organizations (NGOs). Pharmacies, drug sellers, private suppliers, and food producers also have an impact on the health of children. Many governments are experimenting with strategies to engage the private sector to improve child health. The article analyses some of the most promising strategies, and suggests that a number of constraints make it hard for policy-makers to emulate these approaches. Few experiences are clearly described, monitored, and evaluated. The article suggests that improving the impact of child health programmes in developing countries requires a more systematic analysis of how to engage the private sector most effectively. The starting point should include the evaluation of the presence and potential of the private sector, including actors such as professional associations, producer organizations, community groups, and patients' organizations. PMID:14997241

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

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 public sector services. 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.

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 undefined as yet but it should not be neglected as a useful complement to public sector services. PMID:25712822

How Old Is Old? Employing Elderly Teachers in the Private Sector Schools in Sri Lanka

ERIC Educational Resources Information Center

Madhuwanthi, L. A. P.

2016-01-01

The purpose of this paper is to explore why private sector schools in Sri Lanka employ elderly teachers (ETs). This paper used semi-structured in-depth interviews with 9 employers/principals in the private sector schools in Sri Lanka. The study found that the reasons for employing ETs in the private sector schools were shortfall of English medium…

Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

PubMed

Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

2012-07-01

The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise other complementary therapies in addition to acupuncture. Future studies should examine the impact of these differences on patients' clinical outcomes.

Private Sector Investment in Pakistani Agriculture: The Role of Infrastructural Investment

DTIC Science & Technology

1999-01-01

private sector will be expected to play the major role in providing capital to the agricultural sector, with the government’s remaining involvement being largely one of furnishing basic infrastructure. The critical question of course is how willing is the private sector to commit capital to agricultural activities in this new policy environment? Has the private sector responded in the past to the increases in profitability provided by an expansion in infrastructure? If so, what types of infrastructure are most conducive in

Who pays when VA users are hospitalized in the private sector? Evidence from three data sources.

PubMed

West, Alan N; Weeks, William B

2007-10-01

Older veterans enrolled in VA healthcare receive much of their medical care in the private sector, through Medicare. Less is known about younger VA enrollees' use of the private sector, or its funding. We compare payers for younger and older enrollees' private sector use in 3 hospitalization datasets. From 1998 to 2000, using private sector discharge data for VA enrollees in New York State, we categorized hospitalizations according to payer (self/family, private insurance, Medicare, Medicaid, other sources). We compared this payer distribution to population-weighted national Medical Expenditure Panel Survey (MEPS) data from 1996-2003 for veterans in VA healthcare. We also compared Medicare utilization in either dataset to hospitalizations for New York veterans from 1998-2000 in the VA-Medicare dataset. Analyses separated patients younger than age 65 from those age 65 or older. VA enrollees under age 65 obtain roughly half their hospitalizations in the private sector; older enrollees use the private sector at least twice as often as the VA. Datasets generally agree on payer distributions. Although older enrollees rely heavily on Medicare, they also use commercial insurance and self/family payments substantially. Half of younger enrollees' non-VA hospitalizations are paid by private insurance, but Medicare, Medicaid, and self/family each pay for one-quarter to one-third of admissions. VA enrollees use the private sector for most of their inpatient care, which is funded by multiple sources. Developing a national UB-92/VA dataset would be critical to understanding veterans' use of the private sector for specific diagnoses and procedures, particularly for the fast growing population of younger veterans.

36 CFR 72.50 - Grant selection criteria.

Code of Federal Regulations, 2010 CFR

2010-07-01

... proposal may lead to a positive, systemic change in how park and recreation services are provided. Extent... method approaches which may prove to be more effective under the private sector. This should in no way...

A Comparative Analysis of Financial Reporting Models for Private and Public Sector Organizations.

DTIC Science & Technology

1995-12-01

The objective of this thesis was to describe and compare different existing and evolving financial reporting models used in both the public and...private sector. To accomplish the objective, this thesis identified the existing financial reporting models for private sector business organizations...private sector nonprofit organizations, and state and local governments, as well as the evolving financial reporting model for the federal government

Infrastructure and Private Sector Investment in Pakistan

DTIC Science & Technology

1997-03-01

manner in which the expansion in various types of infrastructural facilities interact with private sector investment, and whether there is a long run...passive role in the country’s development. That is public facilities have largely expanded in response to the needs created by private sector investment...tangible needs created by private sector expansion it has, no doubt, been very effective in alleviating real bottlenecks. (JEL F21, 053).

Testimony. Federal White-Collar Employee Salary Reform

DTIC Science & Technology

1990-03-14

each locality. GAO also points out that private sector companies often grant salary increases to individual employees based on their job performance...by private sector employers for similar jobs. The comparability principle holds that the private sector will determine the "going rates" for jobs...established to maintain salary comparability with the private sector has not been followed for many years. Every year, beginning in 1978, Presidents have

Labor Market Uncertainty and Private Sector Labor Supply in Russia

DTIC Science & Technology

2000-09-01

The development of a vibrant private sector has been one of the key failures of the transitional period in Russia. This paper develops a theoretical...Monitoring Survey for the years 1994 - 1996 & 1998. As hypothesized, a decrease in private sector earnings variability is estimated to increase the likelihood...of private sector employment for individuals with constrained consumption smoothing ability. Evidence of ex-ante intra-household risk sharing is also

Analysis of Survivor Benefit Plan - Acceptance and Comparison with Private Sector

DTIC Science & Technology

1989-01-01

I COPY AIU WAR COLLEGE ,.SEARCH REPORT ,YSIS OF SURVIVOR BENEFIT PLAN-__CCEPTANCE ’-U AND COMPARISON WITH PRIVATE SECTOR LIEUENNT COLONEL JOHN R...AAA AIR WAR COLLEGE AIR UNIVERSITY ANALYSIS OF SURVIVOR BENEFIT PLAN--ACCEPTANCE AND COMPARISON WITH PRIVATE SECTOR by John R. Adams Lieutenant...Survivor Benefit Plan (SBP)--Acceptance and Comparison With Private Sector . AUTHORS: John R. Adams, Lieutenant Colonel, USAF; Daniel 3. Kohn

20 CFR 641.600 - What is the purpose of the private sector training projects authorized under section 502(e) of...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the purpose of the private sector... EMPLOYMENT PROGRAM Private Sector Training Projects Under Section 502(e) of the OAA § 641.600 What is the purpose of the private sector training projects authorized under section 502(e) of the OAA? The purpose of...

Cyclical absenteeism among private sector, public sector and self-employed workers.

PubMed

Pfeifer, Christian

2013-03-01

This research note analyzes differences in the number of absent working days and doctor visits and in their cyclicality between private sector, public sector and self-employed workers. For this purpose, I used large-scale German survey data for the years 1995 to 2007 to estimate random effects negative binomial (count data) models. The main findings are as follows. (i) Public sector workers have on average more absent working days than private sector and self-employed workers. Self-employed workers have fewer absent working days and doctor visits than dependent employed workers. (ii) The regional unemployment rate is on average negatively correlated with the number of absent working days among private and public sector workers as well as among self-employed men. The correlations between regional unemployment rate and doctor visits are only significantly negative among private sector workers. Copyright © 2012 John Wiley & Sons, Ltd.

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.

The change in capacity and service delivery at public and private hospitals in Turkey: a closer look at regional differences.

PubMed

Aksan, Hediye A D; Ergin, Işıl; Ocek, Zeliha

2010-11-01

Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services.This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions.

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 that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff. Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients.

Privatization of solid waste collection services: Lessons from Gaborone.

PubMed

Bolaane, Benjamin; Isaac, Emmanuel

2015-06-01

Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

78 FR 41959 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC); Notice of Meeting AGENCY... Classified National Security Information Program for State, Local, Tribal, and Private Sector Entities. FOR..., announcement is made for the following committee meeting. Name of Committee: State, Local, Tribal, and Private...

Enterprise Funds: Evolving Models for Private Sector Development in Central and Eastern Europe

DTIC Science & Technology

1994-03-01

and Hungary to help private sector development in those countries. Enterprise funds for the former Czech and Slovak Federal Republic were created in...institutions are reluctant to invest. The enterprise funds are also to provide technical assistance for private sector development in the host country...Strategies of loan programs developed. Poland and Hungary had taken some steps toward the creation of a private sector before the collapse of communism

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…

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 funding appeared between the two sectors, such that public funds and personnel were redirected to private sector development, followed by reductions in public sector service budgets and staff. Conclusions Studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients. Please see later in the article for the Editors' Summary PMID:22723748

Enrolments, Funding and Student Staff Ratios by Sector. Policy Note. Number 2

ERIC Educational Resources Information Center

Group of Eight (NJ1), 2011

2011-01-01

This briefing examines government and private funding across educational sectors. Key findings include: (1) Differences in funding for public and private education across the sectors: (a) do not reflect policy coherence; and (b) entrench inequities; (2) All sectors receive funding from both public and private sources, though the shares vary.…

75 FR 47548 - President's Export Council Subcommittee on Export Administration; Notice of Recruitment of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-06

... selected from firms producing a broad range of goods, software, and technologies presently controlled for... their services. The PECSEA is seeking private-sector members with senior export control expertise and...

75 FR 54857 - President's Export Council, Subcommittee on Export Administration; Notice of Recruitment of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... industry representatives are selected from firms producing a broad range of goods, software, and... Subcommittee will not be compensated for their services. The PECSEA is seeking private-sector members with...

The dominance of the private sector in the provision of emergency obstetric care: studies from Gujarat, India.

PubMed

Salazar, Mariano; Vora, Kranti; De Costa, Ayesha

2016-07-07

India has experienced a steep rise in institutional childbirth. The relative contributions of public and private sector facilities to emergency obstetric care (EmOC) has not been studied in this setting. This paper aims to study in three districts of Gujarat state, India:(a) the availability of EmOC facilities in the public and private sectors; (b) the availability and distribution of human resources for birth attendance in the two sectors; and (c) to benchmark the above against 2005 World Health Report benchmarks (WHR2005). A cross-sectional survey of obstetric care facilities reporting 30 or more births in the last three months was conducted (n = 159). Performance of EmOC signal functions and availability of human resources were assessed. EmOC provision was dominated by private facilities (112/159) which were located mainly in district headquarters or small urban towns. The number of basic and comprehensive EmOC facilities was below WHR2005 benchmarks. A high number of private facilities performed C-sections but not all basic signal functions (72/159). Public facilities were the main EmOC providers in rural areas and 40/47 functioned at less than basic EmOC level. The rate of obstetricians per 1000 births was higher in the private sector. The private sector is the dominant EmOC provider in the state. Given the highly skewed distribution of facilities and resources in the private sector, state led partnerships with the private sector so that all women in the state receive care is important alongside strengthening the public sector.

Combining DRGs and per diem payments in the private sector: the Equitable Payment Model.

PubMed

Hanning, Brian W T

2005-02-01

The many types of payment models used in the Australian private sector are reviewed. Their features are compared and contrasted to those desirable in an optimal private sector payment model. The EPM(TM) (Equitable Payment Model) is discussed and its consistency with the desirable features of an optimal private sector payment model outlined. These include being based on a robust classification system, nationally benchmarked length of stay (LOS) results, nationally benchmarked relative cost and encouraging continual improvement in efficiency to the benefit of both health funds and private hospitals. The advantages in the context of the private sector of EPM(TM) being a per diem model, albeit very different to current per diem models, are discussed. The advantages of EPM(TM) for hospitals and health funds are outlined.

76 FR 70224 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-10

... claimed is correct. Respondents: Private Sector: Businesses or other for-profits. Estimated Total Burden... Return, for the employees involved. Respondents: Private Sector: Businesses or other for-profits, Not.... Respondents: Private Sector: Businesses or other for-profits. [[Page 70225

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.

'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-effective for retention than wage increases, and imply that it is not necessarily just a matter of putting more money into the public sector to increase retention.

Utilization of HIV-related services from the private health sector: A multi-country analysis.

PubMed

Wang, Wenjuan; Sulzbach, Sara; De, Susna

2011-01-01

Increasing the participation of the private health sector in the AIDS response could help to achieve universal access to comprehensive HIV prevention, treatment, care and support. Yet little is known about the extent to which the private health sector is delivering HIV-related services. This study uses data from the Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS) from 12 countries in Africa, Asia and Latin America and the Caribbean to explore use of HIV testing and STI care from the private for-profit sector, and its association with household wealth status. The analysis indicates that the private for-profit health sector is active in HIV-related service delivery, although the level of participation varies by region and country. From 3 to 45 percent of women and 6 to 42 percent of men reported the private for-profit sector as their source of the most recent HIV testing. While in some countries, use of the private for-profit health sector for HIV testing and STI care increases with wealth, in others the relationship is not clear, as there are no significant differences in using private for-profit HIV-related services between the rich and the poor. We conclude that as the global AIDS response evolves from emergency relief to sustained country programs, broader consideration of the role of the private for-profit health sector may be warranted. Copyright © 2010 Elsevier Ltd. All rights reserved.

[How to improve resource allocation in health care for better equity in Africa? Some directions for the future].

PubMed

Marek, Tonia

2008-12-01

Most projects financed by governments often end in deceptive results; certain indicators of health improve little, and certain not at all. Why? One cause could be the concentration of initiatives in the public sector, whereas half of heath care spending in Africa is in the private sector. It is time to consider the health care system in its entirety, and not just the public part. In this article the private sector is defined as all service provision provided by non-governmental supplier, either in the formal private sector (pharmacy, private hospital, etc.) or in the informal private sector (local, traditional therapists, informal consultations, for example).

Women's autonomy and scheduled cesarean sections in Brazil: a cautionary tale.

PubMed

Potter, Joseph E; Hopkins, Kristine; Faúndes, Anibal; Perpétuo, Ignez

2008-03-01

In Brazil, one-fourth of all women deliver in the private sector, where the rate of cesarean deliveries is extremely high (70%). Most (64%) private sector cesareans are scheduled, although many women would have preferred a vaginal delivery. The question this study addresses is whether childbearing women were induced to accept the procedure by their physicians, and if so, how? Three face-to-face structured interviews were conducted with 1,612 women (519 private sector and 1,093 public sector) early in pregnancy, approximately 1 month before their due date, and approximately 1 month postpartum. For all private sector patients having a scheduled cesarean section, women's self-reported reasons given for programming surgical delivery were classified into three groups according to obstetrical justification. After loss to follow-up (19.2% of private sector and 34.4% of public sector), our final sample included 1,136 women (419 private sector and 717 public sector). Compared with public sector participants in the final sample, on average, private sector participants were older by 3.4 years (28.7 vs 25.3 yr), had 0.4 fewer previous deliveries (0.6 vs 1.0), and had 3.4 more years of education (11.0 vs 7.6 yr). The final samples also differed slightly with respect to preference for vaginal delivery: 72.3 percent among those in the private sector and 79.6 percent in public sector. The cesarean section rate was 72 percent in the private sector and 31 percent in the public sector. Of the women with reports about the timing of the cesarean decision, 64.4 percent had a scheduled cesarean delivery in the private sector compared with 23.7 percent in the public sector. Many cesarean sections were scheduled for an "unjustified" medical reason, especially among women who, during pregnancy, had declared a preference for a vaginal delivery. Among 96 women in this latter group, the reason reported for the procedure was unjustified in 33 cases. On the other hand, more cesarean deliveries were scheduled for "no medical justification," including physician's or the woman's convenience, among women who preferred to deliver by cesarean (35/65). The incidence of real medical reasons for a scheduled cesarean section diagnosed before the onset of labor among private sector patients who had no previous cesarean birth and who wanted a vaginal delivery was 13 percent (31/243). The data suggest that doctors frequently persuaded their patients to accept a scheduled cesarean section for conditions that either did not exist or did not justify this procedure. The problem identified in this paper may extend well beyond Brazil and should be of concern to those with responsibility for ethical behavior in obstetrics.

Petroleum Based Development and the Private Sector: A Critique of the Saudi Arabian Industrialization Strategy

DTIC Science & Technology

1985-01-01

1985 2. REPORT TYPE 3. DATES COVERED 00-00-1985 to 00-00-1985 4. TITLE AND SUBTITLE Petroleum Based Development and the Private Sector : A...PETROLEUM BASED DEVELOPMENT AND THE PRIVATE SECTOR : A CRITIQUE OF THE SAUDI ARABIAN INDUSTRIALIZATION STRATEGY By Robert E. Looney In almost every country...providing incentives and external economies to the private sector to establish a number of industries supplying the basic consumer and development needs of

[Collaboration between public health nurses and the private sector].

PubMed

Marutani, Miki; Okada, Yumiko; Hasegawa, Takashi

2016-01-01

We clarified collaborations between public health nurses (PHNs) and the private sector, such as nonprofit organizations. Semi-structured interviews were conducted with 11 private sector organizations and 13 PHNs who collaborate with them between December 2012 to October 2013. Interview guides were: overall suicide preventive measurements, details of collaboration between private sector organizations and PHNs, and suicide prevention outcomes/issues. Data from private sector organizations and PHNs were separately analyzed and categories created using qualitative and inductive design. Private sector organizations' and PHNs' categories were compared and separated into core categories by similarities. Six categories were created: 1. establishing a base of mutual understanding; 2. raising public awareness of each aim/characteristic; 3. competently helping high suicidal risk persons detected during each activity; 4. guarding lives and rehabilitating livelihoods after intervention; 5. restoring suicide attempters/bereaved met in each activity; and 6. continuing/expanding activities with reciprocal cohesion/evaluation. PHNs are required to have the following suicide prevention tasks when collaborating with private sector organizations: understanding the private sector civilization, sharing PHN experiences, improving social determinants of health, meeting basic needs, supporting foundation/difficulties each other (Dear editor. Thank you for kind comments. I was going to explain that PHNs and NPOs support each other their foundation of activity and difficulties in their activities. The foundations include knowledge, information, budgets, manpower etc. The difficulties mean like suffering faced with suicide during activities.), and enhancing local governments' flexibilities/ promptness.

Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania

PubMed Central

2012-01-01

Background Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector. Methods To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data. Results ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29–1.18 US$). Conclusions In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs. PMID:22455367

Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania.

PubMed

Malisa, Allen Lewis; Kiriba, Deodatus

2012-03-28

Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector. To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs) in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data. ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$). By contrast, ALU that was available in the private sector (coartem) was being sold at a price of about 10,000 TShs (5.9 US$), the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug) was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29-1.18 US$). In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.

An Examination of Three Forms of Private Sector Financing of Military Facilities

DTIC Science & Technology

1988-09-01

The purpose of this study was to introduce the concept of Private Sector Financing (PSF) of military facilities instead of acquiring facilities via... Private sector financing; Military construction; Leasing; Contracting out; Outleasing; Military family housing. Theses.

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…

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)

Lessons Learned from the Private Sector

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

Robichaud, Robert J

This session is focused on lessons learned from private sector energy projects that could be applied to the federal sector. This presentation tees up the subsequent presentations by outlining the differences between private and federal sectors in objectives, metrics for determining success, funding resources/mechanisms, payback and ROI evaluation, risk tolerance/aversion, new technology adoption perspectives, and contracting mechanisms.

Private and Public Sector Enterprise Resource Planning System Post-Implementation Practices: A Comparative Mixed Method Investigation

ERIC Educational Resources Information Center

Bachman, Charles A.

2010-01-01

While private sector organizations have implemented enterprise resource planning (ERP) systems since the mid 1990s, ERP implementations within the public sector lagged by several years. This research conducted a mixed method, comparative assessment of post "go-live" ERP implementations between public and private sector organization. Based on a…

Reducing Avoidable Deaths Among Veterans: Directing Private-Sector Surgical Care to High-Performance Hospitals

PubMed Central

Weeks, William B.; West, Alan N.; Wallace, Amy E.; Lee, Richard E.; Goodman, David C.; Dimick, Justin B.; Bagian, James P.

2007-01-01

Objectives. We quantified older (65 years and older) Veterans Health Administration (VHA) patients’ use of the private sector to obtain 14 surgical procedures and assessed the potential impact of directing that care to high-performance hospitals. Methods. Using a merged VHA–Medicare inpatient database for 2000 and 2001, we determined where older VHA enrollees obtained 6 cardiovascular surgeries and 8 cancer resections and whether private-sector care was obtained in high- or low-performance hospitals (based on historical performance and determined 2 years in advance of the service year). We then modeled the mortality and travel burden effect of directing private-sector care to high-performance hospitals. Results. Older veterans obtained most of their procedures in the private sector, but that care was equally distributed across high- and low-performance hospitals. Directing private-sector care to high-performance hospitals could have led to the avoidance of 376 to 584 deaths, most through improved cardiovascular care outcomes. Using historical mortality to define performance would produce better outcomes with lower travel time. Conclusions. Policy that directs older VHA enrollees’ private-sector care to high-performance hospitals promises to reduce mortality for VHA’s service population and warrants further exploration. PMID:17971543

The change in capacity and service delivery at public and private hospitals in Turkey: A closer look at regional differences

PubMed Central

2010-01-01

Background Substantial regional health inequalities have been shown to exist in Turkey for major health indicators. Turkish data on hospitals deserves a closer examination with a special emphasis on the regional differences in the context of the rapid privatization of the secondary or tertiary level health services. This study aims to evaluate the change in capacity and service delivery at public and private hospitals in Turkey between 2001-2006 and to determine the regional differences. Methods Data for this retrospective study was provided from Statistical Almanacs of Inpatient Services (2001-2006). Hospitals in each of the 81 provinces were grouped into two categories: public and private. Provinces were grouped into six regions according to a development index composed by the State Planning Organisation. The number of facilities, hospital beds, outpatient admissions, inpatient admissions (per 100 000), number of deliveries and surgical operations (per 10 000) were calculated for public and private hospitals in each province and region. Regional comparisons were based on calculation of ratios for Region 1(R1) to Region 6(R6). Results Public facilities had a fundamental role in service delivery. However, private sector grew rapidly in Turkey between 2001-2006 in capacity and service delivery. In public sector, there were 2.3 fold increase in the number of beds in R1 to R6 in 2001. This ratio was 69.9 fold for private sector. The substantial regional inequalities in public and private sector decreased for the private sector enormously while a little decrease was observed for the public sector. In 2001 in R1, big surgical operations were performed six times more than R6 at the public sector whereas the difference was 117.7 fold for the same operations in the same regions for the private sector. These ratios decreased to 3.6 for the public sector and 13.9 for the private sector in 2006. Conclusions The private health sector has grown enormously between 2001-2006 in Turkey including the less developed regions of the country. Given the fact that majority of people living in these underdeveloped regions are uninsured, the expansion of the private sector may not contribute in reducing the inequalities in access to health care. In fact, it may widen the existing gap for access to health between high and low income earners in these underdeveloped regions. PMID:21040539

Final Environmental Assessment for the Military Housing Privatization Initiative (MHPI), Moody Air Force Base, Georgia

DTIC Science & Technology

2014-03-01

the number of appropriate private sector housing units available to military families within 20 miles, or a GO-minute commute during peak driving...likely be accomplished by purchasing wetland mitigation credits at a USACE-approved mitigation bank in the service area where Moody AFB is located...authorized the Department of Defense (DoD) to engage private sector businesses through a process of housing privatization, wherein private sector housing

Sharing the Knowledge: Government-Private Sector Partnerships to Enhance Information Security

DTIC Science & Technology

2000-05-01

private sector . However, substantial barriers threaten to block information exchanges between the government and private sector . These barriers include concerns over release of sensitive material under Freedom of Information Act requests, antitrust actions, protection of business confidential and other private material, possible liability due to shared information, disclosure of classified information, and burdens entailed with cooperating with law enforcement agencies. There is good cause to believe that the government and private

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 contraceptive markets for the private sector to exploit.

Use of Private Sector Temporaries.

DTIC Science & Technology

1995-01-01

causing the reduction in personnel. My solution to this problem is to authorize and find the use of private sector temporaries to perform the workload...discuss cost factors, and describe the benefits Defense Finance and Accounting Service will receive by using private sector temporaries (AN)

75 FR 67992 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2008-0017] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... on an initial small business plan to address small business concerns in the Voluntary Private Sector...

29 CFR 1908.3 - Eligibility and funding.

Code of Federal Regulations, 2010 CFR

2010-07-01

... agreement with the Assistant Secretary to perform consultation for private sector employers; except that a... if that Plan does not include provisions for federally funded consultation to private sector... in providing consultation to private sector employers only. (i) In all States with Plans approved...

78 FR 29812 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-21

.... Affected Public: Private Sector: Businesses or other for-profits. Estimated Annual Burden Hours: 81,190... was computed and deposited. Affected Public: Private Sector: Businesses or other for-profits... taxpayer examinations. Affected Public: Private Sector: Businesses or other for-profits. Estimated Annual...

77 FR 51108 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... monitor the elections. Affected Public: Private Sector: Business or other for-profits. Estimated Total... the substantiation requirement for contributions of $250 or more. Affected Public: Private Sector... qualified intellectual property contributions after June 3, 2004. Affected Public: Private Sector: Not-for...

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

University-Private Sector Research Partnerships in the Innovation Ecosystem

DTIC Science & Technology

2008-11-01

private sector . There are several trends that PCAST considers to fall specifically within context of university- private sector research partnerships. The first is the growing imbalance between the academic research capacity and the Federal research budget. The second development is the reduction in basic research performed by the industrial sector. Private foundations are expanding their capacity to fund research, a trend expected to be important in the future. Lastly, the accelerating speed of technological development requires new methods of

How do dual practitioners divide their time? The cases of three African capital cities.

PubMed

McPake, Barbara; Russo, Giuliano; Tseng, Fu-Min

2014-12-01

Health professionals dual practice has received increasing attention, particularly in the context of the universal health coverage movement. This paper explores the determinants of doctors' choices to become a dual practitioner and of dual practitioners' choices to allocate time to the private sector in the capital cities of Mozambique, Guinea Bissau and Cape Verde. The data are drawn from a survey conducted in 2012 among 329 physicians. We use a two-part model to analyse the decision of both public and private practitioners to become dual practitioners, and to allocate time between public and private sectors. We impute potential earnings in public and private practice by using nearest-neighbour propensity score matching. Our results show that hourly wage in the private sector, number of dependents, length of time as a physician, work outside city, and being a specialist with or without technology all have a positive association with the probability of being a dual physician, while number of dependents displays a negative sign. Level of salaries in the public sector are not associated with dual practice engagement, with important implications for attempts aimed at retaining professionals in the public sector through wage increases. As predicted by theory that recognises doctors' role in price setting, earnings rates are not significant predictors of private sector time allocation; personal characteristics of physicians appear more important, such as age, number of dependents, specialist without technology, specialist with technology, and three reasons for not working more hours in the private sector. Answers to questions about the factors that limit working hours in the private sector have significant predictive power, suggesting that type of employment in the private sector may be an underlying determinant of both dual practice engagement and time allocation decisions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Real or Illusory Growth in an Oil-Based Economy: Government Expenditures and Private Sector Investment in Saudi Arabia

DTIC Science & Technology

1992-02-10

private sector investment in Saudi Arabia. The main finding is that in Saudi Arabia at least infrastructure investment does not appear to have played a strong role in stimulating private sector investment. Instead, the private investors appear to be much more sensitive to shorter run current conditions created by government

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.

Do elections matter for private-sector healthcare management in Brazil? An analysis of municipal health policy.

PubMed

McGregor, Alecia J; Siqueira, Carlos Eduardo; Zaslavsky, Alan M; Blendon, Robert J

2017-07-12

This study analyzed several political determinants of increased private-sector management in Brazilian health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which remains severely underfunded. Given the overhead costs associated with privately contracted health services, increased private management is one driver of higher expenditures in the system. Although left parties campaign most vocally in support of greater public control of the SUS, the extent to which their stated positions translate into health care policy remains untested. Drawing on multiple publicly available data sources, we used linear regression to analyze how political party-in-power and existing private sector health care contracting affect the share of privately managed health care services and outsourcing in municipalities. Data from two election periods-2004 to 2008 and 2008 to 2012-were analyzed. Our findings showed that although private sector contracting varies greatly across municipalities, this variation is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor role in municipal-level health care administration. Existing levels of private sector management appear to have a greater effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in the evolution of Brazilian health care delivery. Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.

75 FR 42766 - National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... Financial Assistance/ Subsidy Arrangement (Arrangement) to notify private insurance companies (Companies... private insurance companies participating under the current FY2010 Arrangement. Any private insurance...] National Flood Insurance Program (NFIP); Assistance to Private Sector Property Insurers, Availability of...

Evaluating the benefits of government funded R & D aimed at the private sector

NASA Technical Reports Server (NTRS)

Greenberg, J. S.

1977-01-01

Federal funding of technological research and development is discussed with regard to the procedures for an economic analysis with the goals of (1) determining when the public sector should invest in a research and development program, (2) evaluating the likelihood of private sector participation in terms of public sector participation, and (3) considering the major factors in the formulation of a research and development program in terms of defining initiatives. Public sector investments are evaluated, noting procedures for determining whether benefits exceed costs. The role of the public sector research and development planning is described, considering the procedure for private sector implementation decisions and a methodology for evaluating the possibility of private sector commercialization. The economic value of the public sector research and development program is presented with attention given to a specific case of NASA-sponsored research and development aimed toward the commercialization of new public communications services.

How do patients access the private sector in Chennai, India? An evaluation of delays in tuberculosis diagnosis.

PubMed

Bronner Murrison, L; Ananthakrishnan, R; Swaminathan, A; Auguesteen, S; Krishnan, N; Pai, M; Dowdy, D W

2016-04-01

The diagnosis and treatment of tuberculosis (TB) in India are characterized by heavy private-sector involvement. Delays in treatment remain poorly characterized among patients seeking care in the Indian private sector. To assess delays in TB diagnosis and treatment initiation among patients diagnosed in the private sector, and pathways to care in an urban setting. Cross-sectional survey of 289 consecutive patients diagnosed with TB in the private sector and referred for anti-tuberculosis treatment through a public-private mix program in Chennai from January 2014 to February 2015. Among 212 patients with pulmonary TB, 90% first contacted a formal private provider, and 78% were diagnosed by the first or second provider seen after a median of three visits per provider. Median total delay was 51 days (mean 68). Consulting an informal (rather than formally trained) provider first was associated with significant increases in total delay (absolute increase 22.8 days, 95%CI 6.2-39.5) and in the risk of prolonged delay >90 days (aRR 2.4, 95%CI 1.3-4.4). Even among patients seeking care in the formal (vs. informal) private sector in Chennai, diagnostic delays are substantial. Novel strategies are required to engage private providers, who often serve as the first point of contact.

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…

Accelerated reforms in healthcare financing: the need to scale up private sector participation in Nigeria.

PubMed

Ejughemre, Ufuoma John

2014-01-01

The health sector, a foremost service sector in Nigeria, faces a number of challenges; primarily, the persistent under-funding of the health sector by the Nigerian government as evidence reveals low allocations to the health sector and poor health system performance which are reflected in key health indices of the country.Notwithstanding, there is evidence that the private sector could be a key player in delivering health services and impacting health outcomes, including those related to healthcare financing. This underscores the need to optimize the role of private sector in complementing the government's commitment to financing healthcare delivery and strengthening the health system in Nigeria. There are also concerns about uneven quality and affordability of private-driven health systems, which necessitates reforms aimed at regulation. Accordingly, the argument is that the benefits of leveraging the private sector in complementing the national government in healthcare financing outweigh the challenges, particularly in light of lean public resources and finite donor supports. This article, therefore, highlights the potential for the Nigerian government to scale up healthcare financing by leveraging private resources, innovations and expertise, while working to achieve the universal health coverage.

75 FR 54422 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

... this new control number. Affected Public: Private Sector: Businesses or other for-profits. Estimated.... Affected Public: Private Sector: Businesses or other for-profits. Estimated Total Reporting Burden: 92,500... to this new control number. Affected Public: Private Sector: Businesses or other for-profits...

75 FR 20865 - Submission for OMB Review: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-21

...-0053. Affected Public: Private sector. Estimated Number of Respondents: 6,646,164. Total Estimated... Control Number: 1210-0092. Affected Public: Private sector. Estimated Number of Respondents: 8,376. Total...: 1210-0095. Affected Public: Private sector. Estimated Number of Respondents: 2,237. Total Estimated...

5 CFR 300.504 - Prohibition on employer-employee relationship

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS EMPLOYMENT (GENERAL) Use of Private Sector Temporaries § 300.504 Prohibition on employer-employee relationship No employer-employee relationship is created by an agency's use of private sector temporaries... appropriate procedures for interaction with private sector temporaries to assure that the supervisory...

Tuberculosis Notification by Private Sector' Physicians in Tehran.

PubMed

Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

2015-01-01

A small proportion of physicians adhere to tuberculosis (TB) notification regulations, particularly in the private sector. In most developing countries, the private sector has dominance over delivering services in big cities. In such circumstances deviation from the TB treatment protocol is frequently happening. This study sought to estimate TB notification in the private sector and settle on determinants of TB notification by private sector physicians. A population-based study has been conducted; private physicians at their clinics were interviewed. The total number of 443 private sectors' physicians has been chosen by the stratified random sampling method. Appropriate descriptive analysis was used to describe the study's participants. Logistic regression was used for bivariable and multivariable analysis. The response rate of the study was 90.06 (399%). Among responders, who had stated that they were suspicious of TB over the recent year, 62 (16.45%) stated that they reported cases of TB at least once during the same period. Having reporting requirements and the number of visited patients was significantly related to TB suspicious (odds ratio = 2.84, confidence interval: 1.62-5, P < 0.01). Workplace and access to relevant resources are associated with TB notification (P < 0.05). In poor resource settings with a high burden of TB, the public health administration can promote notification activities in the private sector by simple and quick interventions. It seems that a considerable fraction of private sector physicians, not all of them, will notify TB if they are provided with primary information and primary resources. To optimize the TB notification, however, intersectoral interventions are more likely to be successful.

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 health system of Argentina].

PubMed

Belló, Mariana; Becerril-Montekio, Victor M

2011-01-01

This paper describes the health system of Argentina.This system has three sectors: public, social security and private.The public sector includes the national and provincial ministries as well as the network of public hospitals and primary health care units which provide care to the poor and uninsured population. This sector is financed with taxes and payments made by social security beneficiaries that use public health care facilities. The social security sector or Obras Sociales (OS) covers all workers of the formal economy and their families. Most OS operate through contracts with private providers and are financed with payroll contributions of employers and employees. Finally, the private sector includes all those private providers offering services to individuals, OS beneficiaries and all those with private health insurance.This sector also includes private insurance agencies called Prepaid Medicine Enterprises, financed mostly through premiums paid by families and/or employers.This paper also discusses some of the recent innovations implemented in Argentina, including the program Remediar.

Role of the private sector in childbirth care: cross-sectional survey evidence from 57 low- and middle-income countries using Demographic and Health Surveys.

PubMed

Benova, Lenka; Macleod, David; Footman, Katharine; Cavallaro, Francesca; Lynch, Caroline A; Campbell, Oona M R

2015-12-01

Maternal mortality rates have decreased globally but remain off track for Millennium Development Goals. Good-quality delivery care is one recognised strategy to address this gap. This study examines the role of the private (non-public) sector in providing delivery care and compares the equity and quality of the sectors. The most recent Demographic and Health Survey (2000-2013) for 57 countries was used to analyse delivery care for most recent birth among >330 000 women. Wealth quintiles were used for equity analysis; skilled birth attendant (SBA) and Caesarean section rates served as proxies for quality of care in cross-sectoral comparisons. The proportion of women who used appropriate delivery care (non-facility with a SBA or facility-based births) varied across regions (49-84%), but wealth-related inequalities were seen in both sectors in all regions. One-fifth of all deliveries occurred in the private sector. Overall, 36% of deliveries with appropriate care occurred in the private sector, ranging from 9% to 46% across regions. The presence of a SBA was comparable between sectors (≥93%) in all regions. In every region, Caesarean section rate was higher in the private compared to public sector. The private sector provided between 13% (Latin America) and 66% (Asia) of Caesarean section deliveries. This study is the most comprehensive assessment to date of coverage, equity and quality indicators of delivery care by sector. The private sector provided a substantial proportion of delivery care in low- and middle-income countries. Further research is necessary to better understand this heterogeneous group of providers and their potential to equitably increase the coverage of good-quality intrapartum care. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Ability Testing for Job Selection: Are the Economic Claims Justified?

ERIC Educational Resources Information Center

Levin, Henry M.

The use of ability testing for job selection has become widespread in the Federal Government and in the U.S. Employment Service, which assists private sector employers. The justification for the practice is based largely on research findings claiming a high level of validity for such tests in predicting job performance. More recently, such claims…

75 FR 43933 - Request for nominations for members to serve on National Institute of Standards and Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... duties. Selection of ISPAB members will not be limited to individuals who are nominated. Nominations that.... Selection of MEP Advisory Board members will not be limited to individuals who are nominated. Nominations... in its official role as the private sector policy advisor of the Institute is concerned. Each such...

Performance-Based Services Acquisition

DTIC Science & Technology

2011-02-01

47  DoD’s acquisition workforce lacks training and experience in services contracting ... 47  Selecting correct metrics...services more effectively; vii (2) the DoD’s acquisition workforce lacks training and experience in services contracting; (3) selecting correct...private sector; (2) improve the training of government services acquisition personnel; and (3) the USD(AT&L) should incentivize the existing workforce

Genetic Counsellors and Private Practice: Professional Turbulence and Common Values.

PubMed

Collis, Sarah; Gaff, Clara; Wake, Samantha; McEwen, Alison

2017-12-27

Genetic counsellors face tensions between past and future identities: between established values and goals, and a broadening scope of settings and activities. This study examines the advent of genetic counsellors in private practice in Australia and New Zealand from the perspectives of the small numbers working in this sector and those who have only worked in public practice. Semi-structured interviews were conducted with 16 genetic counsellors who had experience in private practice, and 14 genetic counsellors without private sector experience. Results demonstrated that circumstantial and personal factors can mitigate the challenges experienced and the amount of support desired by those who had established a private practice, and those who were employed by private companies. Notably, most participants with private sector experience perceived themselves to be viewed negatively by other genetic counsellors. Most participants without private sector experience expressed concern that the challenges they believed genetic counsellors face in private practice may impact service quality, but wished to address such concerns by providing appropriate support. Together, our results reinforce that participants in private and public sectors are strong advocates for peer support, multidisciplinary team work, and professional development. These core values, and seeking understanding of different circumstances and support needs, will enable genetic counsellors in different sectors to move forward together. Our results suggest supports that may be acted upon by members of the profession, professional groups, and training programs, in Australia, New Zealand, and overseas.

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 sector than in the public healthcare sector. With the social and economic benefits of early intervention in cases of DHI well established internationally, SA healthcare providers in both the public and private sectors need to develop screening, diagnostic and (re)habilitation services for children with hearing impairment.

Government Investment in Manufacturing: Stimulus or Hindrance to Pakistan’s Private Sector?

DTIC Science & Technology

1999-01-01

private sector , but it also has diverted funds away from productive activities that would most likely have encouraged a follow-on expansion in private investment. Has the expansion of private investment in manufacturing increased the profitability of investment in other key sectors of the economy? And, if so, in which areas? Has government investment in manufacturing produced similar effects? Would a diversion of public investment funds from manufacturing to areas supporting private investment (energy, infrastructure) stimulate greater amounts of private investment, and if

75 FR 43799 - Employee Contribution Elections and Contribution Allocations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-27

... or deferred arrangements established for private-sector employees under section 401(k) of the... tribal governments and the private sector have been assessed. This regulation will not compel the..., or by the private sector. Therefore, a statement under Sec. 1532 is not required. Submission to...

48 CFR 52.207-2 - Notice of Streamlined Competition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... under contract or by Government performance. (b) The Government will evaluate the cost of private sector... accordance with the Circular. If the performance decision favors private sector performance, the Contracting Officer shall either award a contract or issue a competitive solicitation for private sector offers. If...

15 CFR 287.1 - Purpose and scope of this guidance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... those of other appropriate government agencies and with those of the private sector to reduce... private sector. This will help ensure more productive use of the increasingly limited Federal resources... countries and U.S. industry in pursuing agreements with foreign national and international private sector...

78 FR 24466 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

.... Affected Public: Private Sector: Businesses or other for-profits. Estimated Annual Burden Hours: 24,206,448... correctly computed. Affected Public: Private Sector: Businesses or other for-profits. Estimated Annual...: Private Sector: Businesses or other for-profits. Estimated Annual Burden Hours: 51,024. OMB Number: 1545...

Medical student teaching in the private sector - An overlooked opportunity?

PubMed

Galletly, Cherrie A; Turnbull, Carol; Goldney, Robert

2016-04-01

One in four psychiatric beds in Australia are located in the private sector, and more than half of Australian psychiatrists undertake private work. However, nearly all medical student teaching in psychiatry takes place in public hospitals. This paper explores the learning opportunities in the private sector. We report the South Australian experience; medical students have been taught in Ramsay Health Care (SA) Mental Health facilities for more than 23 years. Our experience demonstrates that clinical teaching in private hospitals is sustainable and well accepted by students, patients and clinicians. The private sector has the capacity to make a much greater contribution to medical student training in psychiatry. © The Royal Australian and New Zealand College of Psychiatrists 2016.

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.

Harnessing private sector expertise to improve complementary feeding within a regulatory framework: Where is the evidence?

PubMed

van Liere, Marti J; Tarlton, Dessie; Menon, Ravi; Yellamanda, M; Reerink, Ietje

2017-10-01

Global recognition that the complex and multicausal problems of malnutrition require all players to collaborate and to invest towards the same objective has led to increased private sector engagement as exemplified through the Scaling Up Nutrition Business Network and mechanisms for blended financing and matched funding, such as the Global Nutrition for Growth Compact. The careful steps made over the past 5 to 10 years have however not taken away or reduced the hesitation and scepticism of the public sector actors towards commercial or even social businesses. Evidence of impact or even a positive contribution of a private sector approach to intermediate nutrition outcomes is still lacking. This commentary aims to discuss the multiple ways in which private sector can leverage its expertise to improve nutrition in general, and complementary feeding in particular. It draws on specific lessons learned in Bangladesh, Côte d'Ivoire, India, Indonesia, and Madagascar on how private sector expertise has contributed, within the boundaries of a regulatory framework, to improve availability, accessibility, affordability, and adequate use of nutritious foods. It concludes that a solid evidence base regarding the contribution of private sector to complementary feeding is still lacking and that the development of a systematic learning agenda is essential to make progress in the area of private sector engagement in nutrition. © 2017 John Wiley & Sons Ltd.

What are the similarities and differences in antimicrobial prescribing between Australian public and private hospitals?

PubMed

Cotta, M O; Chen, C; Tacey, M; James, R S; Buising, K L; Marshall, C; Thursky, K A

2016-10-01

Identifying themes associated with inappropriate prescribing in Australian public and private hospitals will help target future antimicrobial stewardship initiatives. To describe current antimicrobial prescribing practices, identify similarities and differences between hospital sectors and provide target areas for improvement specific to each hospital sector. All hospitals included in the study were part of the 2014 national antimicrobial prescribing survey and conducted one of the following: a whole hospital point prevalence survey, serial point prevalence surveys or a sample of randomly selected patients. Data on the types of antibiotics used, their indications for use and the quality of prescription based on compliance with national and local prescribing guidelines were collected. Two hundred and two hospitals (166 public and 36 private) comprising 10 882 patients and 15 967 antimicrobial prescriptions were included. Public hospitals had higher proportions of prescriptions for treatment (81.5% vs 48.4%) and medical prophylaxis (8.8% and 4.6%), whilst private hospitals had significantly higher surgical prophylaxis use (9.6% vs 46.9%) (P < 0.001). In public hospitals, the main reasons for non-compliance of treatment prescriptions were spectrum being too broad (30.5%) while in private it was incorrect dosing. Prolonged duration was the main reason for non-compliance among surgical prophylaxis prescriptions in both types of hospitals. Australian hospitals need to target specific areas to improve antimicrobial use. Specifically, unnecessary broad-spectrum therapy should be a priority area in public hospitals, whilst emphasis on curtailing antimicrobial overuse in surgical prophylaxis needs to be urgently addressed across in the private hospital sector. © 2016 Royal Australasian College of Physicians.

Private Education in Poland: Breaking the Mould?

NASA Astrophysics Data System (ADS)

Klus-Stanska, Dorota; Olek, Hilary

1998-03-01

The burgeoning private sector is perhaps the most tangible of the changes in education which followed the upheavals of 1989/90 in Central and Eastern Europe. This article sets out to analyse the growth of private education in Poland and its contribution to the ongoing processes of democratisation and educational development. The authors argue that the euphoria of the period immediately following the overthrow of one-party communism encouraged unrealistic expectations of educational reform. Their analysis of private sector schooling in Poland suggests that its development has occurred in a haphazard fashion, reflecting the uncertainties of a society undergoing a painful process of transition. Symptomatic of this has been the failure to establish a clear regulatory framework for the private sector - an omission which has undermined the credibility of private schools. Nevertheless, the authors argue that the development of private sector schooling in Poland has brought diversity and a degree of innovation to a system previously almost devoid of either. There is now an urgent need for the evaluation and dissemination of private sector initiatives, which can serve as examples for future educational decision-making in Poland.

A statewide review of postnatal care in private hospitals in Victoria, Australia.

PubMed

Rayner, Jo-Anne; McLachlan, Helen L; Forster, Della A; Peters, Louise; Yelland, Jane

2010-05-28

Concerns have been raised in Australia and internationally regarding the quality and effectiveness of hospital postnatal care, although Australian women receiving postnatal care in the private maternity sector rate their satisfaction with care more highly than women receiving public maternity care. In Victoria, Australia, two-thirds of women receive their maternity care in the public sector and the remainder in private health care sector. A statewide review of public hospital postnatal care in Victoria from the perspective of care providers found many barriers to care provision including the busyness of postnatal wards, inadequate staffing and priority being given to other episodes of care; however the study did not include private hospitals. The aim of this study was replicate the review in the private sector, to explore the structure and organisation of postnatal care in private hospitals and identify those aspects of care potentially impacting on women's experiences and maternal and infant care. This provides a more complete overview of the organisational structures and processes in postnatal care in all Victorian hospitals from the perspective of care providers. A mixed method design was used. A structured postal survey was sent to all Victorian private hospitals (n = 19) and key informant interviews were undertaken with selected clinical midwives, maternity unit managers and obstetricians (n = 11). Survey data were analysed using descriptive statistics and interview data analysed thematically. Private hospital care providers report that postnatal care is provided in very busy environments, and that meeting the aims of postnatal care (breastfeeding support, education of parents and facilitating rest and recovery for women following birth) was difficult in the context of increased acuity of postnatal care; prioritising of other areas over postnatal care; high midwife-to-woman ratios; and the number and frequency of visitors. These findings were similar to the public review. Organisational differences in postnatal care were found between the two sectors: private hospitals are more likely to have a separate postnatal care unit with single rooms and can accommodate partners' over-night; very few have a policy of infant rooming-in; and most have well-baby nurseries. Private hospitals are also more likely to employ staff other than midwives, have fewer core postnatal staff and have a greater dependence on casual and bank staff to provide postnatal care. There are similarities and differences in the organisation and provision of private postnatal care compared to postnatal care in public hospitals. Key differences between the two sectors relate to the organisational and aesthetic aspects of service provision rather than the delivery of postnatal care. The key messages emerging from both reviews is the need to review and monitor the adequacy of staffing levels and to develop alternative approaches to postnatal care to improve this episode of care for women and care providers alike. We also recommend further research to provide a greater evidence-base for postnatal care provision.

78 FR 37542 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-21

...; Affected Public: Private Sector (Business or other for- profit and Not-for-profit institutions); Number of...: Occasionally; Affected Public: Private Sector--Business or other for- profits; Number of Respondents: 500...); Frequency: Monthly; Affected Public: Private sector (business or other for-profits and not-for-profit...

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...

48 CFR 5231.205-90 - Shipbuilding capability preservation agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... an incentive for a shipbuilder to obtain new private sector work, thereby reducing the Navy's cost of... agreement permits the contractor to claim certain indirect costs attributable to its private sector work as... subsection, means an additional indirect cost that results from performing private sector work described in a...

Private-Sector Financing of Child Development Centers.

DTIC Science & Technology

1987-01-01

Military Departments to determine the feasibility of private - sector or so-called ’third-day’ financing of the centers. In this arrangement, land is...that private - sector financing was not feasible. Our review and analysis of a broader test by the Department of the Navy under a concession arrangement

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...

76 FR 41826 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Information Security Oversight Office State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records... Information Program for State, Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on...

48 CFR 35.017 - Federally Funded Research and Development Centers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... enable agencies to use private sector resources to accomplish tasks that are integral to the mission and... to installations equipment and real property to compete with the private sector. However, an FFRDC... legislation, when the work is not otherwise available from the private sector. (3) FFRDC's are operated...

Private-Sector Coalitions and State-Level Education Reform. Policy Bulletin.

ERIC Educational Resources Information Center

Hamrick, Flo

The influence of the private sector on education has been and continues to be significant. The use of scientific management in education, which led to standardized testing, accountability, and educational administration, came from the private sector. In recent times, many businesses have formed charitable and professional support partnerships with…

Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense

DTIC Science & Technology

2006-04-30

Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= REFORM OF BUDGETING FOR ACQUISITION: LESSONS FROM PRIVATE SECTOR CAPITAL BUDGETING FOR THE DEPARTMENT OF DEFENSE...TITLE AND SUBTITLE Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense 5a. CONTRACT...Reform of Budgeting for Acquisition: Lessons from Private Sector Capital Budgeting for the Department of Defense Presenter: Jerry McCaffery, PhD, serves

Review of the President’s Fiscal Year 2009 Budget Request for the Defense Health Program’s Private Sector Care Budget Activity Group

DTIC Science & Technology

2008-05-28

2009 budget request for the Defense Health Program’s Private Sector Care BAG. To do this, we reviewed (1) DOD’s justification for the request for the... Private Sector Care BAG, including the underlying estimates and the extent to which DOD considered historical information; and (2) changes between this...develop the budget requests for the Private Sector Care BAG in fiscal years 2008 and 2009. We also interviewed officials and analyzed documents from

Public–private interaction in pharmaceutical research

PubMed Central

Cockburn, Iain; Henderson, Rebecca

1996-01-01

We empirically examine interaction between the public and private sectors in pharmaceutical research using qualitative data on the drug discovery process and quantitative data on the incidence of coauthorship between public and private institutions. We find evidence of significant reciprocal interaction, and reject a simple “linear” dichotomous model in which the public sector performs basic research and the private sector exploits it. Linkages to the public sector differ across firms, reflecting variation in internal incentives and policy choices, and the nature of these linkages correlates with their research performance. PMID:8917485

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.

Evaluation of public-private partnership contract types for roadway construction, maintenance, and rehabilitation.

DOT National Transportation Integrated Search

2015-12-31

Public-private partnerships (PPPs) in transportation infrastructure projects refer to contractual agreements formed : between a public Agency and a private sector entity to allow for greater private sector participation in project : delivery. At the ...

Accelerating TB notification from the private health sector in Delhi, India.

PubMed

Kundu, Debashish; Chopra, Kamal; Khanna, Ashwani; Babbar, Neeti; Padmini, T J

2016-01-01

In India, almost half of all patients with tuberculosis (TB) seek care in the private sector as the first point of care. The national programme is unable to support such TB patients and facilitate effective treatment, as there is no information on TB and Multi or Extensively Drug Resistant TB (M/XDR-TB) diagnosis and treatment in private sector. To improve this situation, Government of India declared TB a notifiable disease for establishing TB surveillance system, to extend supportive mechanism for TB treatment adherence and standardised practices in the private sector. But TB notification from the private sector is a challenge and still a lot needs to be done to accelerate TB notification. Delhi State TB Control Programme had taken initiatives for improving notification of TB cases from the private sector in 2014. Key steps taken were to constitute a state level TB notification committee to oversee the progress of TB notification efforts in the state and direct 'one to one' sensitisation of private practitioners (PPs) (in single PP's clinic, corporate hospitals and laboratories) by the state notification teams with the help of available tools for sensitising the PP on TB notification - TB Notification Government Order, Guidance Tool for TB Notification and Standards of TB Care in India. As a result of focussed state level interventions, without much external support, there was an accelerated notification of TB cases from the private sector. TB notification cases from the private sector rose from 341 (in 2013) to 4049 (by the end of March 2015). Active state level initiatives have led to increase in TB case notification. Copyright © 2016 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Insurance status and time to completion of surgery for breast cancer.

PubMed

Solomon, Matthew; Cochrane, Colin T; Grieve, David A

2016-01-01

The aim of this study was to compare the time to re-operation, following inadequate loco-regional surgery for breast cancer, between the public and private sectors of the Sunshine Coast region. A retrospective review was performed of the medical records of all female patients undergoing guide wire-localized, breast-conserving surgery at Nambour General Hospital and in the local private sector from January 2009 until April 2010. The dates of initial consultation, operation, post-operative consultation and any subsequent reoperation were recorded. One hundred and seventeen public sector patients and 113 private sector patients were identified during the study period. Thirty-seven public patients (32%) and 46 private patients (41%) required re-operation. This difference was not significant (χ(2) = 2.06, degrees of freedom (df) = 1, P = 0.15). The mean time and standard error from the initial consultation to the first operation and re-operation in the public sector was 26 (2.3) and 62 (3.8) days, and in the private sector was 12 (1.2) and 30 (4.4) days, respectively P < 0.001. On average, 70% of public patients and 96% of private patients completed the surgical component of their breast cancer management within the Queensland Health-recommended time frame of 30 days (χ(2) = 26, df = 1, P < 0.001). While experiencing similar rates of re-operative surgery in breast cancer management in the public and private sectors, the private sector deals with this issue in a more time efficient manner. An opportunity for intervention by quarantining theatre time is explored to improve the public sector time management. © 2015 Royal Australasian College of Surgeons.

[Private health insurance in Brazil: approaches to public/private patterns in healthcare].

PubMed

Sestelo, José Antonio de Freitas; Souza, Luis Eugenio Portela Fernandes de; Bahia, Lígia

2013-05-01

This article draws on a previous review of 270 articles on private health plans published from 2000 to 2010 and selects 17 that specifically address the issue of the relationship between the public and private healthcare sectors. Content analysis considered the studies' concepts and terms, related theoretical elements, and predominant lines of argument. A reading of the argumentative strategies detected the existence of a critical view of the modus operandi in the public/private relationship based on Social Medicine and the theoretical tenets of the Brazilian Health Reform Movement. The study also identified contributions based on neoliberal business approaches that focus strictly on economic issues to discuss private health insurance. Understanding the public/private link in healthcare obviously requires the development of a solid empirical base, analyzed with adequate theoretical assumptions due to the inherent degree of complexity in the public/private healthcare interface.

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.

TennCare and academic medical centers: the lessons from Tennessee.

PubMed

Meyer, G S; Blumenthal, D

1996-09-04

To ascertain the potential impact of public-sector-driven health system reform (Medicaid and Medicare programs) on academic medical centers (AMCs). A qualitative, case-study investigation of how 2 of Tennessee's 4 AMCs were affected by the TennCare program, which enrolled all of the state's Medicaid recipients and a sizable portion of its uninsured in managed care organizations (MCOs) in January 1994. We reviewed pertinent documents related to the AMCs, response to TennCare; interviewed AMC executives and staff, state officials, and representatives of MCOs serving TennCare beneficiaries; and conducted site visits at both AMCs. Changes in clinical revenues, clinical volume, patient selection, support for the AMCs, teaching and research missions, and the AMCs' response to these changes. Both AMCs studied experienced large revenue shortfalls, the closure of some specialty services, adverse patient selection, and loss of the patient volume needed to do clinical research, and had to reduce the number of training program positions. Longer-term consequences of TennCare for AMCs may include the integration of community-based services into academic missions, the acceleration of clinical diversification, and the attainment of experience in managed care, anticipating the evolution of the private-sector market. The consequences of public-sector health system reform for AMCs are similar to, and equally as challenging as, the effects of private-sector changes in health care delivery. Important differences include the rapidity with which public-sector reforms can transform the AMC market, the vulnerability of special payments to AMCs, such as graduate medical education funding, and the accountability of managers of public-sector initiatives to the political process. It remains to be seen whether public-sector reforms will afford some competitive advantage to AMCs over the long term.

Computer Model Helps Communities Gauge Effects of New Industry.

ERIC Educational Resources Information Center

Long, Celeste; And Others

1987-01-01

Describes computer Industrial Impact Model used by Texas Agricultural Extension Service rural planners to assess potential benefits and costs of new firms on community private and public sectors. Presents selected data/results for two communities assessing impact of the same plant. (NEC)

Job attitudes and well-being among public vs. private physicians: organizational justice and job control as mediators.

PubMed

Heponiemi, Tarja; Kuusio, Hannamaria; Sinervo, Timo; Elovainio, Marko

2011-08-01

The present study examined whether there are differences in job-related attitudes and well-being among physicians working in private sector and public sector. In addition, we examined whether psychosocial factors (organizational justice and job control) could mediate these possible differences in different sectors. Cross-sectional survey data from the Finnish Health Professional Study was used. A random sample of Finnish physicians included 1522 women and 1047 men aged 25-65 years. Outcome variables were job satisfaction, organizational commitment, psychological distress, work ability and sleeping problems. Job control and organizational justice were measured using established questionnaires. Series of regression analyses were performed and the mediational effects were tested following the procedures outlined by Baron and Kenny. Physicians working in private sector had higher levels of job satisfaction and organizational commitment and lower levels of psychological distress and sleeping problems when compared with physicians working in public sector. Private physicians also had higher levels of organizational justice, which acted as a mediator behind more positive attitudes and better well-being in private sector. Private physicians had higher levels of job control but it did not act as a mediator. Private physicians feel better than public physicians and this is partly due to higher organizational justice in private sector. Public health care organizations should invest effort to increase the fairness in their organizations and management and pay more attention in improving the well-being of their employees, which could possibly increase the attractiveness of public sector as a career option.

Contribution of the private sector healthcare service providers to malaria diagnosis in a prevention of re-introduction setting.

PubMed

Fernando, Sumadhya Deepika; Dharmawardana, Priyani; Epasinghe, Geethanee; Senanayake, Niroshana; Rodrigo, Chaturaka; Premaratne, Risintha; Wickremasinghe, Rajitha

2016-10-18

Sri Lanka is currently in the prevention of re-introduction phase of malaria. The engagement of the private sector health care institutions in malaria surveillance is important. The purpose of the study was to determine the number of diagnostic tests carried out, the number of positive cases identified and the referral system for diagnosis in the private sector and to estimate the costs involved. This prospective study of private sector laboratories within the Colombo District of Sri Lanka was carried out over a 6-month period in 2015. The management of registered private sector laboratories was contacted individually and the purpose of the study was explained. A reporting format was developed and introduced for monthly reporting. Forty-one laboratories were eligible to be included in the study and 28 participated by reporting data on a monthly basis. Excluding blood bank samples and routine testing for foreign employment, malaria diagnostic tests were carried out on 973 individuals during the 6-month period and nine malaria cases were identified. In 2015, a total of 36 malaria cases were reported from Sri Lanka. Of these, 24 (67 %) were diagnosed in the Colombo District and 50 % of them were diagnosed in private hospitals. An equal number of cases were diagnosed from the private sector and government sector in the Colombo District in 2015. The private sector being a major contributor in the detection of imported malaria cases in the country should be actively engaged in the national malaria surveillance system.

Feeling Good About the Iron Rice Bowl: Economic Sector and Happiness in Post-Reform Urban China*

PubMed Central

Wang, Jia; Xie, Yu

2015-01-01

Situated in China’s market transition, this study examines the relationship between economic sector and a worker’s happiness in post-reform urban China. Using datasets from the Chinese General Social Surveys 2003, 2006 and 2008, we find that workers in the state sector enjoy a subjective premium in well-being – reporting significantly higher levels of happiness than their counterparts in the private sector. We also find that during a period when a large wave of workers moved from the state sector to the private sector, those remaining in the state sector reported being significantly happier than did former state sector workers who had moved, whether the move was voluntary or involuntary. We attribute the higher level of reported happiness in the state sector than in the private sector to the disparity by sector in the provision of social welfare benefits. Those who made voluntary state-to-private moves experienced a trade-off in enjoying higher payoffs while losing job security, whereas involuntary mobiles experienced downward mobility and suffered a long-term psychological penalty. PMID:26188448

Feeling good about the iron rice bowl: Economic sector and happiness in post-reform urban China.

PubMed

Wang, Jia; Xie, Yu

2015-09-01

Situated in China's market transition, this study examines the relationship between economic sector and a worker's happiness in post-reform urban China. Using datasets from the Chinese General Social Surveys 2003, 2006 and 2008, we find that workers in the state sector enjoy a subjective premium in well-being - reporting significantly higher levels of happiness than their counterparts in the private sector. We also find that during a period when a large wave of workers moved from the state sector to the private sector, those remaining in the state sector reported being significantly happier than did former state sector workers who had moved, whether the move was voluntary or involuntary. We attribute the higher level of reported happiness in the state sector than in the private sector to the disparity by sector in the provision of social welfare benefits. Those who made voluntary state-to-private moves experienced a trade-off in enjoying higher payoffs while losing job security, whereas involuntary mobiles experienced downward mobility and suffered a long-term psychological penalty. Copyright © 2015 Elsevier Inc. All rights reserved.

Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study.

PubMed

Talisuna, Ambrose O; Daumerie, Penny Grewal; Balyeku, Andrew; Egan, Timothy; Piot, Bram; Coghlan, Renia; Lugand, Maud; Bwire, Godfrey; Rwakimari, John Bosco; Ndyomugyenyi, Richard; Kato, Fred; Byangire, Maria; Kagwa, Paul; Sebisubi, Fred; Nahamya, David; Bonabana, Angela; Mpanga-Mukasa, Susan; Buyungo, Peter; Lukwago, Julius; Batte, Allan; Nakanwagi, Grace; Tibenderana, James; Nayer, Kinny; Reddy, Kishore; Dokwal, Nilesh; Rugumambaju, Sylvester; Kidde, Saul; Banerji, Jaya; Jagoe, George

2012-10-29

Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Four intervention districts were purposefully selected to receive branded subsidized medicines - "ACT with a leaf", while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention's impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, "ACT with a leaf" accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had "ACT with a leaf" purchased for them more often than those aged above five years. There was no evidence of price gouging. These data demonstrate that a supply-side subsidy and an intensive communications campaign significantly increased the uptake and use of ACT in the private sector in Uganda.

Closing the access barrier for effective anti-malarials in the private sector in rural Uganda: consortium for ACT private sector subsidy (CAPSS) pilot study

PubMed Central

2012-01-01

Background Artemisinin-based combination therapy (ACT), the treatment of choice for uncomplicated falciparum malaria, is unaffordable and generally inaccessible in the private sector, the first port of call for most malaria treatment across rural Africa. Between August 2007 and May 2010, the Uganda Ministry of Health and the Medicines for Malaria Venture conducted the Consortium for ACT Private Sector Subsidy (CAPSS) pilot study to test whether access to ACT in the private sector could be improved through the provision of a high level supply chain subsidy. Methods Four intervention districts were purposefully selected to receive branded subsidized medicines - “ACT with a leaf”, while the fifth district acted as the control. Baseline and evaluation outlet exit surveys and retail audits were conducted at licensed and unlicensed drug outlets in the intervention and control districts. A survey-adjusted, multivariate logistic regression model was used to analyse the intervention’s impact on: ACT uptake and price; purchase of ACT within 24 hours of symptom onset; ACT availability and displacement of sub-optimal anti-malarial. Results At baseline, ACT accounted for less than 1% of anti-malarials purchased from licensed drug shops for children less than five years old. However, at evaluation, “ACT with a leaf” accounted for 69% of anti-malarial purchased in the interventions districts. Purchase of ACT within 24 hours of symptom onset for children under five years rose from 0.8% at baseline to 26.2% (95% CI: 23.2-29.2%) at evaluation in the intervention districts. In the control district, it rose modestly from 1.8% to 5.6% (95% CI: 4.0-7.3%). The odds of purchasing ACT within 24 hours in the intervention districts compared to the control was 0.46 (95% CI: 0.08-2.68, p=0.4) at baseline and significant increased to 6.11 (95% CI: 4.32-8.62, p<0.0001) at evaluation. Children less than five years of age had “ACT with a leaf” purchased for them more often than those aged above five years. There was no evidence of price gouging. Conclusions These data demonstrate that a supply-side subsidy and an intensive communications campaign significantly increased the uptake and use of ACT in the private sector in Uganda. PMID:23107021

2010 Staff Organization for Optimum C2: A Private Sector Analysis

DTIC Science & Technology

1998-02-13

control over business operations. Warfighting CINCs can benefit from the lessons learned in the private sector by adapting those lessons to future military... private sector analysis. Through the use of a networked command and control system and a "matrix" staff structure, the model consolidates the JFC staff

What's yours, mine, and ours : overcoming intellectual property rights issues : a cross-cutting study : facilitating private-sector participation and expediting deployment

DOT National Transportation Integrated Search

2000-08-01

Debate over the ownership and use of intellectual property developed jointly by the public and private sectors has caused delays in ITS deployment projects. While a fundamental business incentive of the private sector for investing in research and de...

Preparing Rehabilitation Counselors for Private Sector Practice within a CORE Accredited Generalist Educational Model

ERIC Educational Resources Information Center

Zanskas, Stephen; Leahy, Michael

2007-01-01

As private sector rehabilitation has matured as a field of practice, the issue of how rehabilitation counselor educators can effectively prepare rehabilitation counselors for practice in this setting remains. This article reviews the literature regarding the training needs of rehabilitation counselors entering private sector practice, and proposes…

System Expertise Training Courses in Private Sector: Can They Be Given Online?

ERIC Educational Resources Information Center

Balci Demirci, Birim

2014-01-01

It is widely known that there are many schools in the private sector offering courses in Computer Technology, Computer Engineering, Information Systems and similar disciplines in addition to Universities presenting such courses. The private sector programs are extremely popular with students already studying at university as well as being of great…

45 CFR 261.12 - What is an individual responsibility plan?

Code of Federal Regulations, 2010 CFR

2010-10-01

...: (a) Should set an employment goal and a plan for moving immediately into private-sector employment... doing other things that will help the individual become or remain employed in the private sector; (c) Should be designed to move the individual into whatever private-sector employment he or she is capable of...

Private Sector Contracting and Democratic Accountability

ERIC Educational Resources Information Center

DiMartino, Catherine; Scott, Janelle

2013-01-01

Public officials are increasingly contracting with the private sector for a range of educational services. With much of the focus on private sector accountability on cost-effectiveness and student performance, less attention has been given to shifts in democratic accountability. Drawing on data from the state of New York, one of the most active…

Typical and Top-Ranked Polish Private Higher Education: Intersectoral and Intrasectoral Distinctiveness

ERIC Educational Resources Information Center

Musial, Joanna

2012-01-01

This dissertation analyzes the degree and shape of differences between private and public sectors (intersectoral) and within the private sector (intrasectoral) in Polish higher education. The intersectoral hypothesis is that Poland's two sectors are quite different and that these differences mostly follow those claimed and so far found in leading…

75 FR 74607 - Correction of Administrative Errors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-01

... established for private-sector employees under section 401(k) of the Internal Revenue Code (26 U.S.C. 401(k... regulation on state, local, and tribal governments and the private sector have been assessed. This regulation... governments, in the aggregate, or by the private sector. Therefore, a statement under section 1532 is not...

Evaluation and Private Philanthropy: View from a Corporation.

ERIC Educational Resources Information Center

Roser, Hal

The role of evaluation in the profit and loss sector of American economy differs from its role in the nonprofit sector. Since corporate industry and private foundations contribute approximately 4.5 billion dollars to help finance the ninety-billion dollar private nonprofit sector, sound planning and evaluation activities are essential to maintain…

Dynamics of Private Sector Support for Education: Experiences in Latin America

ERIC Educational Resources Information Center

Brady, Kristin; Galisson, Kirsten

2008-01-01

Recognizing the diversity of models and strategies for private sector participation in education that have emerged in Latin America, the United States Agency for International Development (USAID) requested the Academy for Educational Development (AED) to conduct research with leaders in the public and private sectors in several countries. While…

Strategies for Involving the Private Sector in Job Training Programs.

ERIC Educational Resources Information Center

Greenwood, Katy; And Others

This two-part report describes various strategies for involving the private sector in job training programs and summarizes a study conducted with prime sponsors of Comprehensive Employment and Training Act (CETA) programs in Texas. Included in a discussion of involving the private sector in job training programs are the following topics: the new…

Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review

PubMed Central

Lussiana, Cristina

2016-01-01

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. PMID:25862732

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.

PRIVATE SECTOR IN HEALTH CARE DELIVERY: A REALITY AND A CHALLENGE IN PAKISTAN.

PubMed

Shaikh, Babar Tasneem

2015-01-01

Under performance of the public sector health care system in Pakistan has created a room for private sector to grow and become popular in health service delivery, despite its questionable quality, high cost and dubious ethics of medical practice. Private sector is no doubt a reality; and is functioning to plug many weaknesses and gaps in health care delivery to the poor people of Pakistan. Yet, it is largely unregulated and unchecked due to the absence of writ of the state. In spite of its inherent trait of profit making, the private sector has played a significant and innovative role both in preventive and curative service provision. Private sector has demonstrated great deal of responsiveness, hence creating a relation of trust with the consumers of health in Pakistan, majority of who spend out of their pocket to buy 'health'. There is definitely a potential to engage and involve private and non-state entities in the health care system building their capacities and instituting regulatory frameworks, to protect the poor's access to health care system.

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

Private Higher Education in India: A Study of Two Private Universities

ERIC Educational Resources Information Center

Angom, Sangeeta

2015-01-01

The Private higher education sector is growing fast in many settings, including India, and there are variations at the national level. Privatization of higher education in India has been the result of changes in the economic policy towards liberalization and privatization by the Government of India. Till 1980, higher education sector was…

Assessment of public vs private MSW management: a case study.

PubMed

Massoud, M A; El-Fadel, M; Abdel Malak, A

2003-09-01

Public-private partnerships in urban environmental services have witnessed increased interest in recent years primarily to reform the weak performance of the public sector, reduce cost, improve efficiency, and ensure environmental protection. In this context, successful public-private partnerships require a thorough analysis of opportunities, a deliberate attention to process details, and a continuous examination of services to determine whether they are more effectively performed by the private sector. A comparative assessment of municipal solid waste collection services in the two largest cities in Lebanon where until recently municipal solid waste collection is private in one and public in the other is conducted. While quality of municipal solid waste collection improved, due to private sector participation, the corresponding cost did not, due to monopoly and an inadequate organizational plan defining a proper division of responsibilities between the private and the public sector.

Health Resources in a 200,000 Urban Indian Population Argues the Need for a Policy on Private Sector Health Services

PubMed Central

Furtado, Kheya Melo; Kar, Anita

2014-01-01

Background: There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Results: Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Conclusions: Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals. PMID:24963226

Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

PubMed

Furtado, Kheya Melo; Kar, Anita

2014-04-01

There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

Review of Private Sector Personnel Screening Practices

DTIC Science & Technology

2000-10-01

private sector investigative sources or methods would be useful to the DoD for conducting national security background investigations. The federal government by and large examines more sources and conducts more thorough investigations than industry. In general, private employers (1) have less access to information about applicants...outsource many elements of background checks. It is recommended that the DoD periodically evaluate private sector screening programs and data sources in order to monitor

[Evaluation of rational prescribing and dispensing of medicines in Mali].

PubMed

Maiga, D; Diawara, A; Maiga, M D

2006-12-01

Pharmaceutical policy in Mali is based on the concept of essential medicines and procurement of generic medicines. Unfortunately, increasing availability of generic medicines via different promotional programs can often be accompanied by their irrational use. This survey was thus designed to evaluate rational prescribing and dispensing of medicines in Mali. A cross-sectional survey was conducted from 1998 to 2005 in 30 primary health centers and 30 private dispensaries; in Bamako and in 6 of the 8 other regions of the country. In each of the visited facilities, 20 prescriptions dispensed at the time of the survey were collected. The average number of medicines per prescription was 3.2+/-1.3 and 2.8+/-1.2 respectively in the public and private sectors. Medicines were prescribed under generic name in 88.2% of the public sector prescriptions and in 30.9% of the private sector ones. Antibiotics were prescribed in 70.4% of the public sector prescriptions and in 50.0% of the private sector prescriptions. In the public sector 33.2% of the prescriptions had injections compared with 14.3% in the private sector (p<0.001). The median price per prescription was lower in the public sector (1575.0 CFA F, or 2.4 Euros, of which 91.3% were actually purchased by the patient) than in the private sector (5317.5 CFA F, or 8.1 Euros, of which 84.6% were purchased). Generic medicines are being used in the public sector but less frequently than in private practice. As therapeutic guidelines are already available, it would be useful to institute interactive information for practitioners through intensive visits by more experienced supervisors. The quality of the prescriptions could thus be optimized.

The Process of Privatization of Health Care Provision in Poland.

PubMed

Kaczmarek, Krzysztof; Flynn, Hannah; Letka-Paralusz, Edyta; Krajewski-Siuda, Krzysztof; Gericke, Christian A

In January 1999, a new institutional structure for Poland's health care system was laid out, instigated by the dramatic change in both the political and economic system. Following the dissolution of state socialism, private financing of health care services was encouraged to fill an important role in meeting rising consumer demand and to encourage a more efficient use of resources through competition and private initiative. However, from the outset of the intended transformations, systemic limitations to the privatization process hindered progression, resulting in varying rates of privatization amongst the distinct health care sectors. The aim of this paper is to describe the privatization process and to analyze its pace and differences in strategic approach in all major health care sectors. Policy analysis of legislation, government directives, and published national and international scientific literature on Polish health reforms between 1999 and 2012 was conducted. The analysis demonstrates a clear disparity in privatization rates in different sectors. The pharmaceutical industry is fully privatized in 2012, and the ambulatory and dental sectors both systematically increased their private market shares to around 70% of all services provided. However, despite a steady increase in the number of private hospitals in Poland since 1999, their overall role in the health care system is comparatively limited. Unclear legal regulations have resulted in a gray area between public and private health care, where informal payments impede the intended function of the system. If left unchanged, official health care in Poland is likely to become an increasingly residual service for the worst-off population segments that are unable to afford the legal private sector or the informal payments which guarantee a higher quality service in the public sector. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

Perceptions of a Methodology for the Development of Productivity Indicators.

DTIC Science & Technology

1982-09-01

leadership it must concentrate as do the Japanese, 1 on improving productivity in all areas of both the public and private sectors . Maintaining industrial...systems. The private sector has developed a very strong productivity measurement system based on profit and economic standings iri the market. However, as...the federal sector (including the Department of Defense) does not produce for profit nor does it compete in the private sector markets, it is not

Lessons from the other side: what can we learn from the private sector?

PubMed

Clarke, D

1999-01-01

Business has reacted in an impressive manner to increasing globalisation, short-term stock market pressure for performance, emerging industries and new technologies. While the private sector has become increasingly competitive, the public sector has not adopted this commercial rigour. Funding pressures on health services will continue, as will increasing consumer and staff demands and the blurring of public and private health care provision. As a result, there are lessons and techniques the public and private health sectors should learn from each other. I have drawn the issues that follow from my experience in the steel and food industries.

The private sector role in HIV/AIDS in the context of an expanded global response: expenditure trends in five sub-Saharan African countries.

PubMed

Sulzbach, Sara; De, Susna; Wang, Wenjuan

2011-07-01

Global financing for the HIV response has reached unprecedented levels in recent years. Over US$10 billion were mobilized in 2007, an effort credited with saving the lives of millions of people living with HIV (PLHIV). A relatively unexamined aspect of the global HIV response is the role of the private sector in financing HIV/AIDS services. As the nature of the response evolves from emergency relief to long-term sustainability, understanding current and potential contributions from the private sector is critical. This paper examines trends in private sector financing, management and resource consumption related to HIV/AIDS in five sub-Saharan African countries, with a particular emphasis on the effects of recently scaled-up donor funding on private sector contributions. We analysed National Health Accounts HIV/AIDS subaccount data for Kenya, Malawi, Rwanda, Tanzania and Zambia between 2002 and 2006. HIV subaccounts provide comparable data on the flow of HIV/AIDS funding from source to use. Findings indicate that private sector contributions decreased in all countries except Tanzania. With regards to managing HIV/AIDS funds, non-governmental organizations are increasingly controlling the largest share of resources relative to other stakeholders, whereas private for-profit entities are managing fewer HIV/AIDS resources since the donor influx. The majority of HIV/AIDS funds were spent in the public sector, although a considerable amount was spent at private facilities, largely fuelled by out-of-pocket (OOP) payments. On the whole, OOP spending by PLHIV decreased over the 4-year period, with the exception of Malawi, demonstrating that PLHIV have increased access to free or subsidized HIV/AIDS services. Our findings suggest that the influx of donor funding has led to decreased private contributions for HIV/AIDS. The reduction in private sector investment and engagement raises concerns about the sustainability of HIV/AIDS programmes over the long term, particularly in light of current global economic crisis and emerging competing priorities.

The number of privately treated tuberculosis cases in India: an estimation from drug sales data.

PubMed

Arinaminpathy, Nimalan; Batra, Deepak; Khaparde, Sunil; Vualnam, Thongsuanmung; Maheshwari, Nilesh; Sharma, Lokesh; Nair, Sreenivas A; Dewan, Puneet

2016-11-01

Understanding the amount of tuberculosis managed by the private sector in India is crucial to understanding the true burden of the disease in the country, and thus globally. In the absence of quality surveillance data on privately treated patients, commercial drug sales data offer an empirical foundation for disease burden estimation. We used a large, nationally representative commercial dataset on sales of 189 anti-tuberculosis products available in India to calculate the amount of anti-tuberculosis treatment in the private sector in 2013-14. We corrected estimates using validation studies that audited prescriptions against tuberculosis diagnosis, and estimated uncertainty using Monte Carlo simulation. To address implications for numbers of patients with tuberculosis, we explored varying assumptions for average duration of tuberculosis treatment and accuracy of private diagnosis. There were 17·793 million patient-months (95% credible interval 16·709 million to 19·841 million) of anti-tuberculosis treatment in the private sector in 2014, twice as many as the public sector. If 40-60% of private-sector tuberculosis diagnoses are correct, and if private-sector tuberculosis treatment lasts on average 2-6 months, this implies that 1·19-5·34 million tuberculosis cases were treated in the private sector in 2014 alone. The midpoint of these ranges yields an estimate of 2·2 million cases, two to three times higher than currently assumed. India's private sector is treating an enormous number of patients for tuberculosis, appreciably higher than has been previously recognised. Accordingly, there is a re-doubled need to address this burden and to strengthen surveillance. Tuberculosis burden estimates in India and worldwide require revision. Bill & Melinda Gates Foundation. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Privatization and the allure of franchising: a Zambian feasibility study.

PubMed

Fiedler, John L; Wight, Jonathan B

2003-01-01

Efforts to privatize portions of the health sector have proven more difficult to implement than had been anticipated previously. One common bottleneck encountered has been the traditional organizational structure of the private sector, with its plethora of independent, single physician practices. The atomistic nature of the sector has rendered many privatization efforts difficult, slow and costly-in terms of both organizational development and administration. In many parts of Africa, in particular, the shortages of human and social capital, and the fragile nature of legal institutions, undermine the appeal of privatization. The private sector is left with inefficiencies, high prices and costs, and a reduced effective demand. The result is the simultaneous existence of excess capacity and unmet need. One potential method to improve the efficiency of the private sector, and thereby enhance the likelihood of successful privatization, is to transfer managerial technology--via franchising--from models that have proven successful elsewhere. This paper presents a feasibility analysis of franchizing the successful Bolivian PROSALUD system's management package to Zambia. The assessment, based on PROSALUD's financial model, demonstrates that technology transfer requires careful adaptation to local conditions and, in this instance, would still require significant external assistance.

20 CFR 641.610 - How are section 502(e) activities administered?

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM Private Sector Training... Department may enter into agreements with States, public agencies, private nonprofit organizations, and private businesses to carry out section 502(e) projects. (b) To the extent possible, private sector...

Migration of South African health workers: the extent to which financial considerations influence internal flows and external movements

PubMed Central

2013-01-01

Background The loss of human resource capacity has had a severe impact on the health system in South Africa. This study investigates the causes of migration focussing on the role of salaries and benefits. Health professionals from public, private and non-governmental (NGO) health facilities located in selected peri–urban and urban areas in KwaZulu-Natal, South Africa were surveyed about their current positions and attitudes toward migration. Methods The study uses cross-sectional data collected in 2009. A total of 694 health professionals (430 in the public sector, 133 in the NGO sector and 131 in the private sector) were surveyed. An additional 11 health professionals were purposively selected for in-depth interviews. Odds ratios with 95% confidence intervals were calculated to determine whether salaries influenced HWs decisions to migrate. Results HWs decision to move was not positively associated with lower salaries. It was found, instead, that the consideration to move was determined by other factors including age, levels of stress experienced and the extent to which they were satisfied at their current place of work. Conclusions The OSD appears to have lowered the risk of HWs migrating due to low salaries. However, the results also indicate that the South African Department of Health needs to improve working conditions for HWs within the public health sector to assist in retention. PMID:23919539

Migration of South African health workers: the extent to which financial considerations influence internal flows and external movements.

PubMed

George, Gavin; Atujuna, Millicent; Gow, Jeff

2013-08-06

The loss of human resource capacity has had a severe impact on the health system in South Africa. This study investigates the causes of migration focussing on the role of salaries and benefits. Health professionals from public, private and non-governmental (NGO) health facilities located in selected peri-urban and urban areas in KwaZulu-Natal, South Africa were surveyed about their current positions and attitudes toward migration. The study uses cross-sectional data collected in 2009. A total of 694 health professionals (430 in the public sector, 133 in the NGO sector and 131 in the private sector) were surveyed. An additional 11 health professionals were purposively selected for in-depth interviews. Odds ratios with 95% confidence intervals were calculated to determine whether salaries influenced HWs decisions to migrate. HWs decision to move was not positively associated with lower salaries. It was found, instead, that the consideration to move was determined by other factors including age, levels of stress experienced and the extent to which they were satisfied at their current place of work. The OSD appears to have lowered the risk of HWs migrating due to low salaries. However, the results also indicate that the South African Department of Health needs to improve working conditions for HWs within the public health sector to assist in retention.

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.

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

31 CFR 50.35 - Entities that share profits and losses with private sector insurers.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Entities that share profits and losses with private sector insurers. 50.35 Section 50.35 Money and Finance: Treasury Office of the...' Compensation Funds § 50.35 Entities that share profits and losses with private sector insurers. (a) Treatment...

77 FR 66180 - Notice of Vacancies on the U.S. Section of the U.S.-Iraq Business Dialogue

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-02

... to facilitate private sector business growth in Iraq and to strengthen trade and investment ties... Section. Each Section consists of members from the private sector, representing the views and interests of the private sector business community. Each Party appoints the members to its respective Section. The...

77 FR 7132 - Request for Applicants for the Appointment to the United States-India CEO Forum

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-10

... appointment or reappointment as representatives to the U.S. Section of the Forum's private sector Committee....-India CEO Forum, consisting of both private and public sector members, brings together leaders of the... comprising private sector members. The Committee will be composed of two Sections, each consisting of 10-12...

78 FR 72640 - Notice of Vacancies on the U.S. Section of the U.S.-Iraq Business Dialogue

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-03

... to facilitate private sector business growth in Iraq and to strengthen trade and investment ties... Section. Each Section consists of members from the private sector, representing the views and interests of the private sector business community. Each Party appoints the members to its respective Section. The...

77 FR 31738 - Supplemental Nutrition Assistance Program: Trafficking Controls and Fraud Investigations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... effects of their regulatory actions on State, local and tribal governments and the private sector. Under... by State, local or tribal governments, in the aggregate, or the private sector, of $100 million or... State, local and tribal governments or the private sector of $100 million or more in any one year. Thus...

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…

The Social Security Program and the Private Sector Alternative: Lessons from History.

ERIC Educational Resources Information Center

Quadagno, Jill

1987-01-01

Used historical evidence to analyze how private sector benefits worked in the past in light of the debate surrounding the Social Security benefits and the federal deficit. Among conclusions reached are that the private sector failed to provide adequate protection for older citizens, and that benefits were inequitably distributed on basis of gender…

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, compared with only 24 (17.4%) of the 138 GPs (p < 0.01). Conclusion Many private-sector doctors are willing to manage public-sector HIV and AIDS patients in the eThekwini Metro, potentially removing some of the current burden on the public health sector.

The Role of Private Health Sector for Tuberculosis Control in Debre Markos Town, Northwest Ethiopia.

PubMed

Reta, Alemayehu; Simachew, Addis

2018-01-01

Tuberculosis has been declared to be a global epidemic. Despite all the effort, only less than half the annual estimated cases are reported by health authorities to the WHO. This could be due to poor reporting from the private sector. In Ethiopia, tuberculosis has also been a major public health problem. The aim of this study was to assess the role of the private health sector in tuberculosis control in Debre Markos. An institution based cross-sectional descriptive study was carried out in private health facilities. A total of 260 tuberculosis suspects attending the private clinics were interviewed. Focus group discussion, checklist, and structured questionnaire were used. Majority of the private clinics were less equipped, poorly regulated, and owned by health workers who were self-employed on a part-time basis. Provider delay of 4 and more months was significantly associated higher likelihood of turning to a private provider (OR = 2.70, 95% CI = (1.20, 6.08)). There is significant delay among tuberculosis patients. Moreover, there is poor regulation of the private health sector by public health authorities. The involvement of the private sector in tuberculosis control should be limited to identification and refer to tuberculosis cases and suspects.

Who, What, Where: an analysis of private sector family planning provision in 57 low- and middle-income countries.

PubMed

Campbell, Oona M R; Benova, Lenka; Macleod, David; Goodman, Catherine; Footman, Katharine; Pereira, Audrey L; Lynch, Caroline A

2015-12-01

Family planning service delivery has been neglected; rigorous analyses of the patterns of contraceptive provision are needed to inform strategies to address this neglect. We used 57 nationally representative Demographic and Health Surveys in low- and middle-income countries (2000-2013) in four geographic regions to estimate need for contraceptive services, and examined the sector of provision, by women's socio-economic position. We also assessed method mix and whether women were informed of side effects. Modern contraceptive use among women in need was lowest in sub-Saharan Africa (39%), with other regions ranging from 64% to 72%. The private sector share of the family planning market was 37-39% of users across the regions and 37% overall (median across countries: 41%). Private sector users accessed medical providers (range across regions: 30-60%, overall mean: 54% and median across countries 23%), specialised drug sellers (range across regions: 31-52%, overall mean: 36% and median across countries: 43%) and retailers (range across regions: 3-14%, overall mean: 6% and median across countries: 6%). Private retailers played a more important role in sub-Saharan Africa (14%) than in other regions (3-5%). NGOs and FBOs served a small percentage. Privileged women (richest wealth quintile, urban residents or secondary-/tertiary-level education) used private sector services more than the less privileged. Contraceptive method types with higher requirements (medical skills) for provision were less likely to be acquired from the private sector, while short-acting methods/injectables were more likely. The percentages of women informed of side effects varied by method and provider subtype, but within subtypes were higher among public than private medical providers for four of five methods assessed. Given the importance of private sector providers, we need to understand why women choose their services, what quality services the private sector provides, and how it can be improved. However, when prioritising one of the two sectors (public vs. private), it is critical to consider the potential impact on contraceptive prevalence and equity of met need. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

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 the other, this study identified areas of responsiveness where each sector needs improvements. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Health reform and cesarean sections in the private sector: The experience of Peru.

PubMed

Arrieta, Alejandro

2011-02-01

To test the hypothesis that the health reform enacted in Peru in 1997 increased the rate of cesarean sections in the private sector due to non-clinical factors. Different rounds of the Demographic and Health Survey are used to estimate determinants of c-section rates in private and public facilities before and after the healthcare reform. Estimations are based on a pooled linear regression controlling by obstetric and socioeconomic characteristics. C-section rates in the private sector grew from 28 to 53% after the health reform. Compared to the Ministry of Health (MOH), giving birth in a private hospital in the post-reform period adds 19% to the probability of c-section. The health reform implemented in the private sector increased physician incentives to over-utilize c-sections. The reform consolidated and raised the market power of private health insurers, but at the same time did not provide mechanisms to enlarge, regulate and disclose information of private providers. All these factors created the conditions for fee-for-service paid providers to perform more c-sections. Comparable trends in c-section rates have been observed in Latin American countries who implemented similar reforms in their private sector, suggesting a need to rethink the role of private health providers in developing countries. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

‘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-making, inter alia. These interventions may be more cost-effective for retention than wage increases, and imply that it is not necessarily just a matter of putting more money into the public sector to increase retention. PMID:23281664

Public or private care: where do specialists spend their time?

PubMed

Freed, Gary L; Turbitt, Erin; Allen, Amy

2017-10-01

Objectives The aim of the present study was to provide data to help clarify the public-private division of clinical care provision by doctors in Australia. Methods A secondary analysis was performed of data from the workforce survey administered by the Australian Health Practitioner Regulation Agency. The questionnaire included demographic and employment questions. Analysis included frequency distributions of demographic variables and mean and median calculations of employment data. Data were analysed from those currently employed in eight adult specialities chosen to provide a mix of surgical and medical fields. The specialties were orthopaedic surgery, otolaryngology, ophthalmology, cardiology, neurology, nephrology, gastroenterology and rheumatology. Results For the specialities analysed in the present study, a large majority of the time spent in patient care was provided in the private sector. For the surgical specialties studied, on average less than 30% of clinical time was spent in the public sector. There was considerable variation among specialties in whether a greater proportion of time was spent in out-patient versus in-patient care and how that was divided between the public and private sectors. Conclusions Ensuring Australians have a medical workforce that meets the needs of the population will require assessments of the public and private medical markets, the needs of each market and the adequacy with which current physician clinical time allocation meets those requirements. By appreciating this nuance, Australia can develop policies and strategies for the current and future speciality workforce to meet the nation's needs. What is known about the topic? Australian medical specialists can split their clinical practice time between the public (e.g. public hospitals, public clinics) and private (e.g. private hospitals, private consulting rooms) sectors. For all medical specialists combined, working hours have been reported to be similar in the public and private sectors. In aggregate, 48% of specialists work across both sectors, 33% work only in public practice and 19% work only in private practice. What does this paper add? Because of the potential for significant variability across specialties, these consolidated figures may be problematic in assessing the public and private allocation of the physician workforce. Herein we provide the first speciality-specific data on the public-private mix of practice in Australia. Among the most important findings from the present study is that, for many specialists in Australia, a large majority of time is spent providing care to patients in the private sector. For the surgical specialties studied, on average less than 30% of clinical time is spent in the public sector. What are the implications for practitioners? Public policies that are designed to ensure an adequate medical workforce will need to take into account the division of time providing care in the public vs. the private sector. Public perceptions of shortages in the public sector may increase the availability of public sector positions.

Household utilization and expenditure on private and public health services in Vietnam.

PubMed

Ha, Nguyen Thi Hong; Berman, Peter; Larsen, Ulla

2002-03-01

The private provision of health services in Vietnam was legalized in 1989 as one of the country's means to mobilize resources and improve efficiency in the health system. Ten years after its legalization, the private sector has widely expanded its activities and become an important provider of health services for the Vietnamese people. However, little is known about its contribution to the overall objectives of the health system in Vietnam. This paper assesses the role of the private health care provider by examining utilization patterns and financial burden for households of private, as compared with public, services. We found that the private sector provided 60% of all outpatient contacts in Vietnam. There was no difference by education, sex or place of residence in the use of private ambulatory health care. Although there was evidence suggesting that rich people use private care more than the poor, this finding was not consistent across all income groups. The private sector served young children in particular. Also, people in households with several sick members at the same time relied more on private than public care, while those with severe illnesses tended to use less private care than public. The financial burden for households from private health care services was roughly a half of that imposed by the public providers. Expenditure on drugs accounted for a substantial percentage of household expenditure in general and health care expenditure in particular. These findings call for a prompt recognition of the private sector as a key player in Vietnam's health system. Health system policies should mobilize positive private sector contributions to health system goals where possible and reduce the negative effects of private provision development.

Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

PubMed

Peters, David H; Mirchandani, Gita G; Hansen, Peter M

2004-10-01

The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research designs, key questions regarding their feasibility and impact remain unanswered. Copyright 2004 Oxford University Press

Development of health biotechnology in developing countries: can private-sector players be the prime movers?

PubMed

Abuduxike, Gulifeiya; Aljunid, Syed Mohamed

2012-01-01

Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor. Copyright © 2012 Elsevier Inc. All rights reserved.

Cooperative partnerships and the role of private landowners

Treesearch

T. Bently Wigley; James M. Sweeney

1993-01-01

Because most land, including forest land, in the United States is privately owned, it is clear the private sector should be a major cooperator in "Partners in Flight" efforts to conserve neotropical migratory birds. The "private sector" is more than forest landowners, whether corporate or noncorporate; it includes agricultural landowners, mining...

Trends in cataract surgical rate and resource utilisation in Egypt.

PubMed

Elbieh, Islam; Bascaran, Covadonga; Blanchet, Karl; Foster, Allen

2018-06-08

To describe cataract services in Egypt and explore resources and practices in public and private sectors. The study was conducted between June and August 2015. All facilities in the country providing cataract services were contacted to obtain information on surgeries performed in 2014. Hospitals performing eye surgery in Quena, Sharkia, and Fayoum regions were visited and a questionnaire on resources for cataract surgery was completed. Cataract surgery was offered in the public sector by 64 government and 16 university teaching hospitals and in the private sector by 101 hospitals. Over 90% of all facilities in the country contacted participated in the study. In 2014, the national cataract surgical rate (CSR) was 3674 varying in governorates from 7579 in Ismailia to 402 in Suez. The private sector performed 70% of cataract surgeries. Analysis of three regions showed an 11.7% increase in cataract output between 2010 and 2014. The average number of cataract surgeries per unit in 2014 was 2272 in private, 1633 in university, and 824 in government hospitals. Private hospitals had 60% of human resources for eye care. Phacoemulsification was the surgical technique in 85.6% of private, 72.1% of university, and 41% of government hospitals. Reasons explaining the differences in output between public and private sectors were the lack of trainers, supervisors, and incentives. The private sector provides most of the cataract services in Egypt, resulting in inadequate services for the poor. There is a 15-fold variation in CSR between the best and least served regions. The public sector could increase cataract output by improving training, supervision, and incentives.

Are PhDs Winners or Losers? Wage Premiums for Doctoral Degrees in Private Sector Employment

ERIC Educational Resources Information Center

Pedersen, Heidi Skovgaard

2016-01-01

Policy makers expect increasing numbers of PhDs to find employment in the private sector. However, the incentive structure for completing a PhD and subsequently seeking private sector employment has not been adequately assessed in the literature. This paper investigates the financial incentives for this career choice of recent Danish PhD…

Stabilising Fragile States

DTIC Science & Technology

2011-01-01

services (and private - sector jobs) throughout the target region. As such, jobs have the potential to redress perceptions of grievances and a lack of...sustainable employment requires a vibrant private sector . Accordingly, short- term employment initiatives should be undertaken in a way that will not...inadvertently undermine prospects for the emergence of a healthy private sector .   Key to maximising the stabilisation benefits of a jobs programme

Patients' appraisals of public and private healthcare: a qualitative study of physiotherapy and osteopathy.

PubMed

Bradbury, Katherine J; Bishop, Felicity L; Yardley, Lucy; Lewith, George

2013-10-01

Patients have previously reported differences in their experiences of treatments received in the public and private sectors; it remains unclear whether such perceived differences are particular to or shared across different interventions. This study explored whether patients' appraisals of public and private treatments are similar when appraising a complementary therapy (osteopathy) compared to a mainstream therapy (physiotherapy). Thirty-five qualitative interviews were analysed thematically. Patients' appraisals varied by health-care sector and therapy type: physiotherapy was appraised more negatively in the National Health Service than the private sector but osteopathy was appraised similarly within both health-care sectors. Potential reasons for this are discussed.

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.

Private sector data for performance management.

DOT National Transportation Integrated Search

2011-07-01

This report examines and analyzes technical and institutional issues associated with the use of private sector travel time and speed data for public sector performance management. The primary data needs for congestion performance measures are outline...

Germplasm Enhancement of Maize: Allelic Diversity and Double Haploid Update

USDA-ARS?s Scientific Manuscript database

The Germplasm Enhancement of Maize (GEM) Project is a collaborative effort of public and private sector researchers to broaden and enhance the germplasm base. To date, 235 germplasm lines have been released to cooperators representing approximately 25 races. These lines were selected based on yiel...

Oral artemisinin monotherapy removal from the private sector in Eastern Myanmar between 2012 and 2014.

PubMed

Khin, Hnin Su Su; Aung, Tin; Thi, Aung; White, Chris

2016-05-23

In 2012 the Artemisinin Monotherapy Therapy Replacement (AMTR) project was implemented in Eastern Myanmar to increase access to subsidized, quality-assured artemisinin combination therapy (ACT) and to remove oral artemisinin monotherapy (AMT) from the private sector. The aim of this paper is to examine changes over time in the private sector anti-malarial landscape and to illustrate the value of complementary interventions in the context of a national ACT subsidy. Three rounds of cross-sectional malaria medicine outlet surveys were conducted, in 2012, 2013 and 2014. Project intervention areas were selected from the Myanmar Artemisinin Resistance Containment (MARC) area. Provider detailing was implemented in these selected areas. Comparison areas were selected outside of this catchment area, from townships in close proximity to the MARC framework. Within each domain, multi-staged sampling was used to select areas for the survey. Outlets with the potential to sell or distribute anti-malarials in the private sector were screened for eligibility. The total number of outlets approached for an interview was as follows in the intervention and comparison areas, respectively: 2012, N = 2046 and 1612; 2013, N = 1636 and 1884; 2014, N = 2939 and 2941. The percentage of pharmacies, general retailers and mobile providers (classed as 'priority outlets') with oral AMT in stock on the day of the survey decreased over time in the intervention areas (2012 = 68 %; 2013 = 48 %; 2014 = 10 %). Conversely, quality-assured ACT availability increased among these outlets (2012 = 4 %; 2013 = 62 %; 2014 = 79 %). Relative oral AMT market share among priority outlets also decreased over time (2012 = 44 %; 2013 = 18 %; 2014 = 14 %), while market share of quality-assured ACT increased (2012 = 3 %; 2013 = 59 %; 2014 = 51 %). Among priority outlets in the comparison area, similar trends were observed, though changes over time were less substantial compared to the intervention area. Other outlet types (community health workers and health facilities) performed relatively well over time though modest improvements were also observed. The findings point to the successful design and implementation of a strategy to rapidly remove oral AMT from pharmacies, general retailers and mobile providers and to replace its use with quality-assured ACT. The evidence also highlights the importance of supporting interventions in the context of a high-level subsidy.

Private sector joins family planning effort.

PubMed

1989-12-01

Projects supported by the Directorate for Population (S&T/POP) of the U.S. Agency for International Development and aimed at increasing for-profit private sector involvement in providing family planning services and products are described. Making products commercially available through social-marketing partnerships with the commercial sector, USAID has saved $1.1 million in commodity costs from Brazil, Dominican Republic, Ecuador, Indonesia, and Peru. Active private sector involvement benefits companies, consumers, and donors through increased corporate profits, healthier employees, improved consumer access at lower cost, and the possibility of sustained family planning programs. Moreover, private, for-profit companies will be able to meet service demands over the next 20 years where traditional government and donor agency sources would fail. Using employee surveys and cost-benefit analyses to demonstrate expected financial and health benefits for businesses and work forces, S&T/POP's Technical Information on Population for the Private Sector (TIPPS) project encourages private companies in developing countries to invest in family planning and maternal/child health care for their employees. 36 companies in 9 countries have responded thus far, which examples provided from Peru and Zimbabwe. The Enterprise program's objectives are also to increase the involvement of for-profit companies in delivering family planning services, and to improve the efficiency and effectiveness of private volunteer organizations in providing services. Projects have been started with mines, factories, banks, insurance companies, and parastatals in 27 countries, with examples cited from Ghana and Indonesia. Finally, the Social Marketing for Change project (SOMARC) builds demand and distributes low-cost contraceptives through commercial channels especially to low-income audiences. Partnerships have been initiated with the private sector in 17 developing countries, with examples provided from the Dominican Republic, Liberia and Ecuador. These projects have increased private sector involvement in family planning, thereby promoting service expansion at lower public sector cost.

Access to artemisinin-combination therapy (ACT) and other anti-malarials: national policy and markets in Sierra Leone.

PubMed

Amuasi, John H; Diap, Graciela; Nguah, Samuel Blay; Karikari, Patrick; Boakye, Isaac; Jambai, Amara; Lahai, Wani Kumba; Louie, Karly S; Kiechel, Jean-Rene

2012-01-01

Malaria remains the leading burden of disease in post-conflict Sierra Leone. To overcome the challenge of anti-malarial drug resistance and improve effective treatment, Sierra Leone adopted artemisinin-combination therapy artesunate-amodiaquine (AS+AQ) as first-line treatment for uncomplicated P. falciparum malaria. Other national policy anti-malarials include artemether-lumefantrine (AL) as an alternative to AS+AQ, quinine and artemether for treatment of complicated malaria; and sulphadoxine-pyrimethamine (SP) for intermittent preventive treatment (IPTp). This study was conducted to evaluate access to national policy recommended anti-malarials. A cross-sectional survey of 127 medicine outlets (public, private and NGO) was conducted in urban and rural areas. The availability on the day of the survey, median prices, and affordability policy and available non-policy anti-malarials were calculated. Anti-malarials were stocked in 79% of all outlets surveyed. AS+AQ was widely available in public medicine outlets; AL was only available in the private and NGO sectors. Quinine was available in nearly two-thirds of public and NGO outlets and over one-third of private outlets. SP was widely available in all outlets. Non-policy anti-malarials were predominantly available in the private outlets. AS+AQ in the public sector was widely offered for free. Among the anti-malarials sold at a cost, the same median price of a course of AS+AQ (US$1.56), quinine tablets (US$0.63), were found in both the public and private sectors. Quinine injection had a median cost of US$0.31 in the public sector and US$0.47 in the private sector, while SP had a median cost of US$0.31 in the public sector compared to US$ 0.63 in the private sector. Non-policy anti-malarials were more affordable than first-line AS+AQ in all sectors. A course of AS+AQ was affordable at nearly two days' worth of wages in both the public and private sectors.

Family planning, antenatal and delivery care: cross-sectional survey evidence on levels of coverage and inequalities by public and private sector in 57 low- and middle-income countries.

PubMed

Campbell, Oona M R; Benova, Lenka; MacLeod, David; Baggaley, Rebecca F; Rodrigues, Laura C; Hanson, Kara; Powell-Jackson, Timothy; Penn-Kekana, Loveday; Polonsky, Reen; Footman, Katharine; Vahanian, Alice; Pereira, Shreya K; Santos, Andreia Costa; Filippi, Veronique G A; Lynch, Caroline A; Goodman, Catherine

2016-04-01

The objective of this study was to assess the role of the private sector in low- and middle-income countries (LMICs). We used Demographic and Health Surveys for 57 countries (2000-2013) to evaluate the private sector's share in providing three reproductive and maternal/newborn health services (family planning, antenatal and delivery care), in total and by socio-economic position. We used data from 865 547 women aged 15-49, representing a total of 3 billion people. We defined 'met and unmet need for services' and 'use of appropriate service types' clearly and developed explicit classifications of source and sector of provision. Across the four regions (sub-Saharan Africa, Middle East/Europe, Asia and Latin America), unmet need ranged from 28% to 61% for family planning, 8% to 22% for ANC and 21% to 51% for delivery care. The private-sector share among users of family planning services was 37-39% across regions (overall mean: 37%; median across countries: 41%). The private-sector market share among users of ANC was 13-61% across regions (overall mean: 44%; median across countries: 15%). The private-sector share among appropriate deliveries was 9-56% across regions (overall mean: 40%; median across countries: 14%). For all three healthcare services, women in the richest wealth quintile used private services more than the poorest. Wealth gaps in met need for services were smallest for family planning and largest for delivery care. The private sector serves substantial numbers of women in LMICs, particularly the richest. To achieve universal health coverage, including adequate quality care, it is imperative to understand this sector, starting with improved data collection on healthcare provision. © 2016 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Availability, Price, and Affordability of Selected Essential Medicines for Chronic Diseases in 11 Countries of the Asia Pacific Region: A Secondary Analysis.

PubMed

Wang, Haipeng; Sun, Qiang; Vitry, Agnes; Nguyen, Tuan Anh

2017-05-01

Access to affordable essential medicines for noncommunicable, chronic diseases is critical in management of the diseases. This study aims to assess the availability, prices, and affordability of medicines for common chronic diseases in the Asia Pacific Region (APR). A secondary analysis of medicines price and availability data from the Health Action International's (HAI) database was undertaken using the standardized WHO/HAI methodology. The median availability of any medicine in the public sector was 35.5% compared with 56.7% in the private sector. Countries paid 1.4 times the International Reference Price to procure lowest-priced generics (LPGs) and 9.1 times for innovator brands (IBs). Patients would have to spend 2.3 and 0.4 day's wages to purchase one month's treatment of a chronic disease for IBs and LPGs, respectively in the private sector. These findings highlight the need to increase availability, reduce prices, and improve affordability of the medicines.

Capital Budgeting: Do Private Sector Methods of Budgeting for Capital Assets Have Applicability to the Department of Defense

DTIC Science & Technology

2005-12-01

private sector and the Department of Defense. Additionally, the purpose is to evaluate the strengths and weaknesses of each capital budgeting method and conduct a comparison. The intent is to identify those capital budgeting practices that are used in the private sector , some of which have been implemented in other public sector organizations, which may have merit for implementation in the Federal sector and possibly the Department of Defense. Finally, a set of conclusions and recommendations on how to implement best practices of capital budgeting for

United States private-sector physicians and pharmaceutical contract research: a qualitative study.

PubMed

Fisher, Jill A; Kalbaugh, Corey A

2012-01-01

There have been dramatic increases over the past 20 years in the number of nonacademic, private-sector physicians who serve as principal investigators on US clinical trials sponsored by the pharmaceutical industry. However, there has been little research on the implications of these investigators' role in clinical investigation. Our objective was to study private-sector clinics involved in US pharmaceutical clinical trials to understand the contract research arrangements supporting drug development, and specifically how private-sector physicians engaged in contract research describe their professional identities. We conducted a qualitative study in 2003-2004 combining observation at 25 private-sector research organizations in the southwestern United States and 63 semi-structured interviews with physicians, research staff, and research participants at those clinics. We used grounded theory to analyze and interpret our data. The 11 private-sector physicians who participated in our study reported becoming principal investigators on industry clinical trials primarily because contract research provides an additional revenue stream. The physicians reported that they saw themselves as trial practitioners and as businesspeople rather than as scientists or researchers. Our findings suggest that in addition to having financial motivation to participate in contract research, these US private-sector physicians have a professional identity aligned with an industry-based approach to research ethics. The generalizability of these findings and whether they have changed in the intervening years should be addressed in future studies. Please see later in the article for the Editors' Summary.

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.

Comparing VA and private sector healthcare costs for end-stage renal disease.

PubMed

Hynes, Denise M; Stroupe, Kevin T; Fischer, Michael J; Reda, Domenic J; Manning, Willard; Browning, Margaret M; Huo, Zhiping; Saban, Karen; Kaufman, James S

2012-02-01

Healthcare for end-stage renal disease (ESRD) is intensive, expensive, and provided in both the public and private sector. Using a societal perspective, we examined healthcare costs and health outcomes for Department of Veterans Affairs (VA) ESRD patients comparing those who received hemodialysis care at VA versus private sector facilities. Dialysis patients were recruited from 8 VA medical centers from 2001 through 2003 and followed for 12 months in a prospective cohort study. Patient demographics, clinical characteristics, quality of life, healthcare use, and cost data were collected. Healthcare data included utilization (VA), claims (Medicare), and patient self-report. Costs included VA calculated costs, Medicare dialysis facility reports and reimbursement rates, and patient self-report. Multivariable regression was used to compare costs between patients receiving dialysis at VA versus private sector facilities. The cohort comprised 334 patients: 170 patients in the VA dialysis group and 164 patients in the private sector group. The VA dialysis group had more comorbidities at baseline, outpatient and emergency visits, prescriptions, and longer hospital stays; they also had more conservative anemia management and lower baseline urea reduction ratio (67% vs. 72%; P<0.001), although levels were consistent with guidelines (Kt/V≥1.2). In adjusted analysis, the VA dialysis group had $36,431 higher costs than those in the private sector dialysis group (P<0.001). Continued research addressing costs and effectiveness of care across public and private sector settings is critical in informing health policy options for patients with complex chronic illnesses such as ESRD.

United States Private-Sector Physicians and Pharmaceutical Contract Research: A Qualitative Study

PubMed Central

Fisher, Jill A.; Kalbaugh, Corey A.

2012-01-01

Background There have been dramatic increases over the past 20 years in the number of nonacademic, private-sector physicians who serve as principal investigators on US clinical trials sponsored by the pharmaceutical industry. However, there has been little research on the implications of these investigators' role in clinical investigation. Our objective was to study private-sector clinics involved in US pharmaceutical clinical trials to understand the contract research arrangements supporting drug development, and specifically how private-sector physicians engaged in contract research describe their professional identities. Methods and Findings We conducted a qualitative study in 2003–2004 combining observation at 25 private-sector research organizations in the southwestern United States and 63 semi-structured interviews with physicians, research staff, and research participants at those clinics. We used grounded theory to analyze and interpret our data. The 11 private-sector physicians who participated in our study reported becoming principal investigators on industry clinical trials primarily because contract research provides an additional revenue stream. The physicians reported that they saw themselves as trial practitioners and as businesspeople rather than as scientists or researchers. Conclusions Our findings suggest that in addition to having financial motivation to participate in contract research, these US private-sector physicians have a professional identity aligned with an industry-based approach to research ethics. The generalizability of these findings and whether they have changed in the intervening years should be addressed in future studies. Please see later in the article for the Editors' Summary. PMID:22911055

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.

Relations among social support, burnout, and experiences of anger: an investigation among emergency nurses.

PubMed

Ersoy-Kart, Müge

2009-01-01

The aim of the present study was to determine whether social support, burnout, and anger expression are related with each other among emergency nurses working in private- or public-sector hospitals. The sample consisted of 100 emergency nurses working in the private or public sector in Ankara, Turkey. The Maslach Burnout Inventory, The Multidimensional Scale of Perceived Social Support, and The Trait-Anger and Anger Expression Scale were used. The results demonstrated that social support did not differentiate among the nurses working in the private sector or in the public sector according to the burnout subscales' scores. However, nurses in the private sector find it more difficult to express their anger. The state-trait anger levels of the nurses differ according to the burnout levels and also according to the sector that they are working in. The congruence between this study's findings and the literature is discussed.

Adoption of formal HIV and AIDS workplace policies: an analysis of industry/sector variations.

PubMed

Bakuwa, Rhoda

2010-12-01

Addressing HIV and AIDS is the responsibility of many stakeholders including private sector companies. However, increasing evidence reveals that the majority of companies around the world are yet to acknowledge and respond to HIV and AIDS as a workplace issue. One factor that has been identified in the literature as playing a role in determining whether a company responds to HIV and AIDS, or not, is the industry/sector in which a company operates. This study therefore sought to empirically examine whether in the context of Malawi there were significant variations in the adoption of formal HIV and AIDS workplace policies based on the industry/sector in which a company was operating, as well as analyse the dynamics underlying such variations. Using survey data collected from 152 randomly selected private sector companies in Malawi, the results of this study revealed significant variations in the adoption of HIV and AIDS workplace policies among companies operating in various sectors. Companies in the service sector were leading the adoption compared to companies in other sectors such as the trading sector. Furthermore, the evidence from this study showed that differences in staff participation in the activities of HIV and AIDS institutions may explain the industry/sector variations. These results provide an important avenue to scale up company responses to HIV and AIDS by intensifying staff participation in the activities of HIV and AIDS institutions. Such institutions appear to play a vital role of providing up to date HIV-and AIDS-related information upon which companies are able to develop a business case for responding to the epidemic.

The role of the private sector in the provision of antenatal care: a study of Demographic and Health Surveys from 46 low- and middle-income countries.

PubMed

Powell-Jackson, Timothy; Macleod, David; Benova, Lenka; Lynch, Caroline; Campbell, Oona M R

2015-02-01

To examine the role of the private sector in the provision of antenatal care (ANC) across low- and middle-income countries. Demographic and Health Survey (DHS) data from 46 countries (representing 2.6 billion people) on components of ANC given to 303 908 women aged 15-49 years for most recent birth were used. We identified 79 unique sources of care which were re-coded into home, public, private (commercial) and private (not-for-profit). Use of ANC and a quality of care index (scaled 0-1) were stratified by type of provider, region and wealth quintile. Linear regressions were used to examine the association between provider type and antenatal quality of care score. Across all countries, the main source of ANC was public (54%), followed by private commercial (36%) and home (5%), but there were large variations by region. Home-based ANC was associated with worse quality of care (0.2; 95% CI -0.2 to -0.19) relative to the public sector, while the private not-for-profit sector (0.03; 95% CI 0.02 to 0.04) was better. There were no differences in quality of care between public and private commercial providers. The market for ANC varies considerably between regions. The two largest sectors - public and private commercial - perform similarly in terms of quality of care. Future research should examine the role of the private sector in other health service domains across multiple countries and test what policies and programmes can encourage private providers to contribute to increased coverage, quality and equity of maternal care. © 2014 John Wiley & Sons Ltd.

Athletic Trainer Services in Public and Private Secondary Schools.

PubMed

Pike, Alicia M; Pryor, Riana R; Vandermark, Lesley W; Mazerolle, Stephanie M; Casa, Douglas J

2017-01-01

 The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored.  To compare the level of AT services in public and private secondary schools.  Concurrent mixed-methods study.  Public and private secondary schools in the United States.  A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private).  School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis.  A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators.  Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector.

Athletic Trainer Services in Public and Private Secondary Schools

PubMed Central

Pike, Alicia M.; Pryor, Riana R.; Vandermark, Lesley W.; Mazerolle, Stephanie M.; Casa, Douglas J.

2017-01-01

Context: The presence of athletic trainers (ATs) in secondary schools to provide medical care is crucial, especially with the rise in sports participation and resulting high volume of injuries. Previous authors have investigated the level of AT services offered, but the differences in medical care offered between the public and private sectors have not been explored. Objective: To compare the level of AT services in public and private secondary schools. Design: Concurrent mixed-methods study. Setting: Public and private secondary schools in the United States. Patients or Other Participants: A total of 10 553 secondary schools responded to the survey (8509 public, 2044 private). Main Outcome Measure(s): School administrators responded to the survey via telephone or e-mail. Descriptive statistics depict national data. Open-ended questions were evaluated through content analysis. Results: A greater percentage of public secondary schools than private secondary schools hired ATs. Public secondary schools provided a higher percentage of full-time, part-time, and clinic AT services than private secondary schools. Only per diem AT services were more frequent in the private sector. Regardless of the extent of services, reasons for not employing an AT were similar between sectors. Common barriers were budget, school size, and lack of awareness of the role of an AT. Unique to the public sector, remote location was identified as a challenge faced by some administrators. Conclusions: Both public and private secondary schools lacked ATs, but higher percentages of total AT services and full-time services were available in the public sector. Despite differences in AT services, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring ATs were comparable between public and private secondary schools; however, remote location was a unique challenge for the public sector. PMID:28157403

To Profit or Not to Profit: The Private Higher Education Sector in Brazil

ERIC Educational Resources Information Center

Salto, Dante J.

2018-01-01

Brazil has by far the largest higher education system in Latin America, with a sizable share of students enrolled in private-sector institutions. Its recently established and fast-growing for-profit sector is one of the largest worldwide. The for-profit sector already surpasses the public sector in student enrollment, and its role is growing.…

Public and Private Schooling in France: An Investigation into Family Choice.

ERIC Educational Resources Information Center

Langouet, Gabriel; Leger, Alain

2000-01-01

During the 1980s, 35 percent of French pupils attended private schools at some point. The private sector (largely state-supported Catholic schools) offered a second chance that was not seized equally. Research shows public-sector recruitment was more democratic; private schools equalized results more successfully. (Contains 12 references.) (MLH)

[Mechanism and implication of regulation of the pricing of essential medicines in the private pharmaceutical sector in Mali].

PubMed

Maïga, D; Maïga, S; Maïga, M D

2010-04-01

The healthcare and pharmaceutical professions in Mali were privatized in 1985. Privatization led to swift expansion of the private sector and upset the balance that had existed between the public and private sectors. A national pharmaceutical policy did not emerge until a decade later. Its purpose was to promote a system ensuring fair access to essential generic medicines for all. It was hoped that synergy between the two sectors would promote that objective. However, the policy calling for distribution of essential generic medicine through the private sector was not accompanied by an adequate system for pricing. This problem led the government to adopt a price regulation policy to realign market dynamics with public health goals. This experience shows that a sustained effort from public policy makers is necessary to prevail against the professional and business interests that can conflict with the public interest. Analysis of this experience also demonstrates the need to improve, restructure, and control the pharmaceutical industry. The government must continue to play its crucial role in the context of limited resources and inequality between consumers and pharmaceutical companies.

Department of Defense Recovering Warrior Task Force

DTIC Science & Technology

2014-09-02

used by RWs, which DoD must first identify, such as private sector job training, employment skills training, apprenticeships, and internships (JTEST- AI ...employment, other transition support, referrals and warm handoffs within and across sectors , and case management. Communities that are geographically remote...of Medicine76; recognition of the need for private sector participation is coalescing. We see evidence of the private sector’s readiness to embrace

Quality Circles in the Navy: Productivity Improvement or Just Another Program?

DTIC Science & Technology

1981-07-01

related problems and recommend solutions to management. Interest in implementation of QCs is spreading rapidly in both the public and private sectors . Ci...main objectives are to (I) describe QCs, (2) provide information regarding current interest and involvement in QCs in Navy and private sector ...3 QCs in the Private Sector . .. ......... ......... ... 4 Current Use of QCs in the Navy .. .. ...... ............. 4 Impact of QCs

Technology Transfer: Use of Federally Funded Research and Development

DTIC Science & Technology

2007-07-19

technology to the private sector and to state and local governments. Despite this, use of federal R&D results has remained restrained, although there has...been a significant increase in private sector interest and activities over the past several years. Critics argue that working with the agencies and...technology transfer, or if the responsibility to use the available resources now rests with the private sector .

Gender Differences in Pay among Recent Graduates: Private Sector Employees in Ireland

ERIC Educational Resources Information Center

Russell, Helen; Smyth, Emer; O'Connell, Philip J.

2010-01-01

In this paper we seek to investigate the role of different factors in accounting for the differences in earnings among recent graduates working in the private sector in Ireland. Three years after graduation there is a pay gap of 8 per cent in hourly wages between male and female graduates in the private sector and a 4 per cent non-significant gap…

Stereosat: A proposed private sector/government joint venture in remote sensing from space

NASA Technical Reports Server (NTRS)

Anglin, R. L.

1980-01-01

Stereosat, a free flying Sun synchronous satellite whose purpose is to obtain worldwide cloud-free stereoscopic images of the Earth's land masses, is proposed as a joint private sector/government venture. A number of potential organization models are identified. The legal, economic, and institutional issues which could impact the continuum of potential joint private sector/government institutional structures are examined.

All That Glitters Is Not Gold: The Quality of Low-Fee Private Schools in Dhaka, Bangladesh

ERIC Educational Resources Information Center

Richardson, Emily Elisabeth

2017-01-01

Bangladesh, home to one of the world's largest and most diverse education sectors, has witnessed rapid growth in its private education sector in recent decades. The majority of this growth has been within the low-fee private school (LFPS) sector, which now accounts for more than 25 percent of total school enrollment. However, the reliability of…

Availability of essential medicines in Ethiopia: an efficiency-equity trade-off?

PubMed

Carasso, Barbara S; Lagarde, Mylene; Tesfaye, Addis; Palmer, Natasha

2009-11-01

To investigate the availability and cost of essential medicines in health centres in rural Ethiopia, and to explore if the fee waiver system protects patients from having to pay for medicines. The study took place in five health centres in rural Ethiopia. Availability and price of selected key essential medicines was established in the budget and special pharmacy of the health centre, as well as private outlets. Information on availability and cost of prescribed drugs was obtained through patient exit-interviews. Availability based of essential drugs at facility level was 91% based on a list of selected drugs vs. 84% based on prescriptions filled. However, less than half the prescribed drugs were obtained from the budget pharmacy, and one in six patients was forced to purchase drugs in the private sector, where drugs are roughly twice as expensive. The waiver system did not safeguard against having to pay for medicines. A revolving drug fund system in Ethiopia seems to improve availability of medicines, and can improve affordability by protecting people from purchasing drugs in the private sector. However, it may result in a parallel system, whereby the poor cannot access drugs if these are not available in the budget pharmacy. Equity is a concern in the absence of an adequate mechanism to protect the poor from catastrophic health expenditure.

Guidance on Software Maintenance. Final Report. Reports on Computer Science and Technology.

ERIC Educational Resources Information Center

Martin, Roger J.; Osborne, Wilma M.

Based on informal discussions with personnel at selected federal agencies and private sector organizations and on additional research, this publication addresses issues and problems of software maintenance and suggests actions and procedures which can help software maintenance organizations meet the growing demands of maintaining existing systems.…

Work Sharing Case Studies.

ERIC Educational Resources Information Center

McCarthy, Maureen E.; And Others

Designed to provide private sector employers with the practical information necessary to select and then to design and implement work sharing arrangements, this book presents case studies of some 36 work sharing programs. Topics covered in the case studies include the circumstances leading to adoption of the program, details of compensation and…

Prospects for Educational Telecomputing: Selected Readings.

ERIC Educational Resources Information Center

Tinker, Robert F., Ed.; Kapisovsky, Peggy M., Ed.

The purpose of this collection of readings was to stimulate debate on the role of educational telecomputing in school reform and restructuring, and how efforts from the public and private sector can coordinate to bring about these changes. The 14 papers are entitled: (1) "Linking for Learning: Computer-and-Communications Network Support for…

75 FR 69631 - National Medal of Technology and Innovation Nomination Evaluation Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-15

... selection. NMTI Nomination Evaluation Committee members are drawn from both the public and private sectors... Technology and Innovation Nomination Evaluation Committee Meeting AGENCY: United States Patent and Trademark... Innovation (NMTI) Nomination Evaluation Committee will meet in closed session on Tuesday, November 30, 2010...

Healthcare identities at the crossroads of service modernisation: the transfer of NHS clinicians to the independent sector?

PubMed

Waring, Justin; Bishop, Simon

2011-07-01

Health policies increasingly support private businesses to take an active role in the organisation and delivery of public healthcare services. For the English NHS, this is exemplified by the introduction of Independent Sector Treatment Centres. A number of these facilities involve the wholesale secondment of NHS clinicians to the private sector which, we suggest, raises important questions about the identities of healthcare professionals accustomed to working in the public sector. Our paper investigates this transition highlighting three prominent discontinuities in clinical work: the ethos of private sector ownership, new lines of authority and fragmented relationships. Drawing on Giddens, we examine how clinicians experience and interpret these changes and how they keep their biographical 'narrative going'. The 'pioneers' interpreted the independent sector as an opportunity to re-invigorate their practice through new roles, relationships and higher quality care; the 'guardians' as an opportunity to replicate and protect the customs and standards of the NHS in the private sector; whilst the 'marooned' longed to return to the NHS. Our study illustrates how the sectoral context can shape healthcare identities, and how contemporary reforms aimed at promoting partnerships across public and private sectors can have profound implications for clinicians. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

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

Using Internet-Based Language Testing Capacity to the Private Sector

ERIC Educational Resources Information Center

Garcia Laborda, Jesus

2009-01-01

Language testing has a large number of commercial applications in both the institutional and the private sectors. Some jobs in the health services sector or the public services sector require foreign language skills and these skills require continuous and efficient language assessments. Based on an experience developed through the cooperation of…

Entrepreneurship in Public Education

ERIC Educational Resources Information Center

McFadden, Brett W.

2013-01-01

The private sector is more often viewed as the realm that is cutting-edge and creative, not the public sector. But this thinking is more myth than fact. There are countless examples of private sector entities that become stagnant and eventually fail. The reality is that no particular sector has a lock on being innovative and entrepreneurial. These…

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.

Constraints, challenges and prospects of public-private partnership in health-care delivery in a developing economy.

PubMed

Anyaehie, Usb; Nwakoby, Ban; Chikwendu, C; Dim, Cc; Uguru, N; Oluka, Cpi; Ogugua, C

2014-01-01

In Nigeria, concerns on the quality and financing of health-care delivery especially in the public sector have initiated reforms including support for public-private partnerships (PPP) at the Federal Ministry of Health. Likewise, Enugu State has developed a draft policy on PPP since 2005. However, non-validation and non-implementation of this policy might have led to loss of interest in the partnership. The aim of this study was to provide evidence for planning the implementation of PPP in Enugu State health system via a multi-sectoral identification of challenges, constraints and prospects. Pre-tested questionnaires were administered to 466 respondents (251 health workers and 215 community members), selected by multi-stage sampling method from nine Local Government Areas of Enugu State, Nigeria, over a study period of April 2011 to September 2011. Data from the questionnaires were collated manually and quantitative data analyzed using SPSS version 15 (Chicago, IL, USA). Only 159 (34.1%, 159/466) of all respondents actually understood the meaning of PPP though 251 (53.9%) of them had claimed knowledge of the concept. This actual understanding was higher among health workers (57.8%, 145/251) when compared with the community members (6.5%, 14/215) (P < 0.001). Post-PPP enlightenment reviews showed a more desire for PPP implementation among private health-care workers (89.4%, 101/113) and community leaders/members (55.4%, 119/215). PPP in health-care delivery in Enugu State is feasible with massive awareness, elaborate stakeholder's engagements and well-structured policy before implementation. A critical challenge will be to convince the public sector workers who are the anticipated partners to accept and support private sector participation.

Establishing and Scaling-Up Clinical Social Franchise Networks: Lessons Learned From Marie Stopes International and Population Services International

PubMed Central

Thurston, Sarah; Chakraborty, Nirali M; Hayes, Brendan; Mackay, Anna; Moon, Pierre

2015-01-01

In many low- and middle-income countries, a majority of people seek health care from the private sector. However, fragmentation, poor economies of scale, inadequate financing, political opposition, a bias toward curative services, and weak regulatory and quality control systems pose serious challenges for the private sector. Social franchising addresses a number of these challenges by organizing small, independent health care businesses into quality-assured networks. Global franchisors Marie Stopes International (MSI) and Population Services International (PSI) have rapidly scaled their family planning social franchising programs in recent years, jointly delivering over 10.8 million couple-years of protection (CYPs) in 2014—up 26% from 8.6 million CYPs just 1 year prior. Drawing on experience across MSI’s 17 and PSI’s 25 social franchise networks across Africa, Asia, and Latin America and the Caribbean, this article documents the organizations’ operational approaches, challenges faced, and solutions implemented. The organizations provide intensive capacity building and support for private-sector providers, including clinical training, branding, monitoring quality of franchised services, and commodity support. In addition, franchising programs engage providers and clients through behavior change communication (BCC) and demand generation activities to raise awareness and to attract clients, and they implement initiatives to ensure services are affordable for the lowest-income clients. Social franchise programs offer the private sector a collective platform to better engage government in health policy advocacy and for integrating into new public health care financing and procurement mechanisms. The future of social franchising will require developing approaches to scale-up and sustain the model cost-effectively, selectively integrating other health services into the franchise package, and being responsive to evolving health care financing approaches with the potential to contribute to universal health coverage. PMID:26085017

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.

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.

Medicine prices and availability in the Brazilian Popular Pharmacy Program.

PubMed

Pinto, Cláudia Du Bocage Santos; Miranda, Elaine Silva; Emmerick, Isabel Cristina Martins; Costa, Nilson do Rosário; Castro, Claudia Garcia Serpa Osorio de

2010-08-01

To analyze the performance of the Programa Farmácia Popular do Brasil (FPB - Brazilian Popular Pharmacy Program) in the public and private sectors, in terms of availability and cost of medicines for hypertension and diabetes. The methodology developed by the World Health Organization, in partnership with the Health Action International, was used to compare medicines prices and availability. This study was performed in May 2007, in different sectors (public, private and the Program's government-managed [FPB-P] and private-sector-managed [FPB-E] categories), in 30 cities in Brazil. A total of four medicines were analyzed: captopril 25mg and hydrochlorothiazide 25mg for hypertension; and metformin 500mg and glibenclamide 5mg for diabetes. FPB-E showed greatest medicine availability, while the public sector the lowest. The percentage of availability of similar medicines was higher than that of generic medicines, both in the public sector and in the FPB-P. Comparison of prices among sectors showed a lower purchase price in the FPB-E, followed by the FPB-P. The FPB-E charged prices that were over 90% cheaper than those in the private sector. The number of working days required to obtain treatment for hypertension and diabetes were fewer in the FPB-E. The lower availability found in the public sector could be one of the reasons for the migration of users from the public sector to the FPB. The high prices in the private sector also contribute for this Program to be an alternative of medicine access in Brazil.

Lessons from America? Commercialization and growth of private medicine in Britain.

PubMed

Rayner, G

1987-01-01

This article examines the transition of the private medical sector in Britain from a mere appendage to the National Health Service to a significant business sector involving multinational enterprise. The author argues that private medicine continues to be in a state of flux because its degree of independence is limited by its links to the dominant public sector, particularly with regard to staffing, and is still vulnerable to attacks from the opposition parties. Private medicine, despite rapid growth in the late 1970s, is beset by mounting costs and intense competition.

Homeland Security and the Private Sector : a CBO Paper

DTIC Science & Technology

2004-12-01

private sector and the nation as a whole that would underlie the expected costs of terrorist attacks and, hence, the broader benefits of security. This paper focuses on those industries for which the expected human and economic losses from a terrorist attack would be highest -- the country’s critical infrastructure. The analysis more narrowly focuses on those industries that reside largely in the private sector and for which an attack could lead to a direct loss of life. The paper also reviews the incentives for private actions to limit

Private Sector Initiative Between the U.S. and Japan

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

None

1998-09-30

OAK-A258 Private Sector Initiative Between the U.S. and Japan. This report for calendar years 1993 through September 1998 describes efforts performed under the Private Sector Initiatives contract. The report also describes those efforts that have continued with private funding after being initiated under this contract. The development of a pyrochemical process, called TRUMP-S, for partitioning actinides from PUREX waste, is described in this report. This effort is funded by the Central Research Institute of Electric Power Industry (CRIEPI), KHI, the United States Department of Energy, and Boeing.

The impact of public employment on health and health inequalities: evidence from China.

PubMed

Zhang, Wei

2011-01-01

Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the "conventional wisdom" that private ownership is almost always superior, and should adjust their labor market policies accordingly.

Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?

PubMed

Montagu, Dominic; Goodman, Catherine

2016-08-06

The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

An empirical analysis of public and private medical practice in Australia.

PubMed

Cheng, Terence C; Joyce, Catherine M; Scott, Anthony

2013-06-01

The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A Proposal for Public and Private Partnership in Extension.

PubMed

Krell, Rayda K; Fisher, Marc L; Steffey, Kevin L

2016-01-01

Public funding for Extension in the United States has been decreasing for many years, but farmers' need for robust information on which to make management decisions has not diminished. The current Extension funding challenges provide motivation to explore a different model for developing and delivering extension. The private sector has partnered with the public sector to fund and conduct agricultural research, but partnering on extension delivery has occurred far less frequently. The fundamental academic strength and established Extension network of the public sector combined with the ability of the private sector to encourage and deliver practical, implementable solutions has the potential to provide measurable benefits to farmers. This paper describes the current Extension climate, presents data from a survey about Extension and industry relationships, presents case studies of successful public- and private-sector extension partnerships, and proposes a framework for evaluating the state of effective partnerships. Synergistic public-private extension efforts could ensure that farmers receive the most current and balanced information available to help with their management decisions.

A Proposal for Public and Private Partnership in Extension

PubMed Central

Krell, Rayda K.; Fisher, Marc L.; Steffey, Kevin L.

2016-01-01

Public funding for Extension in the United States has been decreasing for many years, but farmers’ need for robust information on which to make management decisions has not diminished. The current Extension funding challenges provide motivation to explore a different model for developing and delivering extension. The private sector has partnered with the public sector to fund and conduct agricultural research, but partnering on extension delivery has occurred far less frequently. The fundamental academic strength and established Extension network of the public sector combined with the ability of the private sector to encourage and deliver practical, implementable solutions has the potential to provide measurable benefits to farmers. This paper describes the current Extension climate, presents data from a survey about Extension and industry relationships, presents case studies of successful public- and private-sector extension partnerships, and proposes a framework for evaluating the state of effective partnerships. Synergistic public–private extension efforts could ensure that farmers receive the most current and balanced information available to help with their management decisions. PMID:26949567

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

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 (76.4 vs 65.8%, p = 0.03). Arthroplasty consumers treated in the private sector are not more satisfied with their acute-care experience nor are they more likely to recommend their hospital provider. Rather, avoidance of complications in either sector appears to result in improved satisfaction as well as a greater likelihood that patients would recommend their hospital provider.

Public-Private Partnerships: The Private Sector and Innovation in Education. Policy Insight Number 142.

ERIC Educational Resources Information Center

David, Anna

1992-01-01

Partnerships between schools and the private sector as an alternative to increased taxes and service cuts are examined in this document. The introduction provides an overview of business involvement in U.S. education. The second section describes the private provision of infrastructure and types of school-business arrangements. Examples include…

Enhancing private sector engagement: Louisiana's business emergency operations centre.

PubMed

Day, Jamison M; Strother, Shannon; Kolluru, Ramesh; Booth, Joseph; Rawls, Jason; Calderon, Andres

2010-07-01

Public sector emergency management is more effective when it coordinates its efforts with private sector companies that can provide useful capabilities faster, cheaper and better than government agencies. A business emergency operations centre (EOC) provides a space for private sector and non-governmental organisations to gather together in support of government efforts. This paper reviews business-related EOC practices in multiple US states and details the development of a new business EOC by the State of Louisiana, including lessons learned in response to the May 2010 oil spill.

29 CFR Appendix C to Part 4022 - Lump Sum Interest Rates for Private-Sector Payments

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Lump Sum Interest Rates for Private-Sector Payments C... Appendix C to Part 4022—Lump Sum Interest Rates for Private-Sector Payments [In using this table: (1) For... (where y is an integer and 0 n 1 + n 2), interest rate i 3 shall apply from the valuation date for a...

Technology Transfer: Use of Federally Funded Research and Development

DTIC Science & Technology

2007-04-24

flows from new commercialization in the private sector ; the government’s requirements for products and processes to operate effectively and...technology to the private sector and to state and local governments. Despite this, use of federal R&D results has remained restrained, although there has...been a significant increase in private sector interest and activities over the past several years. Critics argue that working with the agencies and

Federal procurement metrication appropriateness and methods

NASA Astrophysics Data System (ADS)

Coella, M. A.

1982-09-01

This study was designed to provide the USMB with a clearer understanding of the basic relationships between the Federal procurement process and private sector suppliers. This was done to gain an understanding of the ways in which Federal procurement can encourage and accommodate initiatives of the private sector and to ensure that the effects of conversion on the Federal and private sectors are understood prior to implementation of procurement decisions and actions.

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.

Private sector response to improving oral health care access.

PubMed

Robinson, Lindsey A

2009-07-01

Despite vast improvements in the oral health status of the United States population over the past 50 years, disparities in oral health status continue, with certain segments of the population carrying a disproportionate disease burden. This article attempts to describe the problem, discuss various frameworks for action, illustrate some solutions developed by the private sector, and present a vision for collaborative action to improve the health of the nation. No one sector of the health care system can resolve the problem. The private sector, the public sector, and the not-for-profit community must collaborate to improve the oral health of the nation.

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.

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.

Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review.

PubMed

Lussiana, Cristina

2016-09-01

The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Findings from a hepatitis B birth dose assessment in health facilities in the Philippines: opportunities to engage the private sector.

PubMed

Patel, Minal K; Capeding, Rosario Z; Ducusin, Joyce U; de Quiroz Castro, Maricel; Garcia, Luzviminda C; Hennessey, Karen

2014-09-03

Hepatitis B vaccination in the Philippines was introduced in 1992 to reduce the high burden of chronic hepatitis B virus (HBV) infection in the population; in 2007, a birth dose (HepB-BD) was introduced to decrease perinatal HBV transmission. Timely HepB-BD coverage, defined as doses given within 24h of birth, was 40% nationally in 2011. A first step in improving timely HepB-BD coverage is to ensure that all newborns born in health facilities are vaccinated. In order to assess ways of improving the Philippines' HepB-BD program, we evaluated knowledge, attitudes, and practices surrounding HepB-BD administration in health facilities. Teams visited selected government clinics, government hospitals, and private hospitals in regions with low reported HepB-BD coverage and interviewed immunization and maternity staff. HepB-BD coverage was calculated in each facility for a 3-month period in 2011. Of the 142 health facilities visited, 12 (8%) did not provide HepB-BD; seven were private hospitals and five were government hospitals. Median timely HepB-BD coverage was 90% (IQR 80%-100%) among government clinics, 87% (IQR 50%-97%) among government hospitals, and 50% (IQR 0%-90%) among private hospitals (p=0.02). The private hospitals were least likely to receive supervision (53% vs. 6%-31%, p=0.0005) and to report vaccination data to the national Expanded Programme on Immunization (36% vs. 96%-100%, p<0.0001). Private sector hospitals in the Philippines, which deliver 18% of newborns, had the lowest timely HepB-BD coverage. Multiple avenues exist to engage the private sector in hepatitis B prevention including through existing laws, newborn health initiatives, hospital accreditation processes, and raising awareness of the government's free vaccine program. Copyright © 2013 World Health Organization (WHO). Published by Elsevier Ltd.. All rights reserved.

Distribution of physical therapists working on public and private establishments in different levels of complexity of health care in Brazil.

PubMed

Costa, Larissa R; Costa, José L R; Oishi, Jorge; Driusso, Patricia

2012-01-01

The Brazilian Health System is organized on a regional and hierarchical form with three levels of complexity of health care. The Primary Care represents the first element of a continuing health care process, complemented by specialized actions. However, the centrality of the specialized care is still a problem in Brazil, especially in the private sector. Studies on the distribution of professionals in the health system allowing the formulation of appropriate policies are needed. To investigate the distribution of physical therapists in the levels of complexity of health care and between public and private establishments, according to data from the National Register of Health Service Providers (NRHSP). A descriptive cross-sectional study was performed considering NRHSP-national bank data collected in March 2010 and demographic census 2010 data. Data were analyzed through descriptive statistics techniques. We identified 53,181 registries of physical therapists, 60% linked to the private sector. Only 13% of all entries were linked to primary care. The predominance in specialized care occurred in the public sector (65%) and private sector (100%). The specialized establishments of private sector linked to the southeast region (16,043) were the main sites of physical therapists. Only the public sector in the south had a majority in the Primary Care. When considering the sizes of the cities, there is focus on specialist care in bigger cities. This study identified the concentration of physical therapists in the specialized care, mostly in metropolis and big cities and in the private sector, with restricted to participation in the primary care.

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

NONE

ADVANCE [Advanced Driver and Vehicle Advisory Navigation ConcEpt] was a public/private partnership conceived and developed by four founding parties. The founding parties include the Federal Highway Administration (FHWA), the Illinois Department of Transportation (IDOT), the University of Illinois at Chicago and Northwestern University operating together under the auspices of the Illinois Universities Transportation Research Consortium (IUTRC), and Motorola, Inc. The major responsibilities of each party are fully described in the Project agreement. Subsequently, these four were joined on the Steering Committee by the American Automobile Association (AAA). This unique blending of public sector, private sector and university interests, augmented bymore » more than two dozen other private sector participants, provided a strong set of resources for ADVANCE. The ADVANCE test area covered over 300 square miles including portions of the City of Chicago and 40 northwest suburban communities. The Project encompasses the high growth areas adjacent to O`Hare International Airport, the Schaumbura/Hoffman Estates office and retail complexes, and the Lake-Cook Road development corridor. It also includes major sports and entertainment complexes such as the Arlington International Racecourse and the Rosemont Horizon. The population in the area is more than 750,000. This volume provides a summary of the insights and achievements made as a result of this field test, and selected appendices containing more detailed information.« less

The state-led large scale public private partnership 'Chiranjeevi Program' to increase access to institutional delivery among poor women in Gujarat, India: How has it done? What can we learn?

PubMed

De Costa, Ayesha; Vora, Kranti S; Ryan, Kayleigh; Sankara Raman, Parvathy; Santacatterina, Michele; Mavalankar, Dileep

2014-01-01

Many low-middle income countries have focused on improving access to and quality of obstetric care, as part of promoting a facility based intra-partum care strategy to reduce maternal mortality. The state of Gujarat in India, implements a facility based intra-partum care program through its large for-profit private obstetric sector, under a state-led public-private-partnership, the Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians to perform deliveries for poor/tribal women. We examine CY performance, its contribution to overall trends in institutional deliveries in Gujarat over the last decade and its effect on private and public sector deliveries there. District level institutional delivery data (public, private, CY), national surveys, poverty estimates, census data were used. Institutional delivery trends in Gujarat 2000-2010 are presented; including contributions of different sectors and CY. Piece-wise regression was used to study the influence of the CY program on public and private sector institutional delivery. Institutional delivery rose from 40.7% (2001) to 89.3% (2010), driven by sharp increases in private sector deliveries. Public sector and CY contributed 25-29% and 13-16% respectively of all deliveries each year. In 2007, 860 of 2000 private obstetricians participated in CY. Since 2007, >600,000 CY deliveries occurred i.e. one-third of births in the target population. Caesareans under CY were 6%, higher than the 2% reported among poor women by the DLHS survey just before CY. CY did not influence the already rising proportion of private sector deliveries in Gujarat. This paper reports a state-led, fully state-funded, large-scale public-private partnership to improve poor women's access to institutional delivery - there have been >600,000 beneficiaries. While caesarean proportions are higher under CY than before, it is uncertain if all beneficiaries who require sections receive these. Other issues to explore include quality of care, provider attrition and the relatively low coverage.

Strengthening referral of sick children from the private health sector and its impact on referral uptake in Uganda: a cluster randomized controlled trial protocol.

PubMed

Buregyeya, Esther; Rutebemberwa, Elizeus; LaRussa, Philip; Mbonye, Anthony

2016-11-11

Uganda's under-five mortality is high, currently estimated at 66/1000 live births. Poor referral of sick children that seek care from the private sector is one of the contributory factors. The proposed intervention aims to improve referral and uptake of referral advice for children that seek care from private facilities (registered drug shops/private clinics). A cluster randomized design will be applied to test the intervention in Mukono District, central Uganda. A sample of study clusters will implement the intervention. The intervention will consist of three components: i) raising awareness in the community: village health teams will discuss the importance of referral and encourage households to save money, ii) training and supervision of providers in the private sector to diagnose, treat and refer sick children, iii) regular meetings between the public and private providers (convened by the district health team) to discuss the referral system. Twenty clusters will be included in the study, randomized in the ratio of 1:1. A minimum of 319 sick children per cluster and the total number of sick children to be recruited from all clusters will be 8910; adjusting for a 10 % loss to follow up and possible withdrawal of private outlets. The immediate sustainable impact will be appropriate treatment of sick children. The intervention is likely to impact on private sector practices since the scope of the services they provide will have expanded. The proposed study is also likely to have an impact on families as; i) they may appreciate the importance of timely referral on child illness management, ii) the cost savings related to reduced morbidity will be used by household to access other social services. The linkage between the private and public sectors will create a potential avenue for delivery of other public health interventions and improved working relations in the two sectors. Further, improved quality of services in the private sector will improve provider confidence and hopefully more clientelle to the private practices. NCT02450630 Registration date: May/9 th /2015.

The State-Led Large Scale Public Private Partnership ‘Chiranjeevi Program’ to Increase Access to Institutional Delivery among Poor Women in Gujarat, India: How Has It Done? What Can We Learn?

PubMed Central

De Costa, Ayesha; Vora, Kranti S.; Ryan, Kayleigh; Sankara Raman, Parvathy; Santacatterina, Michele; Mavalankar, Dileep

2014-01-01

Background Many low-middle income countries have focused on improving access to and quality of obstetric care, as part of promoting a facility based intra-partum care strategy to reduce maternal mortality. The state of Gujarat in India, implements a facility based intra-partum care program through its large for-profit private obstetric sector, under a state-led public-private-partnership, the Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians to perform deliveries for poor/tribal women. We examine CY performance, its contribution to overall trends in institutional deliveries in Gujarat over the last decade and its effect on private and public sector deliveries there. Methods District level institutional delivery data (public, private, CY), national surveys, poverty estimates, census data were used. Institutional delivery trends in Gujarat 2000–2010 are presented; including contributions of different sectors and CY. Piece-wise regression was used to study the influence of the CY program on public and private sector institutional delivery. Results Institutional delivery rose from 40.7% (2001) to 89.3% (2010), driven by sharp increases in private sector deliveries. Public sector and CY contributed 25–29% and 13–16% respectively of all deliveries each year. In 2007, 860 of 2000 private obstetricians participated in CY. Since 2007, >600,000 CY deliveries occurred i.e. one-third of births in the target population. Caesareans under CY were 6%, higher than the 2% reported among poor women by the DLHS survey just before CY. CY did not influence the already rising proportion of private sector deliveries in Gujarat. Conclusion This paper reports a state-led, fully state-funded, large-scale public-private partnership to improve poor women’s access to institutional delivery - there have been >600,000 beneficiaries. While caesarean proportions are higher under CY than before, it is uncertain if all beneficiaries who require sections receive these. Other issues to explore include quality of care, provider attrition and the relatively low coverage. PMID:24787692

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. This article adds to our understanding, particularly for mid-level cadres, and highlights the need to ensure balanced health labour market incentives which take into account not only the changing context but also needs at different points in individuals' life cycles and across all core service delivery sectors.

Quantifying the economic impact of government and charity funding of medical research on private research and development funding in the United Kingdom.

PubMed

Sussex, Jon; Feng, Yan; Mestre-Ferrandiz, Jorge; Pistollato, Michele; Hafner, Marco; Burridge, Peter; Grant, Jonathan

2016-02-24

Government- and charity-funded medical research and private sector research and development (R&D) are widely held to be complements. The only attempts to measure this complementarity so far have used data from the United States of America and are inevitably increasingly out of date. This study estimates the magnitude of the effect of government and charity biomedical and health research expenditure in the United Kingdom (UK), separately and in total, on subsequent private pharmaceutical sector R&D expenditure in the UK. The results for this study are obtained by fitting an econometric vector error correction model (VECM) to time series for biomedical and health R&D expenditure in the UK for ten disease areas (including 'other') for the government, charity and private sectors. The VECM model describes the relationship between public (i.e. government and charities combined) sector expenditure, private sector expenditure and global pharmaceutical sales as a combination of a long-term equilibrium and short-term movements. There is a statistically significant complementary relationship between public biomedical and health research expenditure and private pharmaceutical R&D expenditure. A 1% increase in public sector expenditure is associated in the best-fit model with a 0.81% increase in private sector expenditure. Sensitivity analysis produces a similar and statistically significant result with a slightly smaller positive elasticity of 0.68. Overall, every additional £1 of public research expenditure is associated with an additional £0.83-£1.07 of private sector R&D spend in the UK; 44% of that additional private sector expenditure occurs within 1 year, with the remainder accumulating over decades. This spillover effect implies a real annual rate of return (in terms of economic impact) to public biomedical and health research in the UK of 15-18%. When combined with previous estimates of the health gain that results from public medical research in cancer and cardiovascular disease, the total rate of return would be around 24-28%. Overall, this suggests that government and charity funded research in the UK crowds in additional private sector R&D in the UK. The implied historical returns from UK government and charity funded investment in medical research in the UK compare favourably with the rates of return achieved on investments in the rest of the UK economy and are greatly in excess of the 3.5% real annual rate of return required by the UK government to public investments generally.

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…

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)

Advanced Traveler Information Service (ATIS) : private sector perceptions and public sector activities

DOT National Transportation Integrated Search

2000-01-01

This paper presents the results of a study by the United States Department of Transportation Volpe Center to determine the nature and extent of the data gap between the needs of private sector Advanced Traveler Information Service (ATIS) provid...

Quantitative option analysis for implementation and management of landfills.

PubMed

Kerestecioğlu, Merih

2016-09-01

The selection of the most feasible strategy for implementation of landfills is a challenging step. Potential implementation options of landfills cover a wide range, from conventional construction contracts to the concessions. Montenegro, seeking to improve the efficiency of the public services while maintaining affordability, was considering privatisation as a way to reduce public spending on service provision. In this study, to determine the most feasible model for construction and operation of a regional landfill, a quantitative risk analysis was implemented with four steps: (i) development of a global risk matrix; (ii) assignment of qualitative probabilities of occurrences and magnitude of impacts; (iii) determination of the risks to be mitigated, monitored, controlled or ignored; (iv) reduction of the main risk elements; and (v) incorporation of quantitative estimates of probability of occurrence and expected impact for each risk element in the reduced risk matrix. The evaluated scenarios were: (i) construction and operation of the regional landfill by the public sector; (ii) construction and operation of the landfill by private sector and transfer of the ownership to the public sector after a pre-defined period; and (iii) operation of the landfill by the private sector, without ownership. The quantitative risk assessment concluded that introduction of a public private partnership is not the most feasible option, unlike the common belief in several public institutions in developing countries. A management contract for the first years of operation was advised to be implemented, after which, a long term operating contract may follow. © The Author(s) 2016.

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 environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.

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-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work. PMID:21108833

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.

[Imaginaries present in the training of health professionals in Brazil and the horizons of supplementary care regulation].

PubMed

Ceccim, Ricardo Burg; Armani, Teresa Borgert; de Oliveira, Dora Lúcia Leidens Correa; Bilibio, Luiz Fernando; Moraes, Maurício; Santos, Naiane Dartora

2008-01-01

This paper is part of a research into the imaginaries present in the training of health professionals with respect to the regulation and exercise of their profession. The professions selected were medicine, odontology and psychology, for which emerging courses require evaluation by the National Health Council. The imaginaries were understood as operators of the virtual and the real with the potential of affirming or denying forms and contents in relation to being a professional or being in the profession. There was evidence for an imaginary of free exercise of the profession in the public sector on state level, where more experience with diseases and diversities of suffering would be gained. The ideal work place would be the private sector allowing for free choices for both professionals and users, but not without connection to the public sector for providing experience, study opportunities and the possibility of research scholarships and overseas training. Despite the expectations in relation to the private sector, currently there is no education in the field of supplementary care or about the meanings of the regulation proposed by the Brazilian Health System.

Case Studies of UMTA Private Sector Initiative Projects in Syracuse, Central New Jersey, and Atlanta

DOT National Transportation Integrated Search

1987-12-01

This report documents the results of three grants awarded in 1983 by the Urban Mass Transportation Administration for Section 8 Private Sector Initiative projects. The grants were intended to encourage cooperative public and private planning for the ...

15 CFR 1160.3 - Assistance to industrial technology partnerships.

Code of Federal Regulations, 2012 CFR

2012-01-01

... INNOVATION Promotion of Private Sector Industrial Technology Partnerships § 1160.3 Assistance to industrial...) Workshops. Upon request, the Secretary may hold workshops with representatives from the private sector and... information. Accordingly, the Department will develop and maintain a list of specific public and private...

15 CFR 1160.3 - Assistance to industrial technology partnerships.

Code of Federal Regulations, 2013 CFR

2013-01-01

... INNOVATION Promotion of Private Sector Industrial Technology Partnerships § 1160.3 Assistance to industrial...) Workshops. Upon request, the Secretary may hold workshops with representatives from the private sector and... information. Accordingly, the Department will develop and maintain a list of specific public and private...

15 CFR 1160.3 - Assistance to industrial technology partnerships.

Code of Federal Regulations, 2011 CFR

2011-01-01

... INNOVATION Promotion of Private Sector Industrial Technology Partnerships § 1160.3 Assistance to industrial...) Workshops. Upon request, the Secretary may hold workshops with representatives from the private sector and... information. Accordingly, the Department will develop and maintain a list of specific public and private...

[Prenatal care in public and private health services: a population-based survey in Rio Grande, Rio Grande do Sul State, Brazil].

PubMed

Cesar, Juraci A; Sutil, Andréa T; Santos, Gabriela B dos; Cunha, Carolina F; Mendoza-Sassi, Raúl A

2012-11-01

This study aimed to evaluate public and private prenatal care for women in Rio Grande, Rio Grande do Sul State, Brazil. Women who gave birth at the two local maternity hospitals from January 1 to December 31, 2010, answered a standardized questionnaire. The interview sites in the public sector were primary health care units with and without the Family Health Strategy (FHS) and outpatient clinics; the private sector included clinics operated by health plans and private physicians' offices. The chi-square test was used to compare proportions. The response rate was 97.2% (2,395 out of 2,464). Among the 23 target variables and indicators, seven showed a clear advantage for mothers who had received prenatal care under the FHS and six for health plan clinics and private offices. Four variables showed virtually universal coverage at all five study sites. Prenatal care showed better coverage for pregnant women treated in the private sector. Pregnant women treated under the FHS showed similar coverage to that in the private sector.

Private sector response against the cholera threat in Trinidad and Tobago.

PubMed

Hospedales, J; Holder, Y; Deyalsingh, I; Paul, R; Rosenbaum, J

1993-01-01

During the first half of 1992 the threat of cholera to Trinidad and Tobago prompted a strong health education effort by public authorities and the private sector. To help assess the private sector effort, the cost of cholera-related advertisements and private announcements placed in the country's two leading newspapers during January-June 1992 were reviewed. The review indicated that an estimated TT$ 540,660 was spent on these ads and announcements, that they contributed strongly to keeping cholera prevention continuously in the public eye, and that most of the messages published were accurate, specific, and safe. The strength and success of the private contribution to cholera prevention in this case suggests that similar approaches could be applied to other health problems and to the cholera problem outside Trinidad and Tobago. Overall, the lesson appears to be that if one can find congruence between private sector motives and public health interests, then the potential prospects for a successful partnership are great.

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.

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 further examine the roles of public and private sectors in financial risk protection through government health insurance.

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 further examine the roles of public and private sectors in financial risk protection through government health insurance. PMID:29149181

2001 survey on primary medical care in Singapore.

PubMed

Emmanuel, S C; Phua, H P; Cheong, P Y

2004-05-01

The 2001 survey on primary medical care was undertaken to compare updated primary healthcare practices such as workload and working hours in the public and private sectors; determine private and public sector market shares in primary medical care provision; and gather the biographical profile and morbidity profile of patients seeking primary medical care from both sectors in Singapore. This is the third survey in its series, the earlier two having been carried out in 1988 and 1993, respectively. The survey questionnaire was sent out to all the 1480 family doctors in private primary health outpatient practice, the 89 community-based paediatricians in the private sector who were registered with the Singapore Medical Council and also to all 152 family doctors working in the public sector primary medical care clinics. The latter comprised the polyclinics under the two health clusters in Singapore, namely the Singapore Health Services and National Healthcare Group, and to a very much smaller extent, the School Health Service's (SHS) outpatient clinics. The survey was conducted on 21 August 2001, and repeated on 25 September 2001 to enable those who had not responded to the original survey date to participate. Subjects consisted of all outpatients who sought treatment at the private family practice clinics (including the clinics of the community-based paediatricians), and the public sector primary medical care clinics, on the survey day. The response rate from the family doctors in private practice was 36 percent. Owing to the structured administrative organisation of the polyclinics and SHS outpatient clinics, all returns were completed and submitted to the respective headquarters. Response from the community-based paediatricians was poor, so their findings were omitted in the survey analysis. The survey showed that the average daily patient-load of a family doctor in private practice was 33 patients per day, which was lower than the 40 patients a day recorded in 1993. The average working hours of each of these private practitioners was 7.6 hours per day. Family doctors in public sector primary medical care clinics were responsible for 16.6 percent of the patient-load for primary medical care in Singapore while the remaining 83.4 percent was provided by family doctors in private practice. Singaporeans made approximately 4.4 visits to a family doctor in 2001, which was lower than the 5.0 visits ascertained in 1993. Chronic medical conditions seen by family doctors as a whole, increased from 29.2 percent in 1993 to 34.3 percent in 2001. Upper respiratory tract infections and hypertension were the two leading disease conditions seen at both private and public sector primary medical care clinics in 2001. The load of hypertension managed at primary medical care clinics had notably increased. The public sector share of outpatient load at 17 percent in 2001 is well within the 25 percent level set in the Government's 1993 White Paper on Affordable Healthcare. The private sector remains the main provider of primary medical care in Singapore, serving 83 percent of the population. The average workload for each family doctor in private practice had dropped from 40 to 33 patients a day between 1993 and 2001. There had been a notable growth in family doctors working in the private sector over this period. Both sectors saw an increase in the chronic disease load that they managed.

Private Higher Education Penetration into a Mature Education Market: The New Zealand Experience. PROPHE Working Paper #6

ERIC Educational Resources Information Center

Abbott, Malcolm

2005-01-01

Since 1989, when it became legally possible for private higher education to operate in New Zealand, the sector has grown to become a significant part of the country's higher education system. We explore the private penetration, trace the changes that have occurred in private higher education, and evaluate the sector's position in New Zealand…

Comparative Aspects of Management Observed by Heads of Public and Private Schools

ERIC Educational Resources Information Center

Imran, Muhammad

2010-01-01

The major purpose of the research was to compare the management aspects in public and private schools. All the heads of secondary schools of public and private sector of the Punjab province, Pakistan constituted population of the study. A sample of 216 head teachers (fifty percent from public sector schools and fifty percent private schools) was…

The Development of Private Higher Education in a Mature Market: A New Zealand Case Study

ERIC Educational Resources Information Center

Xiaoying, Ma; Abbott, Malcolm

2008-01-01

Since 1989, when it became legally possible for private higher education to operate in New Zealand, the sector has grown to become a significant part of the country's higher education system. This paper explores the private penetration, traces the changes that have occurred in private higher education, and evaluate the sector's position in New…

Training and Jobs Programs in Action: Case Studies in Private-Sector Initiatives for the Hard-to-Employ.

ERIC Educational Resources Information Center

Robison, David

This book contains fifty-three case studies covering a wide variety of private-sector activities and public-private partnerships designed to increase training and employment opportunities for the hard-to-employ and speed the transition of the unemployed from government support and subsidized jobs to permanent private employment. Compiled from a…

Public-Private Partnership. An Opportunity for Urban Communities. A Statement by the Research and Policy Committee of the Committee for Economic Development.

ERIC Educational Resources Information Center

Committee for Economic Development, New York, NY. Research and Policy Committee.

In this era of constrained resources, the public and private sectors must join forces to revitalize their local urban communities. Public-private partnership means cooperation among individuals and organizations in the public and private sectors for mutual benefit. Such cooperation has two dimensions--the policy dimension and the operational…

Economic Segmentation and Health Inequalities in Urban Post-Reform China.

PubMed

Kwon, Soyoung

2016-01-01

During economic reform, Chinese economic labor markets became segmented by state sector associated with a planned redistributive economy and private sector associated with the market economy. By considering an economic sector as a concrete institutional setting in post-reform China, this paper compares the extent to which socioeconomic status, measured by education and income, is associated with self-rated health between state sector and private sector. The sample is limited to urban Chinese employees between the ages of 18 and 55 who were active in the labor force. By analyzing pooled data from the 1991-2006 Chinese Health and Nutrition Survey , I find that there is a stronger association between income and self-rated health in the private sector than in the state sector. This study suggests that sectoral differences between market and redistributive economies are an important key to understanding health inequalities in post-reform urban China.

Economic Segmentation and Health Inequalities in Urban Post-Reform China

PubMed Central

Kwon, Soyoung

2016-01-01

During economic reform, Chinese economic labor markets became segmented by state sector associated with a planned redistributive economy and private sector associated with the market economy. By considering an economic sector as a concrete institutional setting in post-reform China, this paper compares the extent to which socioeconomic status, measured by education and income, is associated with self-rated health between state sector and private sector. The sample is limited to urban Chinese employees between the ages of 18 and 55 who were active in the labor force. By analyzing pooled data from the 1991–2006 Chinese Health and Nutrition Survey, I find that there is a stronger association between income and self-rated health in the private sector than in the state sector. This study suggests that sectoral differences between market and redistributive economies are an important key to understanding health inequalities in post-reform urban China. PMID:29546178

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.

Promoting safe motherhood through the private sector in low- and middle-income countries.

PubMed Central

Brugha, Ruair; Pritze-Aliassime, Susanne

2003-01-01

The formal private sector could play a significant role in determining whether success or failure is achieved in working towards goals for safe motherhood in many low- and middle-income settings. Established private providers, especially nurses/midwives, have the potential to contribute to safe motherhood practices if they are involved in the care continuum. However, they have largely been overlooked by policy-makers in low-income settings. The private sector (mainly doctors) contributes to overprovision and high Caesarean section rates in settings where it provides care to wealthier segments of the population; such care is often funded through third-party payment schemes. In poorer settings, especially rural areas, private nurses/midwives and the women who choose to use them are likely to experience similar constraints to those encountered in the public sector - for example, poor or unaffordable access to higher level facilities for the management of obstetrical emergencies. Policy-makers at the country-level need to map the health system and understand the nature and distribution of the private sector, and what influences it. This potential resource could then be mobilized to work towards the achievement of safe motherhood goals. PMID:14576894

Managing the public-private mix to achieve universal health coverage.

PubMed

McPake, Barbara; Hanson, Kara

2016-08-06

The private sector has a large and growing role in health systems in low-income and middle-income countries. The goal of universal health coverage provides a renewed focus on taking a system perspective in designing policies to manage the private sector. This perspective requires choosing policies that will contribute to the performance of the system as a whole, rather than of any sector individually. Here we draw and extrapolate main messages from the papers in this Series and additional sources to inform policy and research agendas in the context of global and country level efforts to secure universal health coverage in low-income and middle-income countries. Recognising that private providers are highly heterogeneous in terms of their size, objectives, and quality, we explore the types of policy that might respond appropriately to the challenges and opportunities created by four stylised private provider types: the low-quality, underqualified sector that serves poor people in many countries; not-for-profit providers that operate on a range of scales; formally registered small-to-medium private practices; and the corporate commercial hospital sector, which is growing rapidly and about which little is known. Copyright © 2016 Elsevier Ltd. All rights reserved.

Experiences of selected countries in the use of public-private partnership in hospital services provision.

PubMed

Sadeghi, Ahmad; Barati, Omid; Bastani, Peivand; Jafari, Davood Danesh; Etemadian, Masoud

2016-11-01

To review the experiences of selected countries in the use of public-private partnership in the provision of hospital services. This comparative study was conducted in 2015 in Iran. To collect data, valid databases as well as articles, theses, reports and related books in the field of private-sector partnership in hospital services were employed. Using purposive sampling, countries such as the United Kingdom, Spain, Canada, Turkey, Australia and Lesotho, which had successful experiences in the field of application of the public-private partnership in hospital services, were included. Likewise, the only experience in Iran in this field was also reviewed. Studies done between 1980 and 2015 were examined. The results obtained from each country were compared. Implementing public-private partnership had great and valuable outcomes and achievements for governmental hospitals. Moreover, clinical and nonclinical service delivery, hospital utilisation and management along with building, repairing and supportive operations through public-private partnership contracts can be differently divided among the partners. Furthermore, duration of the projects ranged from 12 to 40 years in different countries, depending on the type of the model used. A successful experience in the use of the public-private partnership in the provision of hospital services was observed.

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.

Assessment of patient safety culture in private and public hospitals in Peru.

PubMed

Arrieta, Alejandro; Suárez, Gabriela; Hakim, Galed

2018-04-01

To assess the patient safety culture in Peruvian hospitals from the perspective of healthcare professionals, and to test for differences between the private and public healthcare sectors. Patient safety is defined as the avoidance and prevention of patient injuries or adverse events resulting from the processes of healthcare delivery. A non-random cross-sectional study conducted online. An online survey was administered from July to August 2016, in Peru. This study reports results from Lima and Callao, which are the capital and the port region of Peru. A total of 1679 healthcare professionals completed the survey. Participants were physicians, medical residents and nurses working in healthcare facilities from the private sector and public sector. Assessment of the degree of patient safety and 12 dimensions of patient safety culture in hospital units as perceived by healthcare professionals. Only 18% of healthcare professionals assess the degree of patient safety in their unit of work as excellent or very good. Significant differences are observed between the patient safety grades in the private sector (37%) compared to the public sub-sectors (13-15%). Moreover, in all patient safety culture dimensions, healthcare professionals from the private sector give more favorable responses for patient safety, than those from the public sub-systems. The most significant difference in support comes from patient safety administrators through communication and information about errors. Overall, the degree of patient safety in Peru is low, with significant gaps that exist between the private and the public sectors.

Are essential medicines in Malaysia accessible, affordable and available?

PubMed

Saleh, Kamaruzaman; Ibrahim, Mohamed I M

2005-12-01

To assess the pharmaceutical sector to know whether people have access to essential medicines. The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory). The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies. Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines. The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary. The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain areas in Sabah availability was less than 80.0% and still a problem.

Retrospective Benefit-Cost Evaluation of U.S. DOE Wind Energy R&D Program: Impact of Selected Energy Technology Investments

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

Pelsoci, Thomas M.

This benefit-cost analysis focuses on the DOE Wind Energy Program's public sector R&D investments and returns. The analysis accounts for the program's additionality – that is, comparing what has happened as a result of the program to what would have happened without it. The analysis does not address the return on the investments of private companies ("private returns"). Public returns on the program's investments from 1976 to 2008 are identified and analyzed using retrospective analysis.

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…

77 FR 69543 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

... exercise of the right to call that is different from the issuer's determination. Affected Public: Private... development credit election is in effect. Affected Public: Private Sector: Business or other for-profits... update Pub. 1212, List of Original Issue Discount Instruments. Affected Public: Private Sector: Business...

Fear and Privatization

ERIC Educational Resources Information Center

Cooper, Bruce S.; Randall, E. Vance

2008-01-01

Supporters of public education fear attempts to privatize schools, while the private sector has always struggled against the monopolistic power of the public schools that educates almost 90% of all K-12 students. This trepidation has recently been intensified by the creation of a "third sector" that includes charter schools, voucher…

Private health care in Nigeria: walking the tightrope.

PubMed

Ogunbekun, I; Ogunbekun, A; Orobaton, N

1999-06-01

The persistently low quality and inadequacy of health services provided in public facilities has made the private sector an unavoidable choice for consumers of health care in Nigeria. Ineffective state regulation, however, has meant little control over the clinical activities of private sector providers while the price of medical services has, in recent years, grown faster than the average rate of inflation. Reforms that are targeted at reorganizing the private sector, with a view to enhancing efficiency in the supply of services, are urgently required if costs are to be contained and consumers assured of good value for money.

Insular pathways to health care in the city: a multilevel analysis of access to hospital care in urban Kerala, India.

PubMed

Levesque, Jean-Frédéric; Haddad, Slim; Narayana, Delampady; Fournier, Pierre

2007-07-01

To identify individual and urban unit characteristics associated with access to inpatient care in public and private sectors in urban Kerala, and to discuss policy implications of inequalities in access. We analysed the NSSO survey (1995-1996) for urban Kerala with regard to source and trajectories of hospitalization. Multinomial multilevel regression models were built for 695 cases nested in 24 urban units. Private sector accounts for 62% of hospitalizations. Only 31% of hospitalizations are in free wards and 20% of public hospitalizations involve payment. Hospitalization pathways suggest a segmentation of public and private health markets. Members of poor and casual worker households have lower propensity of hospitalization in paying public wards or private hospitals. There were important variations between cities, with higher odds of private hospitalization in towns with fewer hospital beds overall and in districts with high private-public bed ratios. Cities from districts with better economic indicators and dominance of private services have higher proportion of private hospitalizations. The private sector is the predominant source of inpatient care in urban Kerala. The public sector has an important role in providing access to care for the poor. Investing in the quality of public services is essential to ensure equity in access.

Providing an Optimal School Context for Talent Development: An Extended Curriculum Program in Practice

ERIC Educational Resources Information Center

Kronborg, Leonie; Plunkett, Margaret

2015-01-01

Developing the talents of academically able students in government secondary schools in Victoria, Australia, has recently gained support through the expansion of Select Entry Accelerated Learning (SEAL) Programs. In the private sector, a similar expansion of interest in talent development has occurred through the development and implementation of…

FISCAL STRUCTURE OF OKLAHOMA, AN OVERVIEW.

ERIC Educational Resources Information Center

SANDMEYER, ROBERT L.

THE REPORT WAS DIVIDED INTO THREE MAJOR SECTIONS--(1) THE PRODUCTION POSSIBILITY CURVE WAS USED TO DEMONSTRATE THE PROBLEM OF RESOURCE ALLOCATION BETWEEN THE PUBLIC AND PRIVATE SECTORS, (2) STATE AND LOCAL REVENUES WERE EXAMINED IN TERMS OF FISCAL CAPACITY AND TAX EFFORT, AND (3) EXPENDITURES ON SELECTED FUNCTIONS OF GOVERNMENT IN OKLAHOMA WERE…

The Relationship between Human Resource Management Practices and Turnover Intentions of Mid-Level Administrators

ERIC Educational Resources Information Center

Tucker-Lively, Felicia L.

2014-01-01

Although "talented employees with unique knowledge and skills are increasingly being viewed as a valuable asset and a source of competitive advantage" in the private sector (Yukl, 2008, p. 710), identification, selection, and development of potential leaders are often inadequate or too late in public institutions (Bisbee, 2007). Studies…

78 FR 64197 - Renewable Energy Policy Business Roundtable in Livermore, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... allowed the private sector to explore areas of mutual concern and share with government officials their... rolling basis in the order they are received. Selected companies will be contacted with information about... send an email to [email protected] with the following information. Name of Applicant Company Name Company...

Indonesian Youth Looking towards the Future

ERIC Educational Resources Information Center

Nilan, Pam; Parker, Lynette; Bennett, Linda; Robinson, Kathryn

2011-01-01

Selected survey data on future aspirations and expectations from 3565 young Indonesians are presented in this study. Muslim-majority Indonesia is an Asian economic success story. The economy has seen solid growth, leading to an expansion of the private sector. The upward credentialling of the labour market and the rapid growth of the middle class…

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

Risk of equine infectious disease transmission by non-race horse movements in Japan.

PubMed

Hayama, Yoko; Kobayashi, Sota; Nishida, Takeshi; Nishiguchi, Akiko; Tsutsui, Toshiyuki

2010-07-01

For determining surveillance programs or infectious disease countermeasures, risk evaluation approaches have been recently undertaken in the field of animal health. In the present study, to help establish efficient and effective surveillance and countermeasures for equine infectious diseases, we evaluated the potential risk of equine infectious disease transmission in non-race horses from the viewpoints of horse movements and health management practices by conducting a survey of non-race horse holdings. From the survey, the non-race horse population was classified into the following five sectors based on their purposes: the equestrian sector, private owner sector, exhibition sector, fattening sector and others. Our survey results showed that the equestrian and private owner sectors had the largest population sizes, and movements between and within these sectors occurred quite frequently, while there was little movement in the other sectors. Qualitative evaluation showed that the equestrian and private owner sectors had relatively high risks of equine infectious disease transmission through horse movements. Therefore, it would be effective to concentrate on these two sectors when implementing surveillance or preventative measures. Special priority should be given to the private owner sector because this sector has not implemented inspection and vaccination well compared with the equestrian sector, which possesses a high compliance rate for these practices. This qualitative risk evaluation focused on horse movements and health management practices could provide a basis for further risk evaluation to establish efficient and effective surveillance and countermeasures for equine infectious diseases.

The Application of Incentives and the Defense Business Operations Fund

DTIC Science & Technology

1993-12-01

The Defense Business Operations Fund (DBOF) is an attempt to incorporate private sector business incentives into the public sector. Truly efficient...or resources are missing an organization will not become more cost effective and efficient. The private sector goal is profit maximization. This goal

Private sector opportunities and threats to achieving malaria elimination in the Greater Mekong Subregion: results from malaria outlet surveys in Cambodia, the Lao PDR, Myanmar, and Thailand.

PubMed

Phok, Sochea; Phanalasy, Saysana; Thein, Si Thu; Likhitsup, Asawin

2017-05-02

The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current coverage of private sector engagement and support through ACTwatch outlet surveys implemented in 2015 and 2016. Over 76,168 outlets were screened, and approximately 6500 interviews were conducted (Cambodia, N = 1303; the Lao People's Democratic Republic (PDR), N = 724; Myanmar, N = 4395; and Thailand, N = 74). There was diversity in the types of private sector outlets providing malaria treatment across countries, and the extent to which they were authorized to test and treat for malaria differed. Among outlets stocking at least one anti-malarial, public sector availability of the first-line treatment for uncomplicated Plasmodium falciparum or Plasmodium vivax malaria was >75%. In the anti-malarial stocking private sector, first-line treatment availability was variable (Cambodia, 70.9%; the Lao PDR, 40.8%; Myanmar P. falciparum = 42.7%, P. vivax = 19.6%; Thailand P. falciparum = 19.6%, P. vivax = 73.3%), as was availability of second-line treatment (the Lao PDR, 74.9%; Thailand, 39.1%; Myanmar, 19.8%; and Cambodia, 0.7%). Treatment not in the National Treatment Guidelines (NTGs) was most common in Myanmar (35.8%) and Cambodia (34.0%), and was typically stocked by the informal sector. The majority of anti-malarials distributed in Cambodia and Myanmar were first-line P. falciparum or P. vivax treatments (90.3% and 77.1%, respectively), however, 8.8% of the market share in Cambodia was treatment not in the NTGs (namely chloroquine) and 17.6% in Myanmar (namely oral artemisinin monotherapy). In the Lao PDR, approximately 9 in 10 anti-malarials distributed in the private sector were second-line treatments-typically locally manufactured chloroquine. In Cambodia, 90% of anti-malarials were distributed through outlets that had confirmatory testing available. Over half of all anti-malarial distribution was by outlets that did not have confirmatory testing available in the Lao PDR (54%) and Myanmar (59%). Availability of quality-assured rapid diagnostic tests (RDT) amongst the RDT-stocking public sector ranged from 99.3% in the Lao PDR to 80.1% in Cambodia. In Cambodia, the Lao PDR, and Myanmar, less than 50% of the private sector reportedly received engagement (access to subsidized commodities, supervision, training or caseload reporting), which was most common among private health facilities and pharmacies. Findings from this multi-country study suggest that Cambodia, the Lao PDR, Myanmar, and Thailand are generally in alignment with national regulations, treatment guidelines, and quality-assurance standards. However, important gaps persist in the private sector which pose a threat to national malaria control and elimination goals. Several options are discussed to help align the private sector anti-malarial market with national elimination strategies.

Retirement before Age 65 Is a Growing Trend in the Private Sector. Report to the Chairman, Subcommittee on Civil Service, Post Office and General Services, Committee on Governmental Affairs, United States Senate.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

The General Accounting Office examined retirement age trends in the private sector to assist the Congress in its effort to devise a retirement system for Federal employees. The Census Bureau's Current Population Survey (CPS) was identified as a source of information about private sector retirement patterns. March 1974, 1979, and 1984 data were…

Bugs & Drugs: Chemi-Bio Terrorism & the U.S. Government

DTIC Science & Technology

2002-05-01

APPARENT ADBICATION OF THAT ROLE AND ALLOWING THE PRIVATE SECTOR , IN PARTICULAR, THE MEDIA TO ASSUME THE LEAD IN EDUCATING THE PUBLIC. 15. NUMBER OF...12 CHAPTER 3 The Private Sector Response 28 CHAPTER 4 Where to from Here…? 35 GLOSSARY 41 BIBLIOGRAPHY 46 iv PREFACE 11 September 2001 is...the apparent abdication of that role in favor of allowing the private sector , in particular, the media to assume the lead in informing the public

JPRS Report: East Asia Southeast Asia.

DTIC Science & Technology

1993-07-26

private sector companies and will be set up on a BOO basis. Speaking in Jakarta on 2 June, Habibie said : "Thus far several companies from the United...private sector the construction of the "Muria" generator on a BOO basis. He said : "Why should we turn over the nuclear powered electricity generator... said that the plan to offer this construction project to the private sector on a BOO basis is quite realistic. However, he quickly added that the

Comparing the Costs of Military Treatment Facilities with Private Sector Care

DTIC Science & Technology

2016-02-01

Log: H 15-000527 Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie INSTITUTE FOR DEFENSE ANALYSES 4850 Mark...other national challenges. Comparing the Costs of Military Treatment Facilities with Private Sector Care Philip M. Lurie I N S T I T U T E F O R D...members. The latter benefit, known as TRICARE, serves 9.5 million beneficiaries worldwide, and consists of care in Military Treatment Facilities (MTFs

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.

The USWRP Workshop on the Weather Research Needs of the Private Sector.

NASA Astrophysics Data System (ADS)

Pielke, Roger A., Jr.; Abraham, Jim; Abrams, Elliot; Block, Jim; Carbone, Richard; Chang, David; Droegemeier, Kelvin; Emanuel, Kerry; Friday, Elbert W. Joe, Jr.; Gall, Robert; Gaynor, John; Getz, Rodger R.; Glickman, Todd; Hoggatt, Bradley; Hooke, William H.; Johnson, Edward R.; Kalnay, Eugenia; Kimpel, James Jeff; Kocin, Paul; Marler, Byron; Morss, Rebecca; Nathan, Ravi; Nelson, Steve; Pielke, Roger, Sr.; Pirone, Maria; Prater, Erwin; Qualley, Warren; Simmons, Kevin; Smith, Michael; Thomson, John; Wilson, Greg

2003-07-01

Private sector meteorology is a rapidly growing enterprise. It has been estimated that the provision of weather information has, by some estimates, a global market totaling in the billions of dollars. Further, the decisions based on such information could easily total trillions of dollars in the U.S. economy alone. The private sector clearly plays an important, and growing, role at the interface of weather research and the weather information needs of society. To date, little information has been paid to the connections of the meteorological research community and the scientific needs of the private sector. Thus, the time is ripe to stimulate a more active dialogue between what is generally considered the "basic" research community of physical and social scientists and those individuals and businesses that provide weather information to myriad customers across the U.S. economy. In December 2000, the U.S. Weather Research Program (supported by NSF, NOAA, NASA, and the U.S. Navy) sponsored a workshop in Palm Springs, California, to bring together weather researchers and representatives of private sector meteorology to discuss needs, wants, opportunities, and challenges and how to enhance the linkages between the two relatively detached communities. The workshop focused on developing a better understanding of the relations of research and private sector meteorology, which ultimately means a better understanding of one of the important connections of research and societal needs.

Private sector tuberculosis prevention in the US: Characteristics associated with interferon-gamma release assay or tuberculin skin testing.

PubMed

Stockbridge, Erica L; Miller, Thaddeus L; Carlson, Erin K; Ho, Christine

2018-01-01

To determine whether latent tuberculosis infection risk factors are associated with an increased likelihood of latent tuberculosis infection testing in the US private healthcare sector. A national sample of medical and pharmacy claims representing services rendered January 2011 through December 2013 for 3,997,986 commercially insured individuals in the US who were 0 to 64 years of age. We used multivariable logistic regression models to determine whether TB/LTBI risk factors were associated with an increased likelihood of Interferon-Gamma Release Assay (IGRA) or Tuberculin Skin Test (TST) testing in the private sector. 4.31% (4.27-4.34%) received at least one TST/IGRA test between 2011 and 2013 while 1.69% (1.67-1.72%) received a TST/IGRA test in 2013. Clinical risk factors associated with a significantly increased likelihood of testing included HIV, immunosuppressive therapy, exposure to tuberculosis, a history of tuberculosis, diabetes, tobacco use, end stage renal disease, and alcohol use disorder. Other significant variables included gender, age, asthma, the state tuberculosis rate, population density, and percent of foreign-born persons in a county. Private sector TST/IGRA testing is not uncommon and testing varies with clinical risk indicators. Thus, the private sector can be a powerful resource in the fight against tuberculosis. Analyses of administrative data can inform how best to leverage private sector healthcare toward tuberculosis prevention activities.

[In-hospital stays for urolithiasis: analysis of French national data].

PubMed

Raynal, G; Merlet, B; Traxer, O

2011-07-01

Urolithiasis is of health economics concern since it is very frequent. However, there is few data upon its issue in France. We have analyzed the data issued from the national coding system for in-hospital stays and interventions, using urolithiasis codes and compared between public and private sectors. We have observed evolution of procedures and stays until 2009. Public and private sectors were quite similar in terms of stays numbers (144,324 in 2009, and an evaluated total cost of more than 168 millions of euros). Since 2000, there has been an increase of more than 20% in the number of stays in the public sector and a stagnation in the private one. Public and private sectors appeared different in terms of: (1) stays without intervention (53 vs 26%; p<0.0001); (2) stays without associated diagnosis (5.78 vs 8.41%; p<0.0001). Since 2006, there has been a stagnation for percutaneous and surgical interventions (less than 5% of the number of interventions) whereas there has been a clear increase in endoscopic (+29% in private sector and +16% in public one) and lithotriptic (+19 and +5%) interventions. There were strong disparities between public and private sectors. Endoscopic interventions and lithotrity sessions have shown a sustained increase. Surgical and percutaneous interventions have shown a stagnation. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Public and private health-care financing with alternate public rationing rules.

PubMed

Cuff, Katherine; Hurley, Jeremiah; Mestelman, Stuart; Muller, Andrew; Nuscheler, Robert

2012-02-01

We develop a model to analyze parallel public and private health-care financing under two alternative public sector rationing rules: needs-based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health-care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health-care resources to treat their beneficiaries. Given individuals' willingnesses-to-pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sector. We show that the private health insurance market is smaller when the public sector rations according to need than when allocation is random. Copyright © 2010 John Wiley & Sons, Ltd.

48 CFR 37.112 - Government use of private sector temporaries.

Code of Federal Regulations, 2011 CFR

2011-10-01

... REGULATION SPECIAL CATEGORIES OF CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.112 Government... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Government use of private... service firms for the brief or intermittent use of the skills of private sector temporaries. Services...

78 FR 76641 - Renewal of Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... 286 1 286 Private Sector/Typical Land Use Application and Permit 43 CFR Part 2920 Form 2920-1 10 120 1,200 Private Sector/Complex Totals 407 1,597 Jean Sonneman, Bureau of Land Management, Information... individuals, private entities, and State or local governments seeking leases, permits, and easements for the...

Exploring Ohio's Private Education Sector. School Survey Series

ERIC Educational Resources Information Center

Catt, Andrew D.

2014-01-01

Exploring Ohio's Private Education Sector is the second entry in the Friedman Foundation for Educational Choice's "School Survey Series." This report synthesizes information on Ohio's private schools collected by the U.S. Department of Education and the Ohio Department of Education (ODE). Two appendices provide supplementary tables and…

Homeschooling, Virtual Learning, and the Eroding Public/Private Binary

ERIC Educational Resources Information Center

Saiger, Aaron

2016-01-01

Regulators ubiquitously dichotomize schooling into two discrete sectors: "public" and "private". Although homeschooling is regulated in some contexts as a third sector, the general approach is to treat it as a species of private education by subjecting it to public regulation while simultaneously denying it public funds. But…

Synthesis of public-private partnerships : potential issues and best practices for program and project implementation and administration.

DOT National Transportation Integrated Search

2015-08-01

Public-private partnerships (P3s or PPPs) offer an innovative procurement method for the public sector. : P3s involve collaborations between the public and private sectors to finance, develop or maintain transportation : infrastructure. In an era of ...

Shifting the burden: the private sector's response to the AIDS epidemic in Africa.

PubMed

Rosen, Sydney; Simon, Jonathon L

2003-01-01

As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include pre-employment screening, reductions in employee benefits, restructured employment contracts, outsourcing of low skilled jobs, selective retrenchments, and changes in production technologies. Between 1997 and 1999 more than two-thirds of large South African employers reduced the level of health care benefits or increased employee contributions. Most firms also have replaced defined-benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined-contribution funds, which eliminate risks to the firm but provide little for families of younger workers who die of AIDS. Contracting out previously permanent jobs is also shielding firms from benefit and turnover costs, effectively shifting the responsibility to care for affected workers and their families to households, nongovernmental organizations, and the government. Many of these changes are responses to globalization that would have occurred in the absence of AIDS, but they are devastating for the households of employees with HIV/AIDS. We argue that the shift in the economic burden of AIDS is a predictable response by business to which a deliberate public policy response is needed. Countries should make explicit decisions about each sector's responsibilities if a socially desirable allocation is to be achieved.

Shifting the burden: the private sector's response to the AIDS epidemic in Africa.

PubMed Central

Rosen, Sydney; Simon, Jonathon L.

2003-01-01

As the economic burden of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organizations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include pre-employment screening, reductions in employee benefits, restructured employment contracts, outsourcing of low skilled jobs, selective retrenchments, and changes in production technologies. Between 1997 and 1999 more than two-thirds of large South African employers reduced the level of health care benefits or increased employee contributions. Most firms also have replaced defined-benefit retirement funds, which expose the firm to large annual costs but provide long-term support for families, with defined-contribution funds, which eliminate risks to the firm but provide little for families of younger workers who die of AIDS. Contracting out previously permanent jobs is also shielding firms from benefit and turnover costs, effectively shifting the responsibility to care for affected workers and their families to households, nongovernmental organizations, and the government. Many of these changes are responses to globalization that would have occurred in the absence of AIDS, but they are devastating for the households of employees with HIV/AIDS. We argue that the shift in the economic burden of AIDS is a predictable response by business to which a deliberate public policy response is needed. Countries should make explicit decisions about each sector's responsibilities if a socially desirable allocation is to be achieved. PMID:12751421

Child Care Challenge. A Report of the Select Committee on Children, Youth, and Families. House of Representatives, One Hundred Second Congress, Second Session. Committee Print.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

In 1991, the Select Committee on Children, Youth, and Families challenged members of the House of Representatives to seek out innovative, high quality child care programs in their districts. The programs were to serve as models for states and local jurisdictions or for employers and others in the public and private sectors who were trying to…

Development of Private Higher Education in Macau: Exploring the Relationship between Government and Private Sector

ERIC Educational Resources Information Center

Lau, Cheng Man Diana; Yuen, Pong Kau

2010-01-01

The development of private higher education in Macau has experienced rapid growth in the past two decades. The purpose of this paper is to understand this trend by investigating the facts and figures supplied by official sources and to analyze the role between the Government and the private sector. This paper shows that the attitude of the Macau…

Which mothers receive a post partum home visit in Queensland, Australia? A cross-sectional retrospective study.

PubMed

Brodribb, Wendy; Miller, Yvette

2015-06-01

Although home visiting in the early post partum period appears to have increased, there are limited data defining which women receive a visit and none that include Queensland. We aimed to investigate patterns of post partum home visiting in the public and private sectors in Queensland. Data were collected via a retrospective cross-sectional survey of women birthing in Queensland between 1 February and 31 May 2010 at 4 months post partum (n = 6948). Logistic regression was used to assess associations between receiving a home visit and sociodemographic, clinical and hospital variables. Analyses were stratified by public and private birthing sector because of significant differences between sectors. Public sector women were more likely to receive a visit from a nurse or midwife (from the hospital or child health sector) within 10 days of hospital discharge (67.2%) than private sector women (7.2%). Length of hospital stay was associated with home visiting in both sectors. Some vulnerable subpopulations in both sectors were more likely to be visited, whereas others were not. Home visiting in Queensland varies markedly between the public and private sector and is less common in some vulnerable populations. Further consideration to improving the equity of community post partum care in Queensland is needed.

Impact on public hospitals if private health insurance rates in Victoria declined.

PubMed

Hanning, Brian W T

2004-12-13

The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

Medicare payment changes and physicians' incomes.

PubMed

Weeks, William B; Wallace, Amy E

2002-01-01

An effort to control the physician portion of Medicare expenditures and to narrow the income gap between primary care and procedure-based physicians was effected through t he enactment of the Medicare Fee Schedule (MFS). To determine whether academic and private sector physicians' incomes had demonstrated changes consistent with payment changes, we collected income information from surveys of private sector physicians and academic physicians in six specialties: (1) family practice; (2) general internal medicine; (3) psychiatry; (4) general surgery; (5) radiology; and (6) anesthesiology. With the exception of general internal medicine, the anticipated changes in Medicare revenue were not closely associated with income changes in either the academic or private sector group. Academic physicians were underpaid, relative to their private sector counterparts, but modestly less so at the end of the period examined. Our findings suggest that using changes in payment schedules to change incomes in order to influence the attractiveness of different specialties, even with a very large payer, may be ineffective. Should academic incomes remain uncompetitive with private sector incomes, it may be increasingly difficult to persuade physicians to enter academic careers.

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.

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.

Mapping South African allied health primary care clinical guideline activity: establishing a stakeholder reference sample.

PubMed

Dizon, Janine Margarita; Grimmer, Karen; Machingaidze, Shingai; McLaren, Pam; Louw, Quinette

2016-10-10

Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant. South African government websites were searched for structures of departments and portfolios, and available CPGs. Professional AH association websites were searched for CPGs, purposively-identified key informants were interviewed, and CPGs previously identified for priority South African primary care conditions were critiqued for AH therapy involvement. Key informants described potentially complex relationships between players who may be engaged in South African AH CPGs, in both public and private sectors. There were disability/rehabilitation portfolios at national and provincial governments, but no uniformity in provincial government organisation of, or support for, PHC AH services. There were no AH primary care therapy CPGs on government websites, although there was 'clinical guidance' in various forms on professional association websites. Only two CPGs of priority South African PHC conditions included mention of any AH therapy (physiotherapy for adult asthma and chronic obstructive pulmonary disease). A comprehensive and wide-reaching stakeholder reference framework would be required in order to capture the heterogeneity of AH primary care CPG activity in South Africa. This should involve the voices of national and purposively-selected provincial governments, academic institutions, consultants, public sector managers and clinicians, private practitioners, professional associations, and private sector insurers. Provincial governments should be selected to reflect heterogeneity in local economics, population demographics and availability of university AH training programs. This investigation should aim to determine the areas of PHC in which AH are engaged.

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 <0.01) and frequency of surgeon visitation (76.4 vs 65.8%, p = 0.03). Conclusions Arthroplasty consumers treated in the private sector are not more satisfied with their acute-care experience nor are they more likely to recommend their hospital provider. Rather, avoidance of complications in either sector appears to result in improved satisfaction as well as a greater likelihood that patients would recommend their hospital provider. PMID:27490358

The private partners of public health: public-private alliances for public good.

PubMed

McDonnell, Sharon; Bryant, Carol; Harris, Jeff; Campbell, Marci Kramish; Lobb, Ano; Hannon, Peggy A; Cross, Jeffrey L; Gray, Barbara

2009-04-01

We sought to convey lessons learned by the Centers for Disease Control and Prevention's (CDC's) Prevention Research Centers (PRCs) about the value and challenges of private-sector alliances resulting in innovative health promotion strategies. Several PRCs based in a variety of workplace and community settings contributed. We conducted interviews with principal investigators, a literature review, and a review of case studies of private-sector alliances in a microbusiness model, a macrobusiness model, and as multiparty partnerships supporting public health research, implementation, and human resource services. Private-sector alliances provide many advantages, particularly access to specialized skills generally beyond the expertise of public health entities. These skills include manufacturing, distribution, marketing, business planning, and development. Alliances also allow ready access to employee populations. Public health entities can offer private-sector partners funding opportunities through special grants, data gathering and analysis skills, and enhanced project credibility and trust. Challenges to successful partnerships include time and resource availability and negotiating the cultural divide between public health and the private sector. Critical to success are knowledge of organizational culture, values, mission, currency, and methods of operation; an understanding of and ability to articulate the benefits of the alliance for each partner; and the ability and time to respond to unexpected changes and opportunities. Private-public health alliances are challenging, and developing them takes time and resources, but aspects of these alliances can capitalize on partners' strengths, counteract weaknesses, and build collaborations that produce better outcomes than otherwise possible. Private partners may be necessary for program initiation or success. CDC guidelines and support materials may help nurture these alliances.

Firm-Level Perspectives on Public Sector Engagement with Private Healthcare Providers: Survey Evidence from Ghana and Kenya

PubMed Central

Sood, Neeraj; Burger, Nicholas; Yoong, Joanne; Kopf, Dan; Spreng, Connor

2011-01-01

Background Health systems in Sub-Saharan Africa (SSA) are in urgent need of improvement. The private health sector is a major provider of care in the region and it will remain a significant actor in the future. Any efforts by SSA governments to improve health systems performance therefore has to account for the private health sector. Regional and international actors increasingly recognize importance of effectively engaging with the private health sector, and initiatives to improve engagement are underway in several countries. However, there is little systematic analysis of private health providers' view and experience with engagement. Methodology/Principal Findings In this study we surveyed private health facilities in Kenya and Ghana to understand the extent to which and how governments interact and engage with these facilities. The results suggest that government engagement with private health facilities is quite limited. The primary focus of this engagement is “command-and-control” type regulations to improve the quality of care. There is little attention paid to building the capacity of health care businesses through either technical or financial assistance. The vast majority of these facilities also receive no government assistance in meeting public health and social goals. Finally, government engagement with private pharmacies is often neglected and clinics receive a disproportionate share of government assistance. Conclusions/Significance Overall, our findings suggest that there may be considerable untapped potential for greater engagement with private health facilities—particularly pharmacies. Improving engagement will likely help governments with limited resources to better take advantage of the private sector capacity to meet access and equity objectives and to accelerate the achievement of the Millennium Development Goals. PMID:22132092

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.

Access in U.S. Higher Education: What Does the For-Profit Sector Contribute? PROPHE Working Paper Series. WP No. 14

ERIC Educational Resources Information Center

Kinser, Kevin

2009-01-01

The private sector's role in higher education access has received limited attention, though the expansion of the sector globally has immediate implications for the ability of the system to serve more students. In the U.S. case, the private sector includes both nonprofit and for-profit forms, with the for-profit institutions comparable in critical…

Partner management for gonococcal and chlamydial infection: expansion of public health services to the private sector and expedited sex partner treatment through a partnership with commercial pharmacies.

PubMed

Golden, M R; Whittington, W L; Handsfield, H H; Malinski, C; Clark, A; Hughes, J P; Gorbach, P M; Holmes, K K

2001-11-01

Public health partner notification (PN) services currently affect only a small minority of patients with gonorrhea or chlamydial infection and new approaches to PN are needed. To expand PN for gonorrhea and chlamydial infection to private sector patients and to assess the feasibility of treating sex partners through commercial pharmacies. Selected patients were offered PN assistance and were randomly offered medication to deliver to their partners. Providers permitted the health department to contact 3613 (91%) of 3972 potentially eligible patients, and 1693 (67%) of 2531 successfully contacted patients consented to interview. Of these, 1095 (65%) reported at least one untreated partner. Most patients (90%) wished to notify partners themselves. Patients were more likely to have partners who had not yet been treated and to request PN assistance if they had more than one sex partner in the preceding 60 days or a partner they did not anticipate having sex with in the future. These two factors characterized 49% of all patients interviewed, 70% of those with a partner that was untreated 7 or more days after index patient treatment, and 83% of those accepting PN assistance. Among 458 randomly selected patients with untreated partners at time of study interview, 346 (76%) agreed to deliver treatment to a partner. Of these, most (266) chose to obtain medication for a partner at a pharmacy, of whom 223 (84%) successfully did so. A substantial minority of private sector patients have untreated partners more than 7 days after their own treatment; some need help with PN, but most will agree to deliver medication to partners themselves.

Cataract surgical rate in Fars Province: Distribution and trend from 2006 to 2010.

PubMed

Hashemi, Hassan; Rezvan, Farhad; Khabazkhoob, Mehdi; Gilasi, Hamidreza; Etemad, Koroush; Mahdavi, Alireza; Asgari, Soheila

2016-03-01

To determine changes in cataract surgical rate (CSR) in Fars Province from 2006 to 2010 and identify the contributions of public and private sectors. This descriptive report is part of the Iranian Cataract Surgery Survey. To determine the provincial CSR, weights of major (>3000 annual surgeries) and minor (≤3000) centers were calculated based on the number of centers chosen for each year and multiplied by their numbers of surgeries. To determine public and private sectors' contributions, the numbers of surgeries in each sector were estimated based on the number of sampled centers. Overall, CSR improved by 25%; the number of CS decreased by 16% in the public sector and increased by 157% in the private sector. In 2006, the public sector contributed to 69% of the CSR, and by 2010, this rate had decreased to 43%. The decreasing contribution of the public sector calls for studies to identify causes and remove potential barriers.

Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan.

PubMed

Chughtai, A A; Qadeer, E; Khan, W; Hadi, H; Memon, I A

2013-03-01

To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37,656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects.

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.

Women Using Physics: Alternate Career Paths, The Private Sector

NASA Astrophysics Data System (ADS)

Tams, Jessica

2006-12-01

For those who have spent their careers inside the safe walls of academia, the word is a little scary. Can I compete? Will I fit in? What do I need to know? Am I prepared? Will I succeed? While many would say: Yes! You are ready to excel! This isn’t actually the case. The private sector comes with many unanticipated shocks to many of us, especially women. This isn’t a group project. This session will discuss entering a quickly growing and competitive technical field and what one can do to prepare for continued success. Preparing and Entering the Private Sector * Women with technical skills are a desired part of the private workforcein general women posses stronger people skills, are more reliable and often more well rounded than their male counterparts. Key factors we will discuss to landing that first job: · Expand your knowledge base with current applications of technology · Preparing a solid employment pitch to highlight strengths: Overcoming stereotypes · Don’t show them your bad side: Why some student projects may hurt you · The private sector attitude toward performance and entry level expectations Excelling in the Private Sector * Now that we have landed a job * for better or worse we are now all about making money and exerting control. What to keep in mind while working in the private sector: · The formative first years: focus on your weaknesses and practice, practice, practice · Men & Women in the workplace: what women subconsciously do to hurt their careers · Politics: Working in a team environment · Polish & Detail & Reliabilit

Lost opportunity cost of surgical training in the Australian private sector.

PubMed

Aitken, R James

2012-03-01

To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

The Role of Organizational Culture in the Leadership of United States Air Force Services Squadrons

DTIC Science & Technology

1988-01-01

correlation to the private sector , while others, e.g., mortuary affairs and honor guard, are strictly military in nature. In any case, all functions and...similar to its private sector commercial hotel or motel counterpart. Air Force personnel traveling as * part of their duty requirement are required to stay...oriented management style prevalent in both the private and public sector ; this is not the case. The question becomes whether one -17 wants to push the

Public-Private Cooperation in the Department of Defense: A Framework for Analysis and Recommendations for Action (Defense Horizons, October 2012)

DTIC Science & Technology

2012-10-01

requirements de - fined by the public sector. CRADAs leverage private sector resources and knowledge to meet the needs of government agencies at no financial...situations helps resolve barriers to cooperation. The evolution of CRA- DAs offers insight into how DOD can interact with multiple partners in a mutually...actions among multiple private power companies, the public sector (at Federal, state, local, and tribal levels), and third parties (hos- pitals

Technology Transfer: Use of Federally Funded Research and Development

DTIC Science & Technology

2007-03-19

private sector ; the government’s requirements for products and processes to operate effectively and efficiently; and the demand for increased goods and services at the state and local level. Congress has established a system to facilitate the transfer of technology to the private sector and to state and local governments. Despite this, use of federal R&D results has remained restrained, although there has been a significant increase in private sector interest and activities over the past several years. Critics argue that

Defense Inventory Management: Expanding Use of Best Practices for Hardware Items Can Reduce Logistics Costs.

DTIC Science & Technology

1998-01-01

This report is the 11th in a series of reports comparing the Department of Defense’s (DOD) logistics practices with those of the private sector . We...leading private sector practices. This report focuses on DOD’S progress in adopting best inventory management practices for hardware items such as bearings...valves, and bolts. The objectives of this review were to determine (1) DOD and private sector practices for managing hardware items, (2) whether DOD

Defense Expenditures in Pakistan: A Source of Stimulus for or Competition With the Private Sector

DTIC Science & Technology

1994-01-01

private sector activity, particularly investment, is the only viable option open to the authorities. It follows that for policy purposes the most important issue involves restructuring government expenditures and their financing in a manner that would provide the maximum inducement to private sector capital formation, especially in manufacturing. Operationally, this means finding an optimal balance between the government’s three most important budgetary items: defense, public consumption and infrastructural development. More importantly because

Social Security: A Present Value Analysis of Old Age Survivors Insurance (OASI) Taxes and Benefits.

DTIC Science & Technology

1995-12-01

private sector plans and provides a spreadsheet model for making this comparison of plans using different assumptions. The investigation was done by collecting data from various books, Government publications, and various Government agencies to conduct a spreadsheet analysis of three different wage-earning groups, assuming various real interest rates potentially earned in the private sector . A comparison of Social Security with alternative private sector plans is important to the DoD/DoN because less constrained budgets could

Is Private Health Care the Answer to the Health Problems of the World's Poor?

PubMed Central

Hanson, Kara; Gilson, Lucy; Goodman, Catherine; Mills, Anne; Smith, Richard; Feachem, Richard; Feachem, Neelam Sekhri; Koehlmoos, Tracey Perez; Kinlaw, Heather

2008-01-01

Background to the debate: The global burden of disease falls disproportionately upon the world's low-income countries, which are often struggling with weak health systems. Both the public and private sector deliver health care in these countries, but the appropriate role for each of these sectors in health system strengthening remains controversial. This debate examines whether the private sector should step up its involvement in the health systems of low-income countries. PMID:19067483

Unhealthy health care costs.

PubMed

Shelton, J K; Janosi, J M

1992-02-01

The private sector has implemented many cost containment measures in efforts to control rising health care costs. However, these measures have not controlled costs in the long run, and can be expected not to succeed as long as business cannot control factors within the health care system which affect costs. Controlling private sector health care costs requires constraints on cost shifting which necessitates a unified financing system with expenditure limits. A unified financing system will involve a partnership between the public and private sectors.

Long shadow of fear in an epidemic: fearonomic effects of Ebola on the private sector in Nigeria.

PubMed

Bali, Sulzhan; Stewart, Kearsley A; Pate, Muhammad Ali

2016-01-01

The already significant impact of the Ebola epidemic on Guinea, Liberia and Sierra Leone, was worsened by a fear of contagion that aggravated the health crisis. However, in contrast to other Ebola-affected countries, Nigeria fared significantly better due to its swift containment of the disease. The objective of our study was to describe the impact of Ebola on the Nigerian private sector. This paper introduces and defines the term fearonomic effect as the direct and indirect economic effects of both misinformation as well as fear-induced aversion behaviour, exhibited by individuals, organisations or countries during an outbreak or an epidemic. This study was designed as a cross-sectional mixed-methods study that used semistructured in-depth interviews and a supporting survey to capture the impact of Ebola on the Nigerian private sector after the outbreak. Themes were generated from the interviews on the direct and indirect impact of Ebola on the private sector; the impact of misinformation and fear-based aversion behaviour in the private sector. Our findings reveal that the fearonomic effects of Ebola included health service outages and reduced healthcare usage as a result of misinformation and aversion behaviour by both patients and providers. Although certain sectors (eg, health sector, aviation sector, hospitality sector) in Nigeria were affected more than others, no business was immune to Ebola's fearonomic effects. We describe how sectors expected to prosper during the outbreak (eg, pharmaceuticals), actually suffered due to the changes in consumption patterns and demand shocks. In a high-stressor epidemic-like setting, altered consumption behaviour due to distorted disease perception, misinformation and fear can trigger short-term economic cascades that can disproportionately affect businesses and lead to financial insecurity of the poorest and the most vulnerable in a society.

Crowd-sourcing delivery system innovation: A public-private solution.

PubMed

Agrawal, Shantanu; Chen, Christopher; Tanio, Craig P

2015-03-01

We propose the establishment of a public-private approach which creates and maintains a "delivery systems innovations knowledge management system" to define, describe, and assess novel delivery approaches. The public sector could provide the foundational technology, resources and convening power for this innovations database. The private sector would contribute practical innovations that could guide annual strategic planning and implementation. A crowd-sourced effort would jump start delivery system reform. We believe that providing a comprehensive knowledge resource will not stifle competition or private sector opportunities but rather augment and speed the application of effective innovation. Copyright © 2014 Elsevier Inc. All rights reserved.

78 FR 59711 - Renewal of Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-27

... Application and Permit, 43 CFR Part 2920, Form 2920-1, 286 1 286 Private Sector/Typical Land Use Application and Permit, 43 CFR Part 2920, Form 2920-1, 10 120 1,200 Private Sector/Complex Totals 407 1,597 Jean... information from individuals, private entities, and State or local governments seeking leases, permits, and...

Intra-Sectoral Diversity: A Political Economy of Thai Private Higher Education

ERIC Educational Resources Information Center

Praphamontripong, Prachayani

2010-01-01

Private higher education (PHE) worldwide has been a rapid development in the last several decades. The private sector will continue to grow, diversify and undoubtedly play a significant role in the political economy of higher education. Nevertheless, systematically empirical studies on the trio relationships among PHE, institutional diversity and…

Diversity of Provision in Higher Education: The Role of the Private Provider

ERIC Educational Resources Information Center

Fielden, John

2013-01-01

This paper assesses the growing UK private sector in education and questions whether it is, as its supporters suggest, a valuable addition to an already diverse national system. An earlier "Perspectives" paper (Woodfield et al 2011) explored the emerging partnerships between public and private sectors. This follow-up explores the roles…

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…

76 FR 59003 - Energy Conservation Program: Compliance Certification for Electric Motors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-23

... effects of Federal regulatory actions on State, local, and Tribal governments and the private sector. For... Tribal governments, in the aggregate, or by the private sector, of $100 million or more (adjusted... provides a new means for manufacturers of electric motors and their private labelers to prepare and submit...

The response of public and private credit markets to typhoons in China

NASA Astrophysics Data System (ADS)

Bao, X.; Hsiang, S. M.

2011-12-01

When natural disasters strike, both public and private credit markets may finance the reconstruction of lost capital. We examine the response of public and private credit markets to cyclone events in China, using provincial fiscal data from 1978 to 2008, and find striking differences in the sectors targeted by public and private creditors. Following a cyclone event, public loans to the agricultural sector expand 2% for every additional 10 m/s in local wind exposure, while private loans to industrial and commercial sectors grow 7% for the same event. In addition, we find that these expansions to local credit markets persist at these levels for at least one year following exposure to a storm. We then demonstrate that these results are consistent with a model in which private creditors maximize profits and the government maximizes equity. In this stylized model, we show that when governments value short-term equity and finance risky sectors with plausibly negative net present value, this may have the perverse effect of encouraging populations and capital to remain in disaster-prone regions and lower equity in the long-run.

A South African public-private partnership HIV treatment model: viability and success factors.

PubMed

Igumbor, Jude; Pascoe, Sophie; Rajap, Shuabe; Townsend, Wendy; Sargent, John; Darkoh, Ernest

2014-01-01

The increasing number of people requiring HIV treatment in South Africa calls for efficient use of its human resources for health in order to ensure optimum treatment coverage and outcomes. This paper describes an innovative public-private partnership model which uses private sector doctors to treat public sector patients and ascertains the model's ability to maintain treatment outcomes over time. The study used a retrospective design based on the electronic records of patients who were down-referred from government hospitals to selected private general medical practitioners (GPs) between November 2005 and October 2012. In total, 2535 unique patient records from 40 GPs were reviewed. The survival functions for mortality and attrition were calculated. Cumulative incidence of mortality for different time cohorts (defined by year of treatment initiation) was also established. The median number of patients per GP was 143 (IQR: 66-246). At the time of down-referral to private GPs, 13.8% of the patients had CD4 count <200 cell/mm(3), this proportion reduced to 6.6% at 12 months and 4.1% at 48 months. Similarly, 88.4% of the patients had suppressed viral load (defined as HIV-1 RNA <400 copies/ml) at 48 months. The patients' probability of survival at 12 and 48 months was 99.0% (95% CI: 98.4%-99.3%) and 89.0% (95% CI: 87.1%-90.0%) respectively. Patient retention at 48 months remained high at 94.3% (95% CI: 93.0%-95.7%). The study findings demonstrate the ability of the GPs to effectively maintain patient treatment outcomes and potentially contribute to HIV treatment scale-up with the relevant support mechanism. The model demonstrates how an assisted private sector based programme can be effectively and efficiently used to either target specific health concerns, key populations or serve as a stop-gap measure to meet urgent health needs.

Private sector health reform in South Africa.

PubMed

Van Den Heever, A M

1998-06-01

This paper discusses some of the trends, debates and policy proposals in relation to the financing of the private health sector in South Africa. The public and private sectors in South Africa are of equivalent size in terms of overall expenditure, but cover substantially different population sizes. Within this context the government has reached the unavoidable conclusion that the private sector has to play some role in ensuring that equity, access and efficiency objectives are achieved for the health system as a whole. However, the private sector is some way off from taking on this responsibility. Substantial increases in per capita costs over the past 15 years, coupled with a degree of deregulation by the former government, have resulted in increasing instability and volatility. The development of a very competitive medical scheme (health insurance) market reinforced by intermediaries with commercial interests has accelerated trends toward excluding high health risks from cover. The approach taken by the government has been to define a new environment which leaves the market open for extensive competition, but removes from schemes the ability to compete by discriminating against high health risks. The only alternatives left to the private market, policy makers hope, will be to go out of business, or to survive through productivity improvements.

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.

Iran plans huge private sector MTBE plant

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

Alperowicz, N.

1992-01-15

An export-oriented 1-million m.t./year methyl tert-butyl ether (MTBE) plant is planned as one of Iran`s private sector investment projects. State-owned National Petrochemical Co (NPC; Tehran) and the Dubai-based Iranian businessman Abdul Wahab Galadari have signed a letter of intent allowing Galadari to develop the venture. Colt Engineering (Calgary, AL) is assisting Galadari with costs, planning and technology selection for the estimated $300-million plus venture. An important meeting with NPC is scheduled end of this month, says Galadari, and a financial package should be put together by end of March or April. The facility will most likely be wholly-owned by themore » Galadari family, roughly 50% by members resident in Iran and the remainder by the Dubai-based concern A.W. Galadari Sons. NPC says it may take a token shareholding in the venture.« less

Student Experiential Opportunities in National Security Careers

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

None, None

2007-12-31

This report documents student experiential opportunities in national security careers as part of the National Security Preparedness Project (NSPP), being performed under a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant. This report includes a brief description of how experiential opportunities assist students in the selection of a career and a list of opportunities in the private sector and government. The purpose of the NSPP is to promote national security technologies through business incubation, technology demonstration and validation, and workforce development. Workforce development activities will facilitate the hiring of students to work with professionals in both the private andmore » public sectors, as well as assist in preparing a workforce for careers in national security. The goal of workforce development under the NSPP grant is to assess workforce needs in national security and implement strategies to develop the appropriate workforce.« less

Why do some physicians in Portuguese-speaking African countries work exclusively for the private sector? Findings from a mixed-methods study.

PubMed

Russo, Giuliano; de Sousa, Bruno; Sidat, Mohsin; Ferrinho, Paulo; Dussault, Gilles

2014-09-11

Despite the growing interest in the private health sector in low- and middle-income countries, little is known about physicians working outside the public sector. The present work adopts a mixed-methods approach to explore characteristics, working patterns, choices, and motivations of the physicians working exclusively for the private sector in the capital cities of Cape Verde, Guinea Bissau, and Mozambique. The paper's objective is to contribute to the understanding of such physicians, ultimately informing the policies regulating the medical profession in low- and middle-income countries. The qualitative part of the study involved 48 interviews with physicians and health policy-makers and aimed at understanding the practice in the three locations. The quantitative study included a survey of 329 physicians, and multivariate analysis was conducted to analyse characteristics, time allocation, earnings, and motivations of those physicians working only for the private sector, in comparison to their public sector-only and dual practice peers. Our findings showed that only a limited proportion of physicians in the three locations work exclusively for the private sector (11.2%), with members of this group being older than those practicing only in the public or in both sectors. They were found to work fewer hours per week (49 hours) than their public (56 hours) and dual practice peers (62 hours) (P <0.001 and P = 0.011, respectively). Their median earnings were USD 4,405 per month, with substantial variations across the three locations. Statistically significant differences were found with the earnings of public-only physicians (P <0.001), but not with those of the dual practice group (P = 0.340). The qualitative data from the interviews showed private-only physicians' preference for an independent and more flexible work modality, and this was quoted as a determining factor for their choice of sector. This group appears to include those working in the more informal sector, and those who decided to leave the civil service following a disagreement with the public employer. The study shows the importance of understanding the relation between health professionals' characteristics, motivations, and their engagement with the private sector to develop effective policies to regulate the profession. This may ultimately contribute to achieving universal access to medical services in low- and middle-income countries.

Brazilian healthcare in the context of austerity: private sector dominant, government sector failing.

PubMed

Costa, Nilson do Rosário

2017-04-01

This paper presents the arguments in favor of government intervention in financing and regulation of health in Brazil. It describes the organizational arrangement of the Brazilian health system, for the purpose of reflection on the austerity agenda proposed for the country. Based on the literature in health economics, it discusses the hypothesis that the health sector in Brazil functions under the dominance of the private sector. The categories employed for analysis are those of the national health spending figures. An international comparison of indicators of health expenses shows that Brazilian public spending is a low proportion of total spending on Brazilian health. Expenditure on individuals' health by out-of-pocket payments is high, and this works against equitability. The private health services sector plays a crucial role in provision, and financing. Contrary to the belief put forward by the austerity agenda, public expenditure cannot be constrained because the government has failed in adequate provision of services to the poor. This paper argues that, since the Constitution did not veto activity by the private sector segment of the market, those interests that have the greatest capacity to vocalize have been successful in imposing their preferences in the configuration of the sector.

45 CFR 1336.61 - Purpose of the Revolving Loan Fund.

Code of Federal Regulations, 2010 CFR

2010-10-01

... specific gaps in local capital markets and to encourage greater private-sector participation in local economic development activities; and (c) Increase capital formation and private-sector jobs for Native...

Depot Maintenance: Issues and Options for Reporting on Military Depots

DTIC Science & Technology

2008-05-15

for assessing the balance of public and private sector depot maintenance workload? (3) What issues might Congress wish to consider to enhance reporting...on military depots capabilities or funding allocations of the public sector versus private sector ? This briefing is intended to satisfy the mandate that GAO review 50/50 reporting requirements.

Collective Bargaining: An Educational Technology.

ERIC Educational Resources Information Center

O'Brien, Gavin W.

Collective bargaining is a technology and not a philosophy or set of moral values. There seems to be an almost irresistible urge among authors of educational bargaining statutes to adopt the basic tenets of private-sector labor law. However, employment and collective bargaining are different in the public sector than in the private sector, and one…

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

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.

Hospital sector choice and support for public hospital care in New Zealand: Results from a labeled discrete choice survey.

PubMed

Brown, Paul; Panattoni, Laura; Cameron, Linda; Knox, Stephanie; Ashton, Toni; Tenbensel, Tim; Windsor, John

2015-09-01

This study uses a discrete choice experiment (DCE) to measure patients' preferences for public and private hospital care in New Zealand. A labeled DCE was administered to 583 members of the general public, with the choice between a public and private hospital for a non-urgent surgery. The results suggest that cost of surgery, waiting times for surgery, option to select a surgeon, convenience, and conditions of the hospital ward are important considerations for patients. The most important determinant of hospital choice was whether it was a public or private hospital, with respondents far more likely to choose a public hospital than a private hospital. The results have implications for government policy toward using private hospitals to clear waiting lists in public hospitals, with these results suggesting the public might not be indifferent to policies that treat private hospitals as substitutes for public hospitals. Copyright © 2015 Elsevier B.V. All rights reserved.

Indian Hills Community College Vocational Outreach Program: Business/Industry and Indian Hills...Partners in Progress.

ERIC Educational Resources Information Center

Poort, Stephen M.; Williamson, Tom

Structured interviews were conducted by selected vocational education instructors at Indian Hills Community College (IHCC) to determine current and projected employment and training needs of private-sector businesses with 200 employees or less and to assess opinions of IHCC programs. Employers were asked to provide information on the number of…

78 FR 67121 - Request for Nominations for Members To Serve on National Institute of Standards and Technology...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-08

... to individuals who are nominated. Nominations that are received and meet the requirements will be.... Selection of MEP Advisory Board members will not be limited to individuals who are nominated. Nominations... official role as the private sector policy adviser of NIST is concerned. Each such report shall identify...

Passive Smoking in the Workplace: Selected Issues.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Office of Technology Assessment.

This report provides information about the health effects of passive smoking, the types of policies that are in force in the public and private sectors to control workplace smoking, and the costs and effects of those policies. The executive summary briefly highlights the three major areas of the report: (1) a review of the studies of health…

Working conditions of bus drivers in the private sector and bus crashes in Kandy district, Sri Lanka: a case-control study.

PubMed

Jayatilleke, A U; Nakahara, S; Dharmaratne, S D; Jayatilleke, A C; Poudel, K C; Jimba, M

2009-04-01

To explore the effects of working conditions of private-bus drivers on bus crashes in Kandy district, Sri Lanka. A case-control study was carried out from August to September 2006. All private-bus drivers registered in Kandy district and involved in crashes reported to the police between November 2005 and April 2006 (n = 63) were selected as cases. Two control groups were included: private-bus drivers working on the same routes as the case drivers (n = 90) and private-bus drivers selected randomly from other routes of the district (n = 111). Data were collected using an anonymous self-administered questionnaire. Associations between working conditions and crashes were analysed using logistic regression. A strong association was observed between drivers' disagreements about working hours and bus crashes (matched controls, adjusted odds ratio (AOR) 5.98, 95% CI 1.02 to 34.90; unmatched controls, AOR 18.74, 95% CI 2.00 to 175.84). A significant association was also observed between low salaries (

15 CFR 285.4 - Establishment of laboratory accreditation programs (LAPs) within NVLAP.

Code of Federal Regulations, 2010 CFR

2010-01-01

... legislative actions or to requests from private sector entities and government agencies. For legislatively mandated LAPs, NVLAP shall establish the LAP. For requests from private sector entities and government...

7 CFR 1955.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... loans sold without insurance in the private sector. These CF loans will be serviced in the private sector, and future revisions to this subpart no longer apply to such loans. This subpart does not apply...

48 CFR 52.207-1 - Notice of Standard Competition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... contract or by Government performance. (b) The Government will evaluate private sector offers, the agency... the Circular. If the performance decision favors a private sector offeror, a contract will be awarded...

Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria.

PubMed

Peterson, Lauren; Comfort, Alison; Hatt, Laurel; van Bastelaer, Thierry

2018-04-15

As a growing number of low- and middle-income countries commit to achieving universal health coverage, one key challenge is how to extend coverage to informal sector workers. Micro health insurance (MHI) provides a potential model to finance health services for this population. This study presents lessons from a pilot study of a mandatory MHI plan offered by a private insurance company and distributed through a microfinance bank to urban, informal sector workers in Lagos, Nigeria. Study methods included a survey of microfinance clients, key informant interviews, and a review of administrative records. Demographic, health care seeking, and willingness-to-pay data suggested that microfinance clients, particularly women, could benefit from a comprehensive MHI plan that improved access to health care and reduced out-of-pocket spending on health services. However, administrative data revealed declining enrollment, and key informant interviews further suggested low use of the health insurance plan. Key implementation challenges, including changes to mandatory enrollment requirements, insufficient client education and marketing, misaligned incentives, and weak back-office systems, undermined enrollment and use of the plan. Mandatory MHI plans, intended to mitigate adverse selection and facilitate private insurers' entry into new markets, present challenges for covering informal sector workers, including when distributed through agents such as a microfinance bank. Properly aligning the incentives of the insurer and the agent are critical to effectively distribute and service insurance. Further, an urban environment presents unique challenges for distributing MHI, addressing client perceptions of health insurance, and meeting their health care needs. Copyright © 2018 John Wiley & Sons, Ltd.

Job satisfaction of registered dental practitioners.

PubMed

Luzzi, L; Spencer, A J; Jones, K; Teusner, D

2005-09-01

This study was designed to measure job satisfaction among registered clinical dentists so as to identify issues which may influence recruitment and retention of dentists in active clinical practice. A questionnaire measuring dimensions of job satisfaction was mailed to a stratified random sample of 80 private and 80 public sector dentists selected from the 1999 Victorian Dental Register. An adjusted response rate of 60 per cent was achieved (n = 87). Analyses showed significant differences (ANOVA; p < 0.05) in levels of satisfaction for various dimensions of job satisfaction by gender, age group and practice type. Differences in job satisfaction between male and female dentists related to the personal time dimension. Differences in satisfaction between dentists of different age groups were attributable to six dimensions: relationships with colleagues, relationships with patients, relationships with staff, personal time, community and administrative responsibilities. Differences between levels of satisfaction among private and public dentists related to the autonomy, relationships with patients, pay and resources dimensions. There are various dimensions of job satisfaction that may be pertinent to issues influencing recruitment and retention of dentists. Differences that exist between levels of job satisfaction among private and public sector dentists, between male and female dentists and dentists of different age groups need to be addressed in order to improve recruitment and retention rates of dentists in active clinical practice in different sectors of the dental care system.

Physiotherapy practice in the private sector: organizational characteristics and models.

PubMed

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

2014-08-29

Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of this study was to: 1) describe characteristics of organizations where physiotherapists practice in the private sector, and 2) explore the existence of a taxonomy of organizational models. This was a cross-sectional quantitative survey of 236 randomly-selected physiotherapists. Participants completed a purpose-designed questionnaire online or by telephone, covering organizational vision, resources, structures and practices. Organizational characteristics were analyzed descriptively, while organizational models were identified by multiple correspondence analyses. Most organizations were for-profit (93.2%), located in urban areas (91.5%), and within buildings containing multiple businesses/organizations (76.7%). The majority included multiple providers (89.8%) from diverse professions, mainly physiotherapy assistants (68.7%), massage therapists (67.3%) and osteopaths (50.2%). Four organizational models were identified: 1) solo practice, 2) middle-scale multiprovider, 3) large-scale multiprovider and 4) mixed. The results of this study provide a detailed description of the organizations where physiotherapists practice, and highlight the importance of human resources in differentiating organizational models. Further research examining the influences of these organizational characteristics and models on outcomes such as physiotherapists' professional practices and patient outcomes are needed.

Implementing Accountable Care Organizations: Lessons From a Qualitative Analysis of Four Private Sector Organizations.

PubMed

Walker, Daniel M; Hefner, Jennifer L; Sova, Lindsey N; Hilligoss, Brian; Song, Paula H; McAlearney, Ann Scheck

Accountable care organizations (ACOs) are emerging across the healthcare marketplace and now include Medicare, Medicaid, and private sector payers covering more than 24 million lives. However, little is known about the process of organizational change required to achieve cost savings and quality improvements from the ACO model. This study applies the complex innovation implementation framework to understand the challenges and facilitators associated with the ACO implementation process. We conducted four case studies of private sector ACOs, selected to achieve variation in terms of geography and organizational maturity. Across sites, we used semistructured interviews with 68 key informants to elicit information regarding ACO implementation. Our analysis found challenges and facilitators across all domains in the conceptual framework. Notably, our findings deviated from the framework in two ways. First, findings from the financial resource availability domain revealed both financial and nonfinancial (i.e., labor) resources that contributed to implementation effectiveness. Second, a new domain, patient engagement, emerged as an important factor in implementation effectiveness. We present these deviations in an adapted framework. As the ACO model proliferates, these findings can support implementation efforts, and they highlight the importance of focusing on patients throughout the process. Importantly, this study extends the complex innovation implementation framework to incorporate consumers into the implementation framework, making it more patient centered and aiding future efforts.

Comparison of Adherence to Chlamydia Screening Guidelines Among Title X Providers and Non-Title X Providers in the California Family Planning, Access, Care, and Treatment Program

PubMed Central

Thiel de Bocanegra, Heike; Hulett, Denis; Park, Hye-Youn; Darney, Philip

2012-01-01

Abstract Background Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ≥26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Methods Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group—Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Results Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ≤25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Conclusions Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low screening rates for older females. PMID:22694761

Exploring a public-private partnership new-graduate physiotherapy recruitment program: a qualitative study.

PubMed

Schmidt, David; Dmytryk, Neil

2014-12-01

Difficulty in attracting allied health staff to rural areas is well known. In 2012, a small rural health facility and local private practice created an informal public-private partnership to recruit two new-graduate physiotherapists. Graduates were employed part-time in both the public and private sectors. This qualitative case study employed an appreciative enquiry framework to explore this partnership model. Three focus groups were held, and a combination of content and thematic analysis was used to derive and organise themes arising from the data. A regional public health service and private physiotherapy practice in the Bega Valley region of south-eastern New South Wales, Australia. New-graduate and second-year physiotherapists (n = 5), private sector managers (n = 3), and public sector managers (n = 4). Perceived benefits of the partnership model and improvements that could be made to further develop the model. Organisational benefits of a shared public-private role included the ability to attract high-quality applicants to difficult-to-fill positions, reduced the risk of new-graduate attrition due to social isolation, enhanced networking between sectors, and enhanced staff skill development through a broad range of clinical and non-clinical experiences. The model relied on management flexibility and has potential to expand to other areas and professions. Dedicated funding support, targeted recruitment strategies and increased planning to ease the transition into the workplace would further enhance the model. An informal public-private partnership to overcome established workforce shortages has proven successful to the benefit of the new graduates and both the public and private sectors. © 2014 National Rural Health Alliance Inc.

Investigating the Effect of Syrian Refugees on the Pharmaceutical Sector in Jordan.

PubMed

Daher, Amirah; Alabbadi, Ibrahim

2017-08-01

The aim of this study was to investigate the effect of Syrian refugees on the pharmaceutical sector in Jordan. Based on a standardized methodology developed by the WHO, Level II Facility (2009) structured questionnaires (including: medicine access [availability, affordability and geographical accessibility], quality, and rational use of medicines) were used to investigate the effect of Syrian refugees influx on the pharmaceutical sector in Jordan. Lists of essential medicines (N = 50) were included in the survey forms. The results showed more progress in all indicators for the public sector compared with the previous results in the 2009 survey and in comparison to the private sector. For example, access to medicines improved in the public sector while it decreased (if it did not remain the same) in the private sector. Also, average stock out duration time decreased dramatically in both public and private sectors. As indicated by the median price ratio (MPR), brand prices increased much in the public health facilities while they decreased by 23%-30% in the private sector. In northern areas where most Syrian refugees stay, a significant decrease in availability was noticed, in addition to the dramatic decrease in days of average stock out and adequate inventory record percentage of those medicines. In conclusion, despite the international help received to support health care provision and medications procurement for the refugees, more support is needed immediately.